Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
wvc aging adult
WVC fall 2010
| Question | Answer |
|---|---|
| Elder skin thickness | Elderly clients are more prone to skin breakdown. |
| Decreased skin vascularity | altered thermo-regulation response can put the elderly at risk for heat stroke |
| Loss of sub-Q fat tissue | decreased insulation can put the elderly at risk for for hypothermia |
| decreased aortic elasticity | produces increased diastolic BP |
| Loss of nerve conduction | response to pain is altered |
| reduced tactile sensation | puts elderly at risk for accidental self injury |
| gerontology | the study of the aging process |
| geriatrics | the branch of clinical medicine specializing in the elderly. |
| young old | 60 through 74 years |
| middle old | 75 through 84 years |
| old old | 85 years and older |
| Erikson: Generativity vs. Stagnation | major task: To achieve life goals established for ones self while considering the welfare of future generations. Age 50-65 |
| stagnation | concerned only about themselves and often feeling bored. |
| Ego integrity vs despair | goal is to review one's life and derive meaning from both positive and negative events while achieving a positive sense of self. Age 65 and up |
| Skeletal Changes in the older adult | Shortening of vertebrae; decrease in bone mass & mineral; slight kyphosis; thinner disks; loss of about 2" between age 20-70 |
| Cardiovascular changes in the older adult | valves become more rigid & thicker; stroke volume decreases; less efficient O2 utilization; aorta becomes dilated and elongated; cardiac output decreases 40% between age 20-65 increased resistance to peripheral blood flow and decreased CO creates |
| Respiratory changes in the older adult | lungs appear larger d/t loss of elasticity (barrel chest); decrease in ciliary action |
| GI changes in the older adult | Decreased taste reduced saliva and salivary ptyalin decreased esophageal motility atrophy of gastric mucosa liver smaller reduced intestinal blood flow decreased stomach motlitiy less HCL, pepsin, lipase, pancreatic enzyme slower peristasis |
| Changes in the female older adult | cervix smaller drier, less elastic vaginal canal flattening of labia uterus becomes smaller vagina becomes more alkaline loss of vulvar fat & hair |
| Changes in the male older adult | enlargement of the prostate gland hypertrophy of prostate can lead to urinary retention & incontinence testosterone production decreases |
| Changes in the Urinary system of the older adult | decreased renal mass loss of nephrons decreased bladder capacity weak bladder muscles between age 20-90 renal blood flow decreases by 53% |
| Changes in the skin of older adult | loss of elastin and collagen changes in collagen causes wrinkles fat redistribution results in loss of subQ cushion increase sensitivity to temp extremes slower healing |
| Changes in the vision of the older adult | acuity begins to decrease at mid-life presbyopia cataract development iris color may fade pupil may become irregular decrease in tears puffy lids night vision impaired problems seeing green, blue, violet |
| Changes in the hearing of the older adult | ear loses sensitivity to sound due to damage of the hair cells in the cochlea Perception of high-frequency sounds declines dramatically |
| Changes in the immune system in the older adult | delayed immune response more likely to be deadly immunity decreases as we age |
| Psychological challenges associated with the older adult | maintaining independence relinquishing power coping with losses initiating a life review process Developing a philosophical perspective on life |
| Pharmacokinetics | The study of the action of drugs within the body, including the mechanisms of absorption, distribution and excretion |
| Changes in the older adult that influence metabolism of medication | Decreased renal function (excretion) Decreased liver function (metabolism) Decreased body fat to lean mass (metabolism) Decreased total body water (metabolism) Diminished level of albumin level (some meds bind to protein) |
| Factors contributing to decreased intake of food | Limited finances physical limmitations decreased sense of smell & taste Dementia depression Dental problems |
| Stress factors in the older adult | Physical Psychological Spiritual Social |
| Risk factors for suicide in the older adult | Divorced Socially isolated Fiscally unstable Untreated mood disorder Alcohol or drug dependent Terminal illness or chronic disease |
| Definition of elder mistreatment | "Intentional actions causing harm or create a risk of harm, intended or not, to a vulnerable elder by a caregiver, or failure by a caregiver to to satisfy the elder's needs, or protect them from harm." |
| Risk factors for victims of elder abuse | White female, 70 or older Mentally or physically impaired Unable to meet daily self care needs Having care taking needs that exceed the abilities of the caregiver |
| Elder victims minimize abuse because: | Fear of retaliation Embarrassment about abuse in the family protectiveness toward a family memeber Fear of being institutionalized |
| Psychological abuse can present as: | anxiety depression agitation increased confusion and other behavior cues |
| Physical abuse can present as: | lacerations bruises fractures burns hair pulls |
| Neglect can present as: | are they dressed appropriate? Dental care Eye glasses Dentures present and well fitting food and hydration needs being meet constant fatigue lack of supervision |
| Sexual abuse can present as: | Bruising and or bleeding around genitalia Itching or rash around genitalia Presence of new STD pain around genitalia |
| Financial abuse can present as: | elder seems confused about the amount of money they think they should have Unmet needs, food, clothing, recreation sudden lack of funds |
| Delirium | Acute onset reversible (e. after seizure, electrolyte imbalance, detox) may be attributed to a physiological cause Environment factors (ICU psychosis) Severe distress or pain most commonly related to infection (sepsis) TREAT THE UNDERLYING CONDITI |
| In general dementia is: | Gradual Progressive Irreversible Generalized impairment of intellectual functioning that interferes with social and occupational functioning |
| Vascular Dementia Multi-infarct dementia | Results from interruption of blood flow to the brain. Onset is rather sudden, although diagnosis may not be made until the cummulative effects of a series of small vascular events becomes clinically apparent. A step-wise progression |
| Genetic theory of aging | aging is an involuntary inherited process |
| wear and tear theory of aging | the body wears out on a scheduled basis |
| Environmental theory of aging | factors in the environment bring about the aging process |
| Immunity theory of aging | Theory that describes the age related decline in immunity |
| Neuroendocrine theory | aging occurs due to a slowing of the secretions of certain hormones |
| Elder Personality theory | Mature men: balanced & maintain close relationships Rocking Chair personalities: passive, content to lean on other for support. Armored men: have well integrated defense mechanisms. Angry men- bitter about life Self haters- animosity turned inward |
| Memory in the older adult | Short term memory declines Long term memory does not show declines |
| Intellectual functioning in the older adult | Problem solving abilities gradually decline as we age |
| Learning ability in the older adult | Slowing of reaction time in the older adult may account for lower performance on tests |
| Loss and grief | By the individuals reach their 60's they have experienced numerous loses and mourning becomes a life long process. |
| Bereavement Overload | Can occour in the older adult because grief is cumulative |
| Depression in the elderly | depression among the elderly is influenced by the variables of: physical illness functional disability cognitive impairment loss of spouse |
| Sleep disorders in elderly | presence of sleep apnea depression & loneliness dementia pain impaired mobility medications inactivity and boredom |
| Reminiscence Therapy | Stimulation of life memories helps older adults work though their losses and maintain self esteem. Gives them an opportunity to come to grip with guilt and regrets. |
| Delirium due to a general medical condition | result of a general medical condition: systemic infection hypoxia fluid or electrolyte imbalence hypercarbia & hypoglycemia hepatic or renal disease |
| Substance induced delirium | delirium attributed to medication side-effects or exposure to toxins: anesthetics; analgesics; anticonvulsants; lithium; muscle relaxants; VOCs; insecticides and after high does of certain 'recreational drugs' |
| Substance withdrawal delirium | after reduction or termination of a substance such as alcohol or sedatives. The delirium is directly related to the half life of the substance ingested. |
| Dementia Classification | Primary dementia- those such as AD Secondary Dementia- are caused or related to another illness or condition such as: HIV or cerebral trauma |
| apraxia | the inability to carry out motor activities despite intact motor function |
| Stage 1 dementia | There is no apparent decline in memeory |
| Stage 2 dementia | Forgetfulness; the individual begins to forget the names of people and losses in short term memory is common |
| Stage 3 dementia | Mild Cognitive Decline; Interference with work performance which becomes noticeable to coworkers |
| Stage 4 dementia | Mild to moderate cognitive decline (confusion); At this stage the individual begins to forget major events in personal history (child's birthday)and declining ability to perform tasks (shopping or finances) |
| Stage 5 dementia | Moderate cognitive decline (early dementia); individual loses ability to perform some ADLs |
| Stage 6 dementia | Moderate to severe cognitive decline (middle dementia); Unable to recall recent major life events or the name of spouse. Incontinence is common |
| Stage 7 dementia | Severe cognitive decline (late dementia); Unable to recognize family members. commonly bedfast and aphasic Depressed immune system |
| Good death | free of avoidable distress |
| Bad death | Pain not having ones wishes followed isolation abandonment constant agonizing about losses associated with death |
| Palliative care | the goal is to relive suffering and support the family and patient while providing the best level of care regardless of the stage of the disease. |
| Cheyene-Stokes respirations | Periods of apnea followed by rapid breathing |
| Death rattle | Secretions in the respiratory tract produce loud, wet respirations, when the patient is nearing death |
| Grief | the emotional feeling related to the perception of loss |
| Mourning | is the outward expression of loss |
| Life review | a structured process of reflecting on one's life |
| Reminiscence | the process of randomly reflecting on memories of events in one's lie |
| PD symptoms | Tremor rigidity slow movement (bradykinesia)] no movement (akinesia) |
| PD and dopamine | dopamine is related to PD, due to insufficient formation of dopamine produced in the dopaminergic neurons of the substantia nigra. |
| Dopamine and ACh relationship in PD | Dopamine inhibits ACh, without ACh inhibited there is a imbalance between Dopamine and ACh, which leads ACH over-stimulating voluntary muscles, thus presenting as the uncontrolled movements seen in PD. |
| Orthostatic hypotension | Orthostatic hypotension, AKA postural hypotension, a form of hypotension in which a person's blood pressure suddenly falls when the person stands up. The drop is > 20/10 mm Hg, may be most pronounced after resting. |
| PD and effects on sympathetic nervous system | PD also effects the sympathetic nervous system seen in the heart and blood vessels. This can present as Orthostatic hypotension. |
| stage 1 PD: Initial Stage | - Unilateral limb movement, minimal weakness, hand & arm trembling |
| Stage 2 PD: Mild stage | Bi lateral limb movement masklike facies Slow, shuffling gait |
| Stage 3 PD: Moderate Disease | Postural instability Increased gait disturbance |
| Stage 4 PD: Severe Disability | Akinesia Rigidity |
| Stage 5 PD: Complete ADL Dependence | Complete ADL Dependence |
| masklike facies (PD) | wide open, fixed, staring gaze caused by rigidity |
| Diagnoses of PD | made after many other neurological disorders are ruled out No specific diagnostic tests Analysis of CSF may show decreased dopamine levels |
| Dopamine agonists | mimic dopamine by stimulating dopamine receptors in the brain. Effective for 3 to 5 years |
| Catechol O methytransferases (COMTs) | Enzymes that inactivate dopamine. Therefore Catechol O methytransferases Inhibitors (COMT Inhibitors) block this activity and prolong dopamine and dopamine agonists |
| Dopamine Receptor Antagonist | prescribed to promote the release of dopamine. ex. Parlodel (bromocriptine mesylate) |
| Cholinesterase inhibitor | works to improve the transmission of acetylcholine ex. revastigmine (Exelon) donpezil (Aricept), galantamine (Reminyl) |
| Injury Prevention and PD | PD patients tend not to sleep well, due in part to drug therapy, some patients take unintentional naps during the day, this nap may happen when the patient is driving or operating heavy equipment. |
| PD and weight loss | food intake is altered and there is an increased number of calories burned due to muscle rigidity. |
| PD disease progression | As the disease progresses effectiveness of the drugs decreases and the family may be referred to palliative care or hospice. |
| AD | A chronic, progressive, degenerative disease that accounts for 60% of the dementias occurring in people over the age of 65. AD is manifested by loss of judgment, memory,viuospatial perception and change in personality. |
| Areas of the brain AD affects | Precentral gyrus of the frontal lobe superior temporal gyrus Hippocampus substantia nigra |
| AD affects on the brain | The brain of an older adult weighs less, widening of the cerebral sulci, narrowing of the gyri, enlargement of ventricles & occupies less space; in the presence of AD these changes are greatly accelerated. |
| Neurofibrillary Tangles | Found in the postmortem AD brain, consisting of tangled masses of fibrous tissue throughout the neurons |
| Neuritic plaques | Found in the postmortem AD brain, consisting of degenerated nerve terminals, particularly found in the hippocampus. |
| Vascular degeneration in AD | Account for partial loss of proper brain function in AD patient |
| AD disease progression | The patient does not necessarily progress form one stage to the next in an orderly fashion. A stage may be by passed or symptoms from many stages may present at one time. |
| Changes in cognition in AD | Attention and concentration Judgment and perception Learning and Memory Communication and language Speed of information processing |
| First signs and symptoms with AD | Short term memory impairment Apraxia (inability to use objects correctly) Aphasia (inability to speak or understand) Anomia (inability to find words) Agnosia (loss of sensory comprehension) |
| Behavior Changes associated with AD | Aggressiveness (verbal and physical abuse tendencies) Rapid mood swings Increased confusion at night (Sundowning) |
| Changes in self care management skills with AD | Decreased interest in personal appearance Selection of clothing is inappropriate for the weather or event loss of bowel and bladder control decreased appetite or ability to eat |
| Laboratory Assessment with AD | No lab test can confirm the diagnosis of AD. Definitive diagnosis is made on the basis of brain tissue examination postmortem. |
| Nursing planning and implementation with AD | The priority for care is safety. |
| Orientation Therapy with AD | for the patient in the early stages of the disease, reality orientation is appropriate. |
| Validation Therapy with AD | For the patient in the later stages of AD reality therapy can cause agitation, validation therapy recognizes and acknowledges the patients feelings and concerns. |
| Relocation stress syndrome | the physical and emotional stress when a person moves from one setting to another. |
| Falls and risk of injury in the elderly | A reduced sense of touch in the elderly makes them more unaware of body position. Increased reaction time results in the person being less aware of a dangerous situation. |
Created by:
plinden3277
Popular Nursing sets