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Gerentology
Nursing Gerentology
| Question | Answer |
|---|---|
| Gerentology | study of the process of aging and problems of aged people |
| Gerontologic Nursing | Concerned with the assessment of health and functionality, status of older adults, planning and implementing services to meet the needs of older adults |
| Geriatrics | branch of medicine that deals with disease and problems of old age |
| Most common problems of elderly | coronary artery disease, sinusitis, diabetes mellitus, heart disease, hypertension, arthritis, hearing impairment, orthopedic problems, cataracts, tinnitus |
| young elderly | 65-74 |
| elderly | 75-84 |
| frail elderly | 85 and older |
| home care | client must have a skilled need for insurance to pay. largest portion of home health agency clients are older adults |
| retirement homes | geared toward the elderly that need a continuum of care |
| rehabilitation facilities | facilities geared to improving functional status. |
| adult day care | community based programs as an alternative to institutionalization |
| assisted living | facilities for patients who need some assistance but are able to maintain a degree of independence and still live in their own apartment. Most expensive |
| Long term care | patients need around the clock care, professional nurse always present, subject to rigid regulations |
| continuing care facilities | have accomodations for independent living, assisted living and long term care, very expensive |
| Medicare | fed funded insurance for those 65 or older |
| managed medicare | medicare managed by a private insurance co. |
| medicaid | state admin program for low income persons. nursing homes must take a certain number of medicaid patients. |
| type A medicare | hospitalization, hospice, skilled nursing available to all. does not include assisted living and rehab. Skilled nursing care only |
| Medicare part B | supplemental to medicare |
| medigap | AARP and BC & BS for example. costs vary |
| Number 1 reason for admission to assisted living? | incontinence |
| Possible signs of UTI in elderly | incontinence, confusion, anorexia, dysuria absent (frequently), change in mental status |
| Possible signs of MI in elderly | possibly no chest pain or pain in atypical location, shortness of breath, dysryhtmia, tachypnea, hypotension |
| Possible signs of pneumonia in elderly | confusion, anorexia, nausea, vomiting, tachycardia. may not have elevated WBC or productive cough |
| Possible signs of hypothyroidism in elderly | slowing down, CHF, lethargy, weakness, depression, afib |
| Considerations when performing health assessment for the older adult | adequate space, minimum noise and distraction, sit/stand in full view, comfortable temp, diffuse lighting, no glares or glossy surfaces, accept slower response times are possible, perform during peak energy time |
| ADL's (activities of daily living) | bathing, dressing, toileting, transfer, continence, mobility |
| Instrumental ADL's | telephone usage, shopping, food prep, housekeeping, laundry, transportation, meds, finances. |
| mini mental exam | orientation, registration, attention, recall, language |
| Orientation | person, place , time |
| registration | recent memory, ie. ask to repeat 3 object previously mentioned |
| attention | spell world backwards, count backwards from 100 by sevens |
| recall | remote memory |
| language | id two objects and ask for names of them, repeat "no if, ands, or buts.3 stage commands |
| depression in elderly | usually temporary, can be treated, rapid onset, self neglect, anhedonia, significant relationship between depression and memory making diagnosis difficult |
| physical signs of depression | fatigue, anorexia, constipation, confusion, lethargy, disinterest, change in sleep pattern |
| delerium | temporary, rapid onset, brief in length, disturbance in consciousness along with rapid change in cognition, disorientation,impaired memory, very agitated, usually specific cause can be identified |
| causes of delerium | opiates, change in environment, head injury, tumor, pain, stress, metabolic disorder, hypoxia, other meds |
| dementia | syndrome of progressive decline that erodes intellectual abilities causing cognition and functional deterioration |
| types of dementia | alzheimers disease, vascular dementia, parkinsons, Mild cognitive impairment (MCI) |
| Alzheimers disease | number one cause of dementia, progressive degeneration and death of brain cells. brain pathways destroyed and shrunken. results in problems in thinking, memory and behaviour. |
| vascular dementia | presents like alzheimers, stepwise decline due to mini strokes. Initial symptom not memory loss |
| parkinsons disease | neurogenerative disorder, degeneration of synapse, resting tremor, bradykinesia, rigidity. |
| Alzheimers disease pathophysiology | amyloid protein leads to neurofibrillary pathology and cell death. tau protein forms tangles, normal cells are crowded out and die, dead cells decrease neurotransmitters such as acetylcholine. |
| Warning signs of Alzheimers disease | memory loss affects job skills, difficulty performing tasks, problem w/language & word finding, disorientation to time & place, poor judgment, difficulty w/ abstractions, misplacing things & blaming others, mood change , loss of executive skills, |
| Differential Diagnosis D.E.M.E.N.T.I.A | D-drugs, E-emotional (depression), M-metabolic (thyroid-hyper and hypo), E- eye, ear disorders, N-nutritional, T-tumor, trauma, I- infection, A- artheroschlerosis decreases circulation to brain |
| Stages of AD | early, middle, late |
| Early Stage of Alzheimers | repetition, misplacement of items, unable to pay bills, unkempt, difficulty with meds, difficulty with simple arithmetic, communication wanes, loss of executive functions |
| Middle Stage of Alzheimers | unaware of very recent events, cannot learn, difficulty with choices, needs detailed instruction for simple tasks, decrease in coordination and balance, self absorbed, delusions or hallucinations, incontinence |
| Late Stage of Alzheimers | no recent or remote memory, little cognitive function, unable to swallow, cannot recognize primary caregiver, agitation |
| Common Alzheimers Meds | Tacrine (cognex), Donepezil(Aricept)- most common, Revastigmine(Exelon), Memantine (Namenda)- becoming more popular, Galantamine (Reminyl) |
| SDAT | Senile Dementia of the Alzheimers Type |
Created by:
troutbaron
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