Test 7 for Showers
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| study of the process of aging and problems of aged people | Gerentology
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| Concerned with the assessment of health and functionality, status of older adults, planning and implementing services to meet the needs of older adults | Gerontologic Nursing
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| branch of medicine that deals with disease and problems of old age | Geriatrics
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| client must have a skilled need for insurance to pay. largest portion of home health agency clients are older adults | home care
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| geared toward the elderly that need a continuum of care | retirement homes
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| facilities geared to improving functional status | rehabilitation facilities
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| community based programs as an alternative to institutionalization | adult day care
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| 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 | assisted living
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| patients need around the clock care, professional nurse always present, subject to rigid regulations | Long term care
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| have accomodations for independent living, assisted living and long term care, very expensive | continuing care facilities
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| 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 | delerium
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| opiates, change in environment, head injury, tumor, pain, stress, metabolic disorder, hypoxia, other meds | causes of delerium
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| syndrome of progressive decline that erodes intellectual abilities causing cognition and functional deterioration | dementia
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| alzheimers disease, vascular dementia, parkinsons, Mild cognitive impairment (MCI) | types of dementia
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| 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 | Alzheimers disease
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| presents like alzheimers, stepwise decline due to mini strokes. Initial symptom not memory loss | vascular dementia
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| neurogenerative disorder, degeneration of synapse, resting tremor, bradykinesia, rigidity. | parkinsons disease
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| 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 | Alzheimers disease pathophysiology
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| 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, | Warning signs of Alzheimers disease
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| 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 | Differential Diagnosis D.E.M.E.N.T.I.A
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| Stages of AD | early, middle, late
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| repetition, misplacement of items, unable to pay bills, unkempt, difficulty with meds, difficulty with simple arithmetic, communication wanes, loss of executive functions | Early Stage of Alzheimers
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| 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 | Middle Stage of Alzheimers
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| no recent or remote memory, little cognitive function, unable to swallow, cannot recognize primary caregiver, agitation | Late Stage of Alzheimers
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| Tacrine (cognex), Donepezil(Aricept)- most common, Revastigmine(Exelon), Memantine (Namenda)- becoming more popular, Galantamine (Reminyl | Common Alzheimers Meds
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| SDAT | Senile Dementia of the Alzheimers Type
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| Physical disorders, Medications, Substance abuse, Social, cultural and demographic factors | Risk factors of Depression in the older adult
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| sleep changes, appetite changes, loss of interest, fatigue, anxiety, low esteem, sucidal thoughts | Signs and symptoms of depression
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| Infliction upon an adult of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish | Elder abuse and neglect
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| Reversible dysfunctional cerbral cortex, which is manifested by a wide varity of neuro-psychatric abnormalities | Delirium
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| Chronic, progressive, acquired brain syndrome, with gradual onset of decline in memory and other cognitive functions sufficent to life | Dementia
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| Neurologic, systemic and psychriatric causes of | delirium
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| a progressive irreversible brain disorder that is characterized by gradual deterioration of memory, cognitive function, reasoning, language and eventually physical functioning and death | Alzheimers diease
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| cell damage and inflammation in the brain, deficiency of neurotransmitters: acetycholine and serotonin, Tau-a protein (organizes nerve centers), ApoE gene | Etiology of alzheimers disease
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| Stages of alzheimers disease | First stage, Second stage and third stage
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| forgetfullness, impairment in judgement, increasing inability to handle routine tasks, lack of spontaneity, lessening of initiative, disorientation of time and place, depression and terror | First stage
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| wandering and preservation, increasing disorientation, increasing forgetfullness, agitation, restlessness, especially at night, develop an inability to attach meaning to their sensory perceptions, inability to think abstractly, muscle twitching, seizure | Second stage
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| disorientation, complete dependence, develop an inability to recognize self and others, speech impairment to muteness, morbid need to put everything in their mouths, necessity to touch everything in sight, become emaciated, complete loss of all body funct | third stage
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| age 65 and older, under 65 with certain disabilities, those with end stage renal disease | Medicare
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| welfare | Medicaid
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| a condition in which there is an involuntary loss of urine | Incontinence
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| inability to hold urine, exacerbated by fluid limiting and frequent urination | Urge incontinence
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| occurs due to increases abdominal pressure, lack of estrogen, vaginal deliveries, prostatic enlargement | Stress Incontinence
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| Chronic progressive disease, average age of onset 65, imbalance of 2 neurotransmitters( dopamine and acetycholine), causes classic S/S, of unknown etiology ( possible- trauma to midbrain, strokes, toxins and atherosclerosis) | Parkinsons Diease
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| sloweness of movement, masklike expression, drooling, soft voice low volume, slow shuffling gait, stooped posture, handwriting becomes small ( micrographia | Parkinsons Diease: Clinical manifestations- Bradykinesia
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| Define: anxiety? | A sense of psychological distress that may or may not have a focus; it is a state of apprehension that may represent a response to environmental stress or a physical disease state.
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| Thought that somone or something is going to harm them | Paranoia
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| What is NOT considered a normal part of the aging process? | Confusion
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| What is the most common psychiatric disorder found in the general medical hospital? | Delirium
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| What is often seen in the hospitalized elderly patient aka ICU psychosis? | Delirium
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| What are signs and symptoms of Delirium? | Confusion, Insomnia/Day night reveresal, Restlessness-"picking" sheets, climbing out of bed, pulling on tubes, may experience hallucination, delusions, may cry and scream
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| What are the causes of Delirium? | Dehydration, Infection, Electrolyte imbalance, head trauma, substane abuse intoxication, withdrawl, sleep deprivation,
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| Identify the causative stressor and correct it, reality orientation, verbally use of calanders, windows ect, maintain safety, provide consistent caregiver/enviroment when possible. | Identify the causative stressor and correct it, reality orientation, verbally use of calanders, windows ect, maintain safety, provide consistent caregiver/enviroment when possible.
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| What are the treatments of Delirium? | Identify the causative stressor and correct it, reality orientation, verbally use of calanders, windows ect, maintain safety, provide consistent caregiver/enviroment when possible.
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| Why should you provide a consistent caregiver/ enviroment for a pt with Delirium? | To decrease anxiey and confusion
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| What is Cognitive impariments characterized by gradual onset and is progressive and permanent Judgement, memory, abstract thinking, and social behavior are affected. | Dementia
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| What are major causes of Dementia? | Alzheimer’s disease (AD), Multi-infarcts(CVA’s), Parkinson’s disease (PD), multiple sclerosis (MS), Head injury
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| How is Alzhemimer’s Disease diagnosised | Related to cognitive and behavior assessments, autopsy reporst verify diagnosis.
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| What happens in mild stage of Alzheimers disease? | frequently repeating oneself, regularly misplacing objects, agnosia,Aphasia, Confabulation, Frustration, Anxiety & depression r/t forgetfulness and short term memory loss, family and friends often not aware of problems
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| Inability to recall familiar words used in conversation | Aphasia
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| not considered lying ego protective | confabulation
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| What are moderate signs and symptoms of Alzhiemer’s disease? | Decreased ability to perform ADLs(incontinent), "lost" in own house, disoriented to time or place, wandering or pacing, prone to accidents due to visual perception difficulties, apraxia, temperament fluctuations, sundowning, easily distracted, family awar
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| inability to perform motor tasks although motor function intact. can not zip or button | Apraxia
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| What are the signs and symptoms of severe Alzhiemers | inability to care for self, lost use of language, almost complete loss of memory, requires care 24/7, almost always bedriddenor sits in a chair all day.
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| What are the treatments for Alxhiemers for cognition | Anticholinesterase(tacrine/Cognex) (Aricept/donepezil) usually used in mild to moderate AD, thought to prevent rapid decline in cognition, pt. should have weekly assessments of liver function
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| What are the nursing interventions for the pt with Alzeimers disease | maintain safety, reality orientation early in the disease process, consistent caregiver/enviroment, routines, use signs to direct pt, encourage simple task to build selfesteem, toilet q 2, distraction when irritable, memory book, be creative, caregiverstr
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| How is Vascular Dementia diagnosised? | by MRI and CT scans
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| What are signs and symptoms of Vascular Dementia? | similar to Alzheimers, more specifically related to area of infarcts.
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| What are some signs of Vascular Dementia that is unlike pts with AD | may have focal neurological signs, extremity weakness, abnormal reflexes, tingling in a limb, slurring of speech, weakness, and drooping of face
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| What are some nursing diagnosis related to delirium and dementia | Acute confusion r/t delirium and underlying (causative agent), Risk for Injury r/t impaired cognition(safety), Chronic Confusion r/t Alzheimers disease, Anticipatory Grieving r/t expected loss of cognitive function
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| Nursing Diagnosis cont. | self care deficits r/t cognitive & motor impairments, Risk for caregiver role strain.
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