1805
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| growth is | physical change and increase in size. rapid during prenatal, neonatl, and infancy. slows during adolescent and minimal during adulthood.
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| development is | increase in complexity of function. skill progession. capacity skill to adapt to environment.behavior aspect. ability to walk, run and talk
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| growth is measured quantitatively by | *height *weight *bone size *dentition
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| growth takes place during | the first 20 years
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| development takes place during | the first 20 years and Beyond
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| Growth and development are influenced by | genetic, temperament, family, nutrition, enviroment, health, & culture
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| integrity vs. despair (65 years to death)Positive behaviors demonstrating mastery | feelings of self-acceptance. sense of dignity, worth, and importance. adaptation to life according to limitations. valuing one's life. sharing wisdom. exploration of philosophy of life and death.
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| integrity vs. despair (65 to death)Negative behaviors demonstrating developmental problems | sense of helplessness, hopelessness, worthlessness, uselessness, and meaninglessness. withdrawal or loneliness. regression. focusing on past mistakes and dissatisfactions. feeling to old to start over. suicidal ideas or apathy.
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| integrity vs. despair (65 to death)Negative behaviors demonstrating developmental problems | inability to occupy self with satisfying activities (hobbies, volunteer work, social events) OR!!! Inability to reduce activities. Overtaxing strength and abilities. Feeling indispensable. denial of death as inevitable
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| when assessing get info from | the Patient! only get it from the family when unable to obtain it from the patient.
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| normal physiological changes in integumentary system include: | skin loses elasticity, becomes drier, age spots develop. Gravity and loss of subcutaneous fat causes wrinkles and sagging. thinning hair in men and women. decreases tolerance to cold. slowed nail growth and increased thickening of nail
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| normal physiological changes in neuromuscular | decreased muscle speed and power. slowed reaction time. loss of height. loss of bone mass. joint stiffness. impaired balance. difficulty in complex learning and abstraction.
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| normal physiological changes in the Neurological system | impaired balance and coordination. degenteration of nerve cells. decrease in neurotransmiters. decrease in rate of nerve conduction. These things cause slowed reation times, medication absorption difficulties, sleep disturbances and sensory changes
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| normal physiological changes in the respiratory system include | respiratory muscle strength decreases. chest wall becomes stiffer. lung expansion decreases. less efficient cough. increased risk of respiratory infections
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| Normal physiological changes in the cardiac system include | decreased cardiac output. decreased vessel elasticity. peripheral pulses weaker. bp commonly elevated but HTN is NOT normal. decreased efficiency of valves. decreased heart muscle fibers.
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| normal physiological changes in the gastrointestinal system | slowing of peristalsis. decreased saliva. decreased to gastric secretions. intoerance to certain foods.
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| normal physiological changes in the musculoskeletal system include | gradual reduction in strength and speed. decalcifications of bones (osteoporosis NOT normal) degenterative joint changes (arthritis not normal) decrease in height due to dehydration of intervertebral disks
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| normal physiological changes in the sensory system * eyes | eyes (presbyopia) less adaption to light/dark chragess, altered color perception, increased sensitivity to glare, lens opacity
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| normal physiological changes in the sensory system * ears | presbycusis, loss of acuity for HIGH frequency sounds. thickening of the tympanic membrane, sclerosis of the inner ear. (hearing loss to LOW pitched sounds is NOT normal)
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| normal physiological changes in the sensory system *taste | gradual decrease, especially sweet.
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| normal physiological changes in the sensory system *smell | often decreases with less interest to food
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| normal physiological changes in the sensory system * touch | decrease in skin receptors LEADS to decreased sensation in pain, touch, and temperature.
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| normal physiological changes in the urinary system in men | men hypertrophy of the prostate gland, LEADS to urinary retention, frequency, incontinence and UTI. Must be distinguised from cancer of prostate.
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| normal physiological changes in the urinary system in women | reduced sphincter tone CAUSING incontinence--stress incontinence COMMON post child birth. SUSCEPTIBLE to UTI due to retension.
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| normal physiological changes in the reproductive system for women | decreased estrogen production. Atrophy of vagina, uterus, and breast. Menopause- degeneration of ovaries LEADING to decreased hormones. changes may or may not LEAD TO decreased libido
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| normal physiological changes in the reproductive system for men | sperm count decreases. atrophy of testes. less firm erection. spermatogenesis continues into the ninth decade
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| normal physiological changes in the breast | women- atrophy, sagging, smallermen-enlarged breast may occur due to meds, decreased testosterone. BOTH are at risk for breast cancer
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| Normal cognitive changes aging | (slowing down) decreased cells in brain, decreased neurotransmitters (these are normal changes in the brain that are present whether cognitive impairment is present or not) (Cognitive impairment is NOT normal)
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| dementia | impairment of itellectual function. interferes with ability to function independently- ADL's, shopping, cooking, social activities. gradual onset, progressive, irreversible. MUst be differentiated from delirium.
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| delirium definition and ques (dilirium is a symptom) | acute confused STATE. usually reversible, often due to physiological causes. onset sudden with rapid fluctuations in orientation, confusion. Cause must be identified and treated. hallucinations may occur.
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| delirium causes | potential causes: electrolyte imbalance, cerebral anoxia. causes hypoglycemia, medications, tumors, subdural hematomas, cerebrovascular infarction, hemorrhage, pneumonia, UTI, other infection's and sensory depprivation eg. hospitalization.
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| Assessing health concerns. Three most common causes of death | heart disease, cancer, and stroke
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| assessing health concerns: invterventions focus on preventions include: | regular exercise, weight reduction if over weight, management of HTN. Smoking cessation. Prevention of falls. immunizatons for flu and pneumonia. Alcohol abuse. nutrition, arthritis, falls, sensory impairments, pain, mdication use, health test and screeni
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| when assessing for alcohol abuse look for: | recent falls, changes in activity, changes in behavior, poor nutrition, and medication noncompliance
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| health concerns for nutrition | affected by level of activity, medical condition, limit intake of fat, salt, sugar, ETOH, affected by dental conditon. Should maintain an exercise program
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| health concerns for arthritis | common in elderly, pain control, ability to move joints, carry out activities
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| health concerns for falls | major safty issues. loss of independence, injuries, hospitalization. focus on managing health conditions, eliminating hazards in the enviroment.
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| health concerns for pain | fear dependence on analgesics (educate them). assessing pain difficult with cognitive impairments. 25%-80% of the elder experience some type of pain
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| health concerns for medication use | polypharmacy major problem. (encourage 1 pharm). patients at risk for adverse reactions: use of to many meds. prescription, OTC, herbal remedies. needs Interventions for health promotion
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| Common health test and screenings for elders | cholesterol, diabetes, mammogram, pap smear, breast exam, prostate exam, vision, hearing, sigmoidoscopy, and colonoscopy
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| total cholesterol and high density lipid protein should be done | every ? years UNTIL age 75
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| diabetes mellitus screening should be done | every 3 years
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| mammogram screening should be done | every 1-2 years of life
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| clinical breast exam should be done | annually (women)
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| Papsmear should be done | annually if there is a history of abnormal smears or previous hysterectomy for malignancy. Women who have regular, normal pap smears or hysterectomy for nonmalignancy do not need pap smears beyond age 65
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| prostate-specific antigen (PSA) should be done | annually
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| sigmoidoscopy should be done | every 5 years
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| colonoscopy should be done | every 10
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| visual and hearing screening should be done | anually
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| height and weight measurements should be done | anually
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| assessing for abuse" | interview patient with out others around. if injury or illness is present assess if it is consistent with patients story. determine when injuy occured/symptoms began. Directly question the patient regarding physical/sexual abuse! have patient describe sup
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| report abuse according to | state guidelines. (inadequate diet could be a sign of abuse and neglect)
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| ___ should be provided to an abused patient | referrals, resources for the patient and caregiver
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| Stratagies for successful aging | maintain interest in leisure activities. Prompltly address medical problems. stop smoking, limit alcohol. participate in social activities, travel continue with learning activities to stimulate cognition (learning a new skill, reading) accept limits
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| task for acute care settings | assess for delirium. provide safty, comfort, nutrition, assess skin integrity, assess and treat pain appropriately.
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