Young adult through older adults
What are some health risks during older adulthood? (at least three)
- Falls, sundowning
- Probabilities of illness increase
- CVD and Stroke
- HTN
- CA
- Respiratory diseases
- Musculoskeletal disorders
- DM
After stating they feel no pain an older adult shows a tense posture, avoids eye contact, and has a resting facial expression of displeasure. What might this indicate, and how would you alter your assessment accordingly?
This indicates that they are feeling pain. Phrase questions about pain differently and use open-ended questions to learn more about their pain.
What is the best way to assess pain levels?
Pain is whatever the person with the pain says it is and it exists whenever the person says it does
After losing their pet dog 7 yo Peter begins to wet the bed again and wants to be picked up. What coping mechanism is he displaying?
Repression- an unconscious psychological defense mechanism that blocks distressing thoughts, memories, or emotions from conscious awareness to protect the individual from anxiety or emotional pain
In which phase of the nursing process are subjective and objective data collected and analyzed?
Assessment
How does cognitive ability generally change with age?
Response time may slow but cognition remains intact
What kind of communication does SOLER support? What does the acronym stand for?
Therapeutic communication
- S- sit facing the patient
- O- open stance or posture while listening
- L- lean toward the speaker
- E- eye contact without staring
- R- relax
Can previous experiences of pain impact future pain experiences? If yes, how?
Yes, previous experiences of pain can profoundly impact new pain experiences. This especially relates to the pain scale
How can you as a nurse comfort a family during a death? (at least three)
Practice active listening and maintain a consistent presence
Offer support without interjecting personal opinions
Provide accurate, honest information
Be sensitive to emotional state and cultural differences
Offer support and validate family feelings
Encourage open dialogue between family members
What is arguably the most important aspect of the nursing process which allows you to analyze the effectiveness of your interventions? And what happens if you determine the intervention was not successful?
Evaluation- the nurse determines wheather the goals/outcomes are met, examines the effectiveness of interventions, and decides wheather the plan of care should be discontinued, continued, or revised
Start the process over again
Which parts of the body/ body systems commonly change due to aging? (at least three)
Skin, hair, facial structure, body build, organ systems
Rory recently experienced a death of a close friend, Emily. Since then she has been talking about the trip Emily is on and how much fun she must be having. She has been refusing to talk about Emily's death or the fight they had before she died. What two defence mechanisms is Rory displaying?
Compensation- individuals counterbalance perceived weaknesses by emphasizing strengths in other areas to protect self-esteem and maintain a positive self-image
AND
Suppression- conscious defense mechanism where an individual intentionally pushes distressing thoughts, emotions, or impulses out of immediate awareness to cope adaptively
What is the difference between pain threshold and pain tolerance?
Pain threshold is the lowest intensity at which the brain recognizes the stimulus as pain
Pain tolerance is the intensity or duration of pain that a patient is able or willing to endure
How might pain management change when the patient is switched from palliative care to hospice care?
Focused more on keeping the patient comfortable. More reliance on intense pain medications like morphine. Less of an emphasis on building habits, losing weight, increasing exercise, eating healthier.
What is wrong with this SMART goal and how would you change it?
The nurse will help the patient ambulate.
Goals need to be patient centered, specific, measurable, achievable, relevant, and time bound
The patient will ambulate to the bathroom 1x per shift (or something similar)
During middle adulthood, what health risks are you significantly more at risk for? (at least 3)
Cardiovascular disease
High blood pressure
High blood cholesterol
Obesity
Type 2 Diabetes Mellitus
Stroke
What is the main purpose of the electronic medical record? (three aspects)
- serves as a major tool for communication between healthcare professionals
- legal document
- assures quality of care measures
- Protects the nurse
- records every action taken in relation to the patient
How would you use nonpharmacological pain management to promote comfort for a patient post hip-replacement surgery? (at least three)
Positioning, massage, progressive relaxation techniques, guided imagery, meditation, distraction, spiritual support, heat/cold therapy, gentle exercise
What nursing care measures can be provided for a dying patient? (at least three)
bathing, oral care, turning and repositioning, and controlling symptoms
What are three facts about incident reports?
Generated when unusual and unexpected event involving a patient, visitor, or staff member occurs
Purpose: To document the details of the incident immediately to ensure accuracy
Not part of the medical record
The fact that an incident report was completed is not recorded in the patient’s medical record; however, the details of a patient incident are documented.
A 78‑year‑old client is admitted with new onset confusion. Which finding should the nurse recognize as NOT a normal age‑related change and report immediately?
A Mild forgetfulness when recalling names
B Slower reaction time when responding to questions
C Sudden onset of confusion with altered attention
D Decreased ability to focus on close objects
C Sudden onset of confusion with altered attention
Sudden onset should be your biggest cue here. Also confusion and altered attention are not normal signs of aging
How can you promote communication for patients with hearing loss? (three methods)
Be sure hearing aids are in place
- Change batteries regularly
- Store in case in drawer so they don’t get lost
Provide adequate lighting and face the patient so they can see your mouth
Sit at eye level if possible
Raise your voice slightly, speak clearly, may have to speak a little slower
Extra patience may be required by the nurse to demonstrate caring while communicating with patients experiencing hearing loss
Provide written material when possible
Dry erase boards and picture boards can be helpful
If sign language is the primary means for communication get an interpreter – not a family member
A nurse is assessing a client with chronic low back pain who reports a pain level of 8/10, but appears relaxed, is smiling, and has normal vital signs. What is the priority nursing action?
A Reassure the client that their pain is not severe based on appearance and vital signs
B Administer the prescribed analgesic and reassess pain
C Document the client’s behavior as “no pain”
D Encourage the client to “tough it out” to avoid opioid use
B- Administer the prescribed analgesic and reassess pain
Pain is what a patient says it is and patients with chronic pain will exhibit symptoms differently.
A patient with metastatic cancer says, “I’m afraid of dying.” What is the nurse’s best initial response?
A “Many people feel that way. Let’s focus on keeping you comfortable.”
B “Try not to think about that; you’re doing well today.”
C “Tell me more about what you’re most afraid of.”
D “Your oncologist can better answer those concerns.”
C “Tell me more about what you’re most afraid of.”
Open ended questions can help you understand what the patient is most afraid of and using therapeutic communication techniques can also help you to comfort the patient without dismissing their concerns
A professor is out with kidney stones and needed emergency surgery to remove them. She will be out for at least 2 weeks. As a staff member what information can be shared with students?
Nothing, the professor is out on medical leave, that is it.