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POTTER & PERRY CHAPTERS 14, 27, 28, 31, 32, 37

Terms in this set (68)

Common physical characteristic myths and stereotypes about older adults.
ill, disabled, physically unattractive
Common psychosocial characteristic myths and stereotypes about older adults.
forgetful, confused, rigid, bored, unfriendly, unable to understand an learn new information
Common lifestyle myths and stereotypes about older adults
many are affluent or many are poor, worthless after leaving workplace
Common developmental tasks of older adults
Adjusting to decreasing health and physical strength, Adjusting to retirement and reduced or fixed income, Adjusting to death of a spouse, children, family, or friends, Accepting self as aging person, Maintaining satisfactory living arrangements, Redefining relationships with adult children and siblings, Finding ways to maintain quality of life.
Common physiological changes of aging.-Integumentary
Loss of skin elasticity with fat loss in extremities, pigmentation changes, glandular atrophy(oil, moisture, sweat glands), thinning hair, with hair turning gray-white(facial hair: decreased in men, increased in women), slower nail growth, atrophy of epidermal arterioles.
Common physiological changes of aging.-Respiratory
Decreased cough reflex; decreased cilia; increased anterior-posterior chest diameter; increased chest wall rigidity; fewer alveoli, increased airway resistance; increased risk of respiratory infections.
Common physiological changes of aging-Cardiovascular
Thickening of blood vessel walls; narrowing of vessel lumen; loss of vessel elasticity; lower cardiac output; decreased number of heart muscle fibers; decreased elasticity and calcification of heart valves; decreased baroreceptor sensitivity; decreased efficiency of venous valves; increased pulmonary vascular tension; increased systolic blood pressure; decreased peripheral circulation.
Common physiological changes of aging.-Gastrointestinal
Periodontal disease; decrease in saliva, gastric secretions, and pancreatic enzymes; smooth muscle changes with decreased esophageal peristalsis and small intestinal motility; gastric atrophy, decreased production of intrinsic factor, increased stomach pH, loss of smooth muscle in the stomach, hemorrhoids, anal fissures; rectal prolapse and impaired rectal sensation.
Common physiological changes of aging.-Musculoskeletal
Decreased muscle mass and strength, decalcification of bones, degenerative joint changes, dehydration of intervertebral disks.
Common physiological changes of aging.-Neurological
Degeneration of nerve cells, decrease in neurotransmitters, decrease in rate of conduction of impulses.
Common physiological changes of aging.-Eyes
Decreased accommodation to near/far vision(presbyopia), difficulty adjusting to changes from light to dark, yellowing of the lens, altered color perception, increased sensitivity to glare, smaller pupils.
Common physiological changes of aging.-Ears
Loss of acuity for high-frequency tones(presbycusis), thickening of tympanic membrane, sclerosis of inner ear, buildup of earwax(cerumen)
Common physiological changes of aging.-Taste
Often diminished; often fewer taste buds
Common physiological changes of aging.-Smell
Often diminished
Common physiological changes of aging.-Touch
Decreased skin receptors
Common physiological changes of aging.-Proprioception
Decreased awareness of body positioning in space.
Common physiological changes of aging.-Genitourinary
Fewer nephrons, 50% decrease in renal blood flow by age 80, decreased bladder capacity.
Male-Enlargement of prostate.
Female-reduced sphincter tone.
Common physiological changes of aging-Reproductive
Male-sperm count diminishes, smaller testes, erections less firm and slow to develop.
Female-decreased estrogen production, degeneration of ovaries, atrophy of vagina, uterus, breasts.
Common physiological changes of aging.-Endocrine
General-alterations in hormone production with decreased ability to respond to stress.
Thyroid-decreased secretions.
Cortisol, glucocorticoids-increased anti-inflammatory hormone
Pancreas-increased fibrosis, decreased secretion of enzymes an hormones.
Common physiological changes of aging.-Immune system
Thymus involution; T-cell function decreases
Delirium-onset, course, progression
Sudden/abrupt; depends on cause.
Short, daily fluctuations in symptoms; worse at night, in darkness, and on awakening.
Abrupt.
Delirium-duration, consciousness, alertness
Hours to less than 1 month; longer if unrecognized and untreated.
Reduced/disturbed.
Fluctuates; lethargic or hypervigilant.
Delirium-attention, orientation, memory
Impaired; fluctuates; inattention; distractible.
Generally impaired; severity varies.
Recent and immediate impaired; forgetful; many need instructions for simple tasks one step at a time.
Delirium-thinking, perception, psychomotor behavior
Disorganized, distorted, fragmented, illogical; incoherent speech, either slow or accelerated.
Distorted, illusions, delusions, and hallucinations; difficulty distinguishing between reality and misperceptions.
Variable; hypokinetic, hyperkinetic, and mixed.
Delirium-sleep/wake cycle, associated features, assessment
Disturbed; cycle reversed.
Variable affective changes; symptoms of autonomic hyperarousal; exaggeration of personality type; associated with acute physical illness.
Distracted from task; makes numerous errors.
Dementia-onset, course, progression
Insidious/slow and often unrecognized.
Long, no diurnal effects; symptoms progressive yet relatively stable over time some deficits with increased stress.
Slow but uneven.
Dementia-duration, consciousness, alertness
Months to years.
Clear.
Generally normal.
Dementia-attention, orientation, memory
Generally normal.
Generally normal to person but not to place or time.
Recent and remote impaired.
Dementia-thinking, perception, psychomotor behavior
Difficulty with abstraction; thoughts diminished; judgment impaired; words difficult to find.
Misperceptions usually absent.
Normal; some have apraxia.
Dementia-sleep/wake cycle, associated features, assessment
Fragmented.
Affect tends to be superficial, inappropriate, and labile(changing); attempts to hide deficits in intellect; personality changes, aphasia, agnosia sometimes present; lacks insight.
Failings highlighted by family, frequent "near miss" answers; struggles with test; great effort to find an appropriate reply; frequent requests for feedback on performance.
Depression-onset, course, progression
Happens with major life changes; often abrupt but can be gradual.
Diurnal effects, typically worse in the morning; situational fluctuations but less than with delirium.
Variable; rapid or slow but even.
Depression-duration, consciousness, alertness
At least 6 weeks; sometimes several months to years.
Clear.
Normal.
Depression-attention, orientation, memory
Minimal impairment but is easily distracted.
Selective disorientation.
Selective or "patchy" impairment; "islands" of intact memory; evaluation often difficult because of low motivation.
Depression-thinking, perception, psychomotor
Intact but with themes of hopelessness, helplessness, or self-deprecation.
Intact; delusions and hallucinations absent except in severe cases.
Variable; psychomotor retardation or agitation.
Depression-sleep/wake cycle, associated features, assessment
Disturbed; usually early morning awakening.
Affect depressed; dysphoric mood; exaggerated and detailed complaints; preoccupied with personal thoughts; insight present; verbal elaboration; somatic complaints, poor hygiene, neglect of self.
Failings highlighted by individual, frequent "don't knows"; little effort; frequently gives up; indifferent toward test; does not care or attempt to find answer.
Issues related to psychosocial changes of aging
Retirement-preretirement planning, affects whole family, loss of work role, health status, sufficient income.
Social isolation- sometimes a choice.
Sexuality- all older adults need to express their sexual feelings. Housing and environment-consider resources that promote independence and functional ability. Safety risks. Furniture must be comfortable and designed for the musculoskeletal changes of older adults.
Death-Loss of relatives and friends. Fear of their own death is uncommon.
Health concerns of older adults.-Heart disease
Heart disease is the leading cause of death in older adults. Common cardiovascular disorders are hypertension and coronary artery disease.
Health concerns of older adults.-Cancer
Malignant neoplasms are the second most common cause of death among older adults.
Health concerns of older adults.-Stroke
Cerebrovascular accidents (CVAs) continue to be the third leading cause of death in the United States and occur as brain ischemia or brain hemorrhage.
Health concerns of older adults.-Smoking
Cigarette smoking is a risk factor among the four most common causes of death: heart disease, cancer, stroke, and lung disease.
Health concerns of older adults.-Alcohol abuse
Alcohol is inexpensive, legal, and accessible. Alcohol abuse may be underidentified in older adults.
Health concerns of older adults.-Nutrition
Lifelong eating habits and situational factors influence how older adults meet their needs for good nutrition. Good nutrition for older adults includes appropriate caloric intake and limited intake of fat, salt, refined sugars, and alcohol. Older adults with dementia need to be closely watched to make sure they are eating appropriate amounts of quality foods.
Health concerns of older adults.-Dental problems
Dental caries, gingivitis, broken or missing teeth, and ill-fitting or missing dentures affect nutritional adequacy, cause pain, and lead to infection. Dentures are not covered by Medicare.
Health concerns of older adults.-Exercise
Regular daily exercise such as walking builds endurance, increases muscle tone, improves joint flexibility, strengthens bones, reduces stress, and contributes to weight loss. Walking is the preferred exercise of many adults.
Health concerns of older adults.-Falls
One in three adults age 65 and older falls each year. Fall-related injuries are often associated with a patient's preexisting medical conditions such as osteoporosis and bleeding tendencies.
Health concerns of older adults-Sensory impairments
Whenever you provide care activities, make sure that the patient is wearing any assist devices such as a hearing aid or glasses so he or she can fully participate in care.
Health concerns of older adults.-Pain
Pain is not a part of healthy aging.
Health concerns of older adults.-Medication use
One of the greatest challenges for older adults is safe medication use. Polypharmacy, the concurrent use of many medications, increases the risk for adverse drug effects.
Nursing interventions related to the physiological, cognitive, and psychosocial changes of aging.
THERAPEUTIC COMMUNICATION skills enable you to perceive and respect the older adult's uniqueness and health care expectations.
TOUCH is a therapeutic tool that you use to help comfort older adults.
REALITY ORIENTATION is a communication technique that makes an older adult more aware of time, place, and person.
VALIDATION THERAPY is an alternative approach to communication with a confused older adult.
REMINISCENCE is recalling the past.
BODY-IMAGE INTERVENTIONS The way that older adults present themselves influences body image and feelings of isolation. The nurse needs to consider the importance to the older adult of presenting a socially acceptable image.
Environmental hazards that pose risks to a person's safety.-OXYGEN
Oxygen is not flammable, but fire needs oxygen to start and keep burning. Also, be aware of factors in a patient's environment that decrease the amount of available oxygen. A furnace, stove, or fireplace that is not properly vented introduces carbon monoxide into the environment. Carbon monoxide affects a person's oxygenation by binding with hemoglobin, preventing formation of oxyhemoglobin and thus reducing the supply of oxygen delivered to tissues.
Environmental hazards that pose risks to a person's safety.-NUTRITION
Groups at the highest risk for foodborne illness are children, pregnant women, older adults, and people with compromised immune systems. Foods that are inadequately prepared or stored or subject to unsanitary conditions increase the patient's risk for infections and food poisoning.
Environmental hazards that pose risks to a person's safety.-TEMPERATURE
Older adults, the young, patients with cardiovascular conditions, patients who have ingested drugs or alcohol in excess, and people who are homeless are at high risk for hypothermia.
Chronically ill patients, older adults, and infants are at greatest risk for injury from extreme heat. These patients need to avoid extremely hot, humid environments.
Methods to reduce physical hazards.-MOTOR VEHICLE ACCIDENTS
Safety belt use, child restraint use, child safety and booster seats, motorcycle helmets, teen driver safety, older adult driver safety
Methods to reduce physical hazards.-POISON
Keep medications, household cleaning solutions, and personal hygiene products out of the reach of toddlers. Using PPE when using toxic cleaning agents. A poison control center is the best resource for patients and parents needing information about the treatment of an accidental poisoning.
Methods to reduce physical hazards.-FALLS
Adequate lighting, barriers along normal walking paths and stairways, and safety devices in the home. Keep unnecessary and unneeded objects off of and away from stairs, floors, bedside tables, closet shelves, refrigerator tops, and bookshelves.
Methods to reduce physical hazards.-DISASTERS
Develop a plan of action for different disasters and make it be known to household.
Methods to reduce transmission of pathogens.-
Proper hand hygiene. Avoiding high-risk behaviors. Immunizations. Proper home pest control. Proper disposal of human waste. Keeping a healthy world environment-avoid polluting the air and water when able.
Specific risks to safety related to developmental age.-INFANT, TODDLER, and PRESCHOOLER
Lead poisoning, poisoning, choking, fire(playing with matches), falls from bicycles and playground equipment. Also, injuries related to riding unrestrained in a motor vehicle, drowning, and head trauma from objects.
Specific risks to safety related to developmental age.-SCHOOL-AGE CHILDREN
Head injuries are a major cause of death, with bicycle accidents being one of the major causes.
Specific risks to safety related to developmental age.-ADOLESCENT
Smoking, drinking alcohol, and using drugs which increases the incidents of accidents such as drowning and motor vehicle accidents.
Specific risks to safety related to developmental age.-ADULT
Frequently related to lifestyle habits.
A person who uses alcohol excessively is at greater risk for motor vehicle accidents.
People who smoke long-term have a greater risk of cardiovascular or pulmonary disease.
An adult that experiences a high level of stress is more likely to have an accident or illness such as headaches, gastrointestinal disorders, and infections.
Specific risks to safety related to developmental age.-OLDER ADULT
Falls that often result in bruises, hip fractures, or head trauma.
Factors to assess when a patient is in restraints.
Pressure ulcers, pneumonia, constipation, incontinence, breathing, circulation, behaviors that necessitated the application of restraints, procedure used in restraining, condition of the body part restrained, evaluation of the patient response.
Four categories of safety risks in a health care agency.-FALLS
The unfamiliar environment, acute illness, surgery, mobility status, medications, treatments, and placement of various tubes and catheters are common challenges that place patients of any age at risk of falling.
Four categories of safety risks in a health care agency.-PATIENT-INHERENT ACCIDENTS
Self-inflicted cuts, injuries, and burns; ingestion or injection of foreign substances; self-mutilation or fire setting; and pinching fingers in drawers or doors. Seizures are the most common.
Four categories of safety risks in a health care agency.-PROCEDURE-RELATED ACCIDENTS
Medication and fluid administration errors, improper application of external devices, and accidents related to improper performance of procedures such as dressing changes or urinary catheter insertion.
Four categories of safety risks in a health care agency.-EQUIPMENT-RELATED ACCIDENTS
Malfunction, disrepair, or misuse of equipment or from an electrical hazard. Do not operate equipment if not had adequate instruction on that piece of equipment.
Assessment activities designed to identify patients' physical, psychosocial, and cognitive status as it pertains to their safety.
Identify patient's perceptions of safety needs and risks, Identify actual and potential threats to the patient's safety, Determine impact of the underlying illness on the patient's safety, Identify the presence of risks for the patient's developmental stage and patient's environment, Determine effect of environmental influence on the patient's safety.
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