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410 week 2B

Gerontological Assessment

QuestionAnswer
Important overview information: Assessment must be adapted for older adults, illness presents differently in older adults, and older adults are heterogenous.
General assessment: What should we look for in overall appearance? Stature? Look for apparent age, body appearance, and posture.
General assessment: What should we look for in gait? Look for spastic, scissors, ataxic, waddling, and shuffling movment
General assessment: What should we look for in mental status? Body movements - tremors, Apparent state of health - signs of illness Speech- clarity, pace, vocabulary, tone, strength, and hoarseness
Aspects of an interview: Place, distance to client, hearing assessment, comprehension, unique statement
Unique situations for an interview? Aphasic, confused, and frail clients may need adjustments for interviewing
Components of a physical assessment: Problem-focused yet thorough, account for patient fatigue, includes all body systems, and patient teaching as needed
What is a functional assessment? A systematic attempt to measure objective performance in ADLs and IADLs while also measuring fundamental tasks and demands in daily life and evaluating the physical and cognitive abilities required to retain independence.
What is functional decline look like in older adults? chronic conditions or comorbidities increase with age
Advantages of assessment instruments: Focuses the interview, standardized, data remains consistent, quantifies data, can evaluate interventions and goals
Disadvantages of assessment instruments: Subject to errors, lack of individualization, not holistic, and time consuming
Describe the scale: KATz Measures bathing, dressing, eating, toileting, transferring, continence, and feeding ADLs with a point given for each activity the provider observes the patient doing
Describe the scale: Pulses Physical condition, upper limbs (self-care), lower limbs (ambulation), sensory abilities, excretory function, social factors
Describe the scale: SPICES Sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls, skin breakdown
Describe the scale: Lawton's IADL scale Assess complex activities for independent living that accounts for gender, shopping, cooking, transportation, using the phone, etc.
What is a cognitive assessment? Evaluation of ability to think, reason, remember, and make judgements, commonly used is Folstein mini-mental status exam
Score interpratation for cognitive assesment: 26+? 20-? 20-25? No impairment, cognitive impairment, needs further testing
Other instruments not mentioned: Geriatric depression scale, short portable mental status questionaire, SLUMS, clock drawing test, and braden scale
What is a medication assessment? Acknowledging all prescription and nonprescription medications the client is taking, questioning the knowledge of the action, administration, and side effects of each medication
What to assess when evaluating if patient needs assistance with medication administration? Assess dexterity, swallowing issues, financial problems, lifestyle habits including nicotine, caffeine, alcohol, and recreational drug use.
What are important lab values to know? Decrease: HgB but can indicate disease and thyroid hormone. Increase: BUN/Creatinine, K+, Glucose (post-prandial) and cholesterol.
What to remember regarding a spiritual assessment? It's not the same as religion as religion is an aspect and spirituality is a coping strategy or resource.
What is important during a spiritual assessment? What is your source of hope/strength? Are you satisfied with your spirituality? Is there a connection between health and spirituality?
Important nursing interventions to remember: Get them up and moving, good nutrition, encourage immunizations and mental stimulation, evaluate health promotion ( early detection and prevention) and support networks
Created by: Kierra R
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