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Fundamentals of Nursing, ch. 19, The Aging Adult
Terms in this set (79)
Attitudes that stereotype the older adult on the basis of chronologic age.
Type of dementia in which discrete patches of brain tissue degenerate; this devastating disease eventually affects all body functions. The first indications of AD usually occur after 60 years of age, and nearly half of 85-year-old adults have the disease. Ultimately fatal.
Downward spiral or sequence of adverse events often triggered by a medical or surgical intervention during the hospitalization of an older adult.
A temporary state of confusion. Drug interactions, circulatory or metabolic problems, nutritional deficiencies, or a worsening illness are likely the real cause. Treatment of delirium may include stopping unnecessary medications, as well as interventions to resolve infection and metabolic alterations.
The acronym ABCDE is used for these interventions and assessments that focus on Awakening and Breathing coordination, choice of Careful sedation, monitoring Delirium, and Early progressive mobility.
Organic impairment of intellectual functioning, gradually leading to interference with social or occupational functioning, memory, and often personality integration. The precipitating factor may be a medical-surgical problem or behavioral or psychiatric symptoms.
Level of health defined by one's ability to carry out usual and desired daily activities.
Nursing specialty concerned with the care of the older adult.
The study of all aspects of the aging process and their consequences.
Universal phenomenon identified by Butler as a review of one's life through one's recollections.
The adult between the ages of 40 and 60 years; also called middle adulthood.
Refers to adults over the age of 65.
The use of many medications at the same time.
Method of care used to promote awareness of reality in confused or disoriented patients.
Universal phenomenon identified by Butler as a review of one's life through one's recollections.
Sense of aloneness because of decreasing relationships with others, resulting from attitudinal, geographic, financial, or illness-related factors. Social isolation is different from ineffective coping. Social isolation is the feeling of being alone; ineffective coping refers to difficulty in adapting or responding to the changes associated with the situation. Ineffective coping can lead to social isolation.
Describes a phenomenon when a person habitually becomes confused or disoriented with darkness.
Genetic Theory of Aging
Holds that lifespan depends to a great extent on genetic factors.
Part of the genetic theory of aging. Organisms wear out from increased metabolic functioning, and cells become exhausted from continual energy depletion from adapting to stressors.
Immunity Theory of Aging
The immunity theory of aging focuses on the functions of the immune system. There is a decrease in size and function of the thymus causes infections. There is much interest in the role of vitamin supplementation.
Cross-linkage is a chemical reaction that produces damage to the DNA and cell death. As one ages, cross-links accumulate, leading to essential molecules in the cell binding together and interfering with normal cell function.
Free Radical Theory
Free radicals, formed during cellular metabolism, are molecules with separated high-energy electrons, which can have adverse effects on adjacent molecules.
Physical changes in the middle adult
Fatty tissue is redistributed
The skin is drier.
Wrinkle lines appear on the face.
Gray hair appears
Cardiac output begins to decrease.
Muscle mass, strength, and agility decrease.
There is a loss of calcium from bones
Visual acuity diminishes, especially for near vision (presbyopia).
Hearing acuity diminishes
Hormone production decreases,
Women undergo menopause, a gradual decrease in ovarian function, with subsequent depletion of estrogen and progesterone. May cause women to experience hot flashes, mood swings, and fatigue. The loss of estrogen also increases the risk for osteoporosis and heart disease.
Cognitive Development in Middle Adults
There often is increased motivation to learn, especially if the knowledge gained can be applied immediately and has personal relevance.
The Middle Adult According to Erikson's Theory
A period of generativity versus stagnation. The tasks are to establish and guide the next generation, accept middle-age changes, adjust to the needs of aging parents, and reevaluate one's goals and accomplishments.
The Middle Adult According to Havighurst's Theory
The middle adult must accept and adjust to physical changes, maintain a satisfactory occupation, assist children to become responsible adults, adjust to aging parents, and relate to one's spouse or partner as a person.
The Middle Adult According to Levinson's Theory
The middle adult may choose either to continue an established lifestyle or to reorganize one's life in a period of midlife transition.
May occur in both men and women in their 40s.
The security of retirement investments and income is critical to ensure that people remain financially stable and that workers receive the pensions they are working toward or have already achieved.
Although for many this is a time of greater security and stability, with stronger emotional commitment and sharing, for some it is a time of disenchantment. Loss of a spouse or partner is more likely in the middle adult years. The loss is a major crisis and a threat to one's self-concept, as well as a major role change.
Moral Development in the Middle Adult
According to Kohlberg (1969), a middle adult may either remain at the conventional level or move to the postconventional level of moral development.
Leading Causes of Death in the Middle Adults
Are malignant neoplasms; cardiovascular disease; unintentional injury including poisoning, motor vehicle accidents, and falls; diabetes mellitus; chronic lower respiratory disease; and cerebrovascular causes (Heron, 2012). Other major health problems include rheumatoid arthritis, obesity, alcoholism, and depression.
Health-promotion Activities in Middle Adults
Eat a diet low in fat and cholesterol, including fruits, vegetables, and fiber; use sugar, salt, and sodium in moderation.
Make regular exercise a part of life.
Drink alcohol in moderation, if at all.
Do not smoke.
Every 3 years to age 40
Every year from age 40
The Affordable Care Act provides free annual wellness visits for people enrolled in Medicare.
Breast self-examination each month
Breast clinical examination every 3 years to age 40, then every year
Mammogram every year beginning age 40
Pelvic examination with Papanicolaou (Pap) exam at least every 3 years
Begin PSA tests every year at age 50.
Testicular self-examination every month.
Men and women.
Fecal occult blood test every year
Digital rectal examination (DRE) every year
Flexible sigmoidoscopy every 3-5 years, or
Colonoscopy with follow-up every 3-5 years depending on size of polyps
Tetanus, diphtheria (Td) or Tdap: 1-dose booster every 10 years of either Td or Tdap; Tdap recommended for adults 65 and older if in contact with a child <12 months of age
Influenza: 1 dose every year
Pneumococcal polysaccharide vaccine (PPV): 1 dose every year up to age 64 for those with medical indications; 1 dose for those unvaccinated by age 65, or who received the first dose more than 5 years previously (before age 65)
Zoster vaccine, live (Zostavax): Recommended for adults 60 years and older to prevent herpes zoster (shingles)
New Roles in the Older Adult
Older adults face numerous role changes related to their age or health status. Lost roles must be replaced with new roles and activities that are acceptable and satisfying to the person. Research has show that most older adults adjust well.
Most common chronic disorders
The most commonly encountered chronic disorders are hypertension, arthritis, heart disease, cancer, diabetes, and sinusitis.
Describes the muscle loss combined with an increase in body fat as people age.
Only about 4% of older adults live in long-term care.
Incontinence is not a part of aging; it requires medical attention.
The blood vessels in the dermis become more fragile, causing increased bruising and purpura (hemorrhaging into the skin).
Sense of taste
Sweet and salty tastes diminish first.
The number of functioning nephron units decreases by 50%; waste products may be filtered and excreted more slowly.
Ability to adapt
As people age, their ability to adapt, not the time it takes for them to adapt, is the key determinant for whether they will be ill or healthy.
Greatest threat to health
The greatest threat to the health of older adults is loss of the physiologic reserve of the various organ systems.
Older adults with a strong self-concept
Describe themselves as being healthier than others or "young for my years".
State Department of Transportation
An additional resource and may request that an older driver be retested based on identification of a concern from a health care provider, a police or accident report, or written expressed concern from a family member.
Older adults often withdraw from usual roles and become more introspective and self-focused. This withdrawal was theorized as intrinsic and inevitable, necessary for successful aging, and beneficial for both the person and for society.
Erikson's Theory of the Older Adult
A time of life review or reminiscence. Ego integrity is facilitated when an older adult has successfully accomplished tasks earlier in life.
Havighurst's Theory of the Older Adult
According to Havighurst (1972), the major tasks of old age are primarily concerned with the maintenance of social contacts and relationships.
Sleep in the Older Adult
The potential with this age group for sleep disorders accompanied by daytime sleepiness contributes to slower response time, impaired memory, and behavior that may be mistaken for some form of cognitive impairment.
Delirium, sleep disturbances, cognitive changes, and diminished functional abilities may result when pain is not managed adequately.
Two or more people may share an apartment or house. Each person usually has a private bedroom and shares the other living spaces. These homes may be sponsored by faith-based groups or community agencies.
The Program of All-Inclusive Care for the Elderly, in which adults age 55 years or older who meet specific criteria can receive comprehensive interdisciplinary care. They also receive support to live in the community as long as possible.
Naturally occurring retirement community - neighborhood or apartment complex whose population is mostly retired people.
Racial and Ethnic Approaches to Community Health
May include providing transportation, food, shelter, social interactions, and even complex medical and nursing treatments.
Kohlberg's Moral Development
Older adults have completed their moral development. Most are at the conventional level, following society's rules in response to others' expectations. Spiritually, an older adult may remain at an earlier level, often at the individuative-reflective level. Most have conjunctive faith.
Spirituality and Transcendence
Are a resource and a source of strength when faced with inevitable change and loss.
Nursing Care for Older Adults Principles
1. Most older people are not impaired but are functional in the community, thereby benefiting from health-oriented interventions.
2. Older people are more vulnerable to physical, emotional, and socioeconomic problems than people in other age groups and may require special attention to health promotion and maintenance.
Implications of polypharmacy
Complicated regimens need careful review to minimize risks and complications and maximize benefits. Nurses must be able to recognize adverse drug reactions in this population instead of mistaking them for age-related changes.
Diminished quality of life
Poverty, the presence of chronic illnesses, and difficulty accessing the health care system make older adults much more vulnerable to a diminished quality of life caused by disease.
The Joint Commission on Teaching
The Joint Commission recommends using both illustrated aids and the teach-back method to communicate health instructions.
African American Mean
African American men are 30% more likely to die from heart disease than non-Hispanic White men. African American adults are diagnosed with diabetes and die from diabetes almost twice as often as a White adult.
The leading causes of illness and death for Hispanic Americans are heart disease, cancer, unintentional injuries (accidents), stroke, and diabetes.
Asian Americans are most at risk for cancer, heart disease, stroke, accidents, and diabetes. Tuberculosis is 11 times more common in this group than the White population.
American Indian/Alaska Natives have an infant mortality rate 60% higher than that of Whites. Leading causes of death and illness are heart disease, cancer, accidents, diabetes, and stroke.
Falls are the most common cause of injuries and hospital admission in older adults. Approximately 30% to 40% of adults over 65 years of age living in the community fall at least once per year. Prevention interventions include the use of vitamin D and exercise.
Three most common geriatric syndromes
Delirium, sleep disorders, and voiding dysfunction.
Elder abuse most commonly occurs in women over 80 years of age. Physical abuse, sexual abuse, emotional or psychological abuse, neglect, abandonment, and financial or material exploitation are all types of elder maltreatment. Identification of elder abuse requires an alert health care provider.
An older patient is more likely than a younger patient to suffer multisystem dysfunctions, iatrogenic complications (caused by medications or treatments), accidents such as falls, and increasing dependence and confusion.
Life expectancy for men is 76 years of age and for women is 81 years of age.
Pain is often experienced by older adults but is not a normal consequence of aging.
THIS SET IS OFTEN IN FOLDERS WITH...
Fundamentals of Nursing, ch. 15 Evaluating
Fundamentals, Lecture 7 Gerontology
Fundamentals of Nursing, ch. 25 Health Assessment
Fundamentals of Nursing, ch. 13 Planning
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