Upgrade to remove ads
NURB 431 - Complex Health Problems
Terms in this set (103)
persons whose conditions require complex continuous care and frequently require services from different practitioners in multiple settings
T/F - now a days, everyone has a comorbidity
What do we need for complex patients?
patients with multiple chronic conditions, frequent hospitalizations, and limitations on their ability to perform basic daily functions due to physical, mental, and psychosocial changes (Robert Wood Johnson Foundation)
What are the typical complex whole system illnesses?
Cancer, Stroke and Brain Injuries, Spinal Cord Injuries
What are our concerns about the aging population?
Safety, Falls, Fires, Accountability for meds
What are our concerns for the community with aging populations?
Safety, Access to Care, Psychosocial Resources, Transportation
What are our national concerns for the aging population?
Medicare, Social Security, Money for the aging patient - retired individuals
65 or older; or under 65 with disabilities
4 Options - A, B, C, & D
which option? covers inpatient care and some nursing facility care
which option? partial outpatient and home health with some preventative services
which option? outlier; private companies that are approved to provide A and B
which option? prescription drugs
Does not cover long term care; no ADLs
Does not cover hearing aids, dentures, or glasses
What is the problem with medicare for the aging population?
A high percentage needs the ADL care that it can't provide (hearing aids, glasses, dentures, etc.)
Needs based program
Helps those with low incomes
Does include long term care
Certain people who can carry both medicare and medicaid
T/F - People can't use both medicare and medicaid
F - since they cover different aspects, they can use them both
which theory? progressive loss of function. decreases along with decreasing fertility and increased mortality; the older we get the less fertile we become and the closer to death we become
Biologic Theories of Aging
What is the etiology of the biologic theory of aging?
Unknown (Could be genetics, stress, diet, environment)
What are therapies for biologic theories of aging?
Anti-aging therapies to slow down or reverse age-related changes that result on chronic illness and disability
which theory? aging result of lifelong genetic damage; faulty copying in dividing cells or the accumulation of errors in information-containing molecules
which theory? atoms and molecules carry unpaired electrons and therefore combine with other molecules causing oxidation
Free Radical Theory
T/F - stochastic theory is persistent over time
What happens to the cells in the Stochastic Theory?
Body cells start to develop spontaneous mutations
What do the free radicals do in the Free Radical Theory?
they stay in the body and damage the good cells
which theory? programmed theory of cell death; impaired ability for cells to continue to divide
which theory? aging occurs because of functional decrements in neurons and associated hormones
T/F - In non-stochastic theory, you can help change how and when you will age
F - predetermined for you
What start declining and wearing out in the neuro-endocrine theory?
What happens when there is a decrease in the functionality of neurons? what does that cause?
Decline in T cells; the body can't fight infection - naturally can't stay healthy
What essentially happens in the neuro-endocrine theory?
self-destruction of the immune system
What can the neuro-endocrine theory help us to explain?
A lot of the disease of aging - diabetes, cancer, hypertension
What happens when acute illnesses exacerbate chronic conditions?
Increased risk for mortality and poorer day to day functioning
How many Americans 65 and older have multiple chronic conditions (MCC)?
3 in 4
What is the goal of nursing with our older adults (OA - 5)?
maintain and enhance functional ability
What do we use the SPICES assessment for?
To assess overall functioning
What does SPICES stand for?
S - Sleep
P - Problems Eating
I - Incontinence
C - Confusion
E - Evidence of Falls
S - Skin
What do we do in the hospital that assess the same thing as the SPICES assessment?
Fall Risk Score and Braden Scale
What do we want to do in order to better treat and care for the geriatric population?
Get more HCP that are certified to work with that population
Who sets the requirements for baccalaureate nurses?
How many gerontological nursing statements are in the baccalaureate competencies?
What is one disease that we have to think of the barriers that could be in the way of older adults receiving, understanding, and giving information?
What is a resource we can use for valid and reliable assessment tools to guid nursing practice for older adults?
Try This Series
T/F - In palliative and hospice care, we don't have to agree with what was done, just need to build a plan for what we would have done
What is a huge key for the aging population?
"Aging in Place"
Being able to stay at home
"Aging in Place"
What is something we can think about when it comes to the houses the elderly lives in
Housing designs and renovations that allow the elderly citizens to remain in their homes longer
provide supervision and care for the elderly or disabled person: social activities, meals, assistance with personal needs, health education and supervision in a safe environment on a temporary basis. Generally open Monday through Friday during normal business hours
Adult Day Care
Assistive devices, adaptive aids, controls or appliances which enable a patient to increase his ability to perform activities of daily living at home
Home-delivered meals delivered to individuals in their homes. Provide at least one-third to two-thirds of the current daily recommended dietary allowance
General household activities and chores: sweeping, mopping, dusting, making the bed, washing dishes, personal laundry, ironing, mending and meal preparation and/or education about the preparation meals. Also grocery shopping, having prescriptions filled, etc
In-home respite care offers relief for home caregivers by providing services to individuals unable to care for themselves. In-home respite services are provided on a short-term basis to individuals in their home.
In-home respite care
Installation of home mobility aids such as ramps, rails, non-skid surfacing, grab bars and other devices that facilitate mobility, modifications to the home to enhance safety.
Minor home modifications
the intermittent provision of direct assistance with activities such as toileting, bathing, dressing, personal hygiene, eating, meal preparation, budget management, attending appointments and interpersonal and social skill building to enable the patient to live in a community setting.
Personal care attendant services
assist individuals with the activities of daily living and related essential household tasks, such as making the bed or washing soiled linens or bedclothes that require immediate attention. This also includes cleaning and maintaining a safe home environment.
Personal care services
allow for individuals to secure help in an emergency through electronic devices and a response center. The individual may wear a portable "help" button which signals a response center.
Personal Emergency Response Systems (PERS)
Provide room and board as well as some assistance with personal needs: eating, bathing, hair and nail grooming; dressing; laundry. No medical care provided. Resident must be physically and mentally capable of finding his way to safety in the event of an emergency without assistance.
T/F - Residential Homes can provide nursing care
F - not licensed
provide skilled nursing and rehabilitative care, such as physical, occupational and speech therapy. Personal services, such as assistance with bathing and grooming, are also available.
Home Health Care
Group living for security and social purposes is offered by retirement communities. Typically complexes of apartments or condominiums, retirement communities are facilities in which seniors live independently. Recreational opportunities commonly are available as well as certain support services such as meals and transportation. Retirement communities sometimes adjoin nursing homes as part of what is called a "continuing care" campus providing a number of different services within the continuum of long-term care.
Who do we definitely need to include in the plan of care for the aging population?
The caregivers - they are huge
What puts stress on the caregivers of elderly patients?
They are trying to maintain their own jobs, home, children while caring for an aging patient
Who is the bridge to the patient?
What is something that causes the elderly patient to have problems coming and saying "I am overwhelmed"?
Role Reversal - dont want their kids to have to take care of them
Who has to have a Minimum Data Set (MDS)?
residents in a medicare or medicaid certified nursing home
US federally mandated process for clinical assessments
Minimum Data Set (MDS)
What is an MDS?
comprehensive assessment of functional capabilities
What does an MDS allow us to do?
Helps identify health problems, create plans of nursing care
When is the MDS required to be filled out?
Required on admission and periodically as status changes
Who is the MDS done by?
How is the MDS transmitted and where to?
Electronically to the state MDS database
T/F - Everything you would do for an assessment is on the MDS?
What is on the MDS?
Cognitive Patterns, Communication, Hearing, Vision, Functioning, Continence, Psychosocial, Diseases (PMH), Nutrition, Skin, Medications and Treatments
What can an MDS help us do?
better understand a residents plan of care
What does the APS do?
Investigates abuse, neglect, self neglect, and exploitation
Who are the endangered adults that APS covers?
At least 18 years of age with mental illness, mental retardation, dementia, or other physical or mental incapacity
Physical harm or any touching (battery) that is unwanted; rude manner; can also happen verbally
Not providing the care that is needed; abandonment; intentionally withholding of care that is needed
Intentionally misusing information or the person's property, person, or services for financial gain
What does Indiana law require when it comes to elder abuse?
Anyone who has a reason to believe another individual is an endangered adult to make a report
T/F - Reports of elder abuse are nonconfidential
F - are confidential
What is something important to maintain cognitive ability in the older adults?
What do we need to understand when teaching older adults?
Understand the "elder culture"
How do we need to refer to older adults?
Mr. and Mrs. -- show respect
What must our teaching strategy be to fit the needs and lifestyle of older adults? Who helps us in that?
Individualized; the patient
What do we need to reduce in order to properly teach the older adults?
How do we compensate for impaired vision?
Adequate diffused light, prescription glasses on
How do we compensate for hearing loss?
Speak clearly and slowly, face the patient while talking, sit on the side they can hear, have the hearing aids on
How do we compensate for physical ability and endurance?
Never rush the older person; do not set time limits on task performance
How do we compensate for memory problems?
Repeat the message, question the patient to make sure they are retaining what you are saying, use terminology they are familiar with
What is paramount for the older adult?
Functional independence - Want them at home for as long as possible
What falls under heath protection?
Safety of the older adult
Strategies to reduce the poor conditions for health
What are the health objectives for the nation?
Disease prevention, health protection, health promotion
what are the factors that affect nurses attitudes toward working with older adults
Ageism (Emotional Constraints, bigger diapers, more weight, talk to you)
What do we need to have when working with older adults?
Culturally competent care
THIS SET IS OFTEN IN FOLDERS WITH...
Epidemiology - Test 3 - NURB 440
NURB 431 Musculoskeletal Part 1
YOU MIGHT ALSO LIKE...
Foundations 105 Chapter 9 Chronic illness and Reha…
Fundamentals Prep U Exam 3 Chapter 8, 9, 10, +
Fundamentals of nursing
foundations chapter 36 study guide
OTHER SETS BY THIS CREATOR
NURB 440 Final
Hematology - Exam 4 - NURB 440
Cancer, Pt. 2 - Exam 4 - NURB 431
Cancer - Exam 4 - NURB 431
OTHER QUIZLET SETS
21.3 Adaptive Immunity
Div. 8 Openings