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44 terms

N146 Final

STUDY
PLAY
Most common perpetrator in elder abuse?
Adult children and spouses of older adult
Phone # to report elder abuse?
1-866-ENDHARM
Most common type of elder abuse?
Neglect
Term to describe view of older people as different and not having the same desires, needs, and concerns as normal people?
Ageism
Erickson's development crisis for the older adult?
Integrity vs. despair
Freud's stage of older adult
Genital stage
Presbyopia
Decline in ability to focus on nearby objects.
Presbycusus
Hearing loss, especially high pitch sounds
Anosmia
Absence of smell
Hypoguesia
Decline in taste
Aguesia
Absence of taste
POLST
Advanced directive form.
Nursing intervention to help maximize pulmonary function
Elevate HOB
Suggestion to reduce cardiac workload
Space out daily activities.
Older adult's total body water composition
At birth, 65%, at 70, 50%
Normal cardiovascular changes in older adult
Lowered cardiac output, impaired blood flow, reduced heart rate during exercise, decreased contractile force, increased dysrhythmias.
Better type of exercise for older adults
Less rigorous exercise w/regular breaks. Spread out the work.
Normal pulmonary changes w/age
Calcification of ribs and vertebral joints. Decreased water composition b/t birth to 70 (65-50%), elastin and collagen lose tensile strength, respiratory muscles atrophy and fatigue.
Other normal changes in pulmonary system
decrease cilia, decrease tidal volume, residual volume increase, alveoli less erlastic, fewer functioning alveoli capillaries.
Preferred drugs to give patient with GERD and diminished kidney function?
Prilosec (omeprazole) and Prevacid b/c they are metabolized in the liver, not the kidneys.
Meds to treat constipation in older adult.
DOSS (docusate) or Senna (senekot)
Diet changes for diverticulitis
25-35 mg fiber daily and adequate fluid intake
Common causes of weight loss in older adult
Ill fitting dentures, age related decreased saliva production, access to food r/t mobility issues
Causes of increased risk for osteoporosis in older adults
Decreased neurons in intestines, decreased Ca+ absorption, slower motility of GI tract
The 4 types of urinary incontinence
Functional
Stress
Overflow
Urge
Functional incontinence (def and intervention)
Issues, such as mobiity, cognitive, communication, prevent client from getting to bathroom on time.

Intervention: Bedside commode, call light, raise toilet seat, grab bar, velcro PJs.
Stress incontinence
Leaking when coughing, laughing, sitting up.

Interventions: Kegels, pads, tricyclic antidepressants (Tofranil (imipramine))
Urge incontinence
Bladder training, briefs/pads, catheters, condom caths, anticholinergics/antispasmodics -- Ditropan (oxybutin), Detrol (tolterodine)
Common changes in musculoskeletal system w/age
Hgt decreases, ligaments stiffen, joint cartilage decreases
Meds Ostearthritis
NSAIDS (for pain, ibuprofen, naproxen), COX-2 (Celebrex), Steroids, Glucosamine chondroitin sulfate (works?), injected artificial joint fluid
Meds Osteoporosis medications
Biphosphonates (Actonel, Foxamax): decreases rate of bone loss
Calcitonin (Miacalcin): spray hormone, decreases bone loss
Boniva: slows bone loss and increases density
Evista: increases bone density
Meds Rheumatoid arthritis
DMARDs: Enbrel, Methotrexate (Rheumatrex, Trexall), leflunomide (Arava), Sulfasalzine (Azulfidine, Sulfazine))
Meds Parkinsons
Sinemet (levodopoa/carpidopa), Dopamine agonists (Parlodel, Permax, Requip, Mirapex) Sinement and Dopamine agonists usually prescribed at the same time but dopamine may not be administered as often.
Meds Stroke
baby aspirin, Clopidogrel (Plavix), Dipyridamole (Aggrenox), Warfarin (Coumadin), Tissue Plasminogen Activator (rtPA, Activase)
Parkinson's
Degenerative neurological disease
Tremors, rigid muscles, impaired balance, and possibly dementia.
Involves lack of dopamine in brain.
Common sleep patterns in older adults
Shorter stage 3 and 4
Take longer to fall asleep
Easily roused by noise
Symptoms of sleep disturbances
Confusion, decreased memory, morning headaches
Assessing older adult re sleep
dietary intake and medication schedules, key points about environment during sleep hours, sleep routines (any sleep aids?)
Meds sleep aids
benadryl, ambien, restoril
Sleep stages
1: drowsy
2-4: Nrem
5: REM
Tests to assess sleep quality
Epworth sleepiness scale and ?
Biological theories of aging
Free Radical theory
Wear and tear theory
Neuroendocrine/Neurochemical theories (exposure to environmental hazards, carcinogens, uv, trauma, infection)
Programmed longevity
Immunological theory
Socio/psychological theories of aging
Disengagement theory: "It's good to make way for the younguns"
Activity theory: Havighurst, deny limitations of age as long as possible, "I'm not THAT old!"
Continuity theory: Latter part of life is continuation of earlier. Prevailing theory today.
Mild Cogntivie Impairment (MCI)
Pre dementia