Ch 8 Recognizing and Analyzing Cues
What are the three initial approaches used in recognizing the cues needed to develop working hypotheses?
What are self-report, report-by-proxy, and direct observations.
P 85
Polypharmacy is defined as:
The use of approximately five or more medications or the use of multiple medications for the same problem.
P. 116
Regarding temperature and the older adult, temperature reaching or exceeding what are very serious in older adults and are more likely to be associated with serious bacterial or viral infections?
100.9 degrees F
P. 228 Safety alert
According to MyPlate for Older Adults, how much of each category should be incorporated into the daily food intake: fruits and vegetables; grains; and protein-rich foods
50, 25, 25
P. 133
What are the four typologies of hydration problems?
Can drink; can't drink; won't drink; and end of life P. 149 Box 11.1
One key point to consider in observing cultural rules and etiquette is to be aware of general health orientation related to what?
Time (past, present, and future).
P 95 Box 8.2
Name three foods to avoid when taking Warfarin.
What are: Kale, spinach, collards, swiss chard, mustard greens, turnip greens, parsley, broccoli, and Brussels sprouts.
P. 117 Box 9.2
Identify three tips for preventing hyperthermia in the older adult.
Drink 2-3 L of cool fluid; minimize exertion, especially during warmest times of the day; apply cold wet compresses, or immerse the hands and the feet in cool water
P. 228 Box 16.2
What are two characteristics of malnutrition?
Insufficient energy intake; weight loss
P. 136 Box 10.3
Dehydration is a problem prevelant amount older adults in all settings and if not treated adquatley, mortality from dehydration can be as high as ___?
50%
P. 149 Safety Alert
Identify the three Gastrointestinal areas of emphasis when conducting a review of systems with an older adult.
Incontinence, constipation, bloating, anorexia; changes in appetitie; and loss of smell or taste
P 97 Box 8.4
What is a potential complication of taking Ginkgo and MAOI or SSRI?
May cause abnormal response or decrease effectiveness.
P. 118 Table 9.3
Identify four tips for best practice for preventing cold discomfort and development of accidental hypothermia in frail elders.
Provide generous quantities of clothing and bedcovers; provide a head covering when possible; dry wet hair quickly with warm air from a hairdryer; provide hot, high-protein meals and bedtime snacks
P 230 Box 16.4
Identify four risk factors for malnutrition.
Depression, dysphagia, poor dentition, polypharmacy
P. 136 box 10.4
What medication classes are risk factors for dehydration in older adults?
Diuretics, laxatives, angiotensin-converting enzyme (ACE) inhibitors, psychotropics
P. 150 box 11.2
What are considerations of common changes in late life during the search for physical cues in older adults related to: temperature, hearing, and vision?
Temperature: Even a low-grade fever can be an indication of a serious illness. Temperature as low as 100 degrees F may indicate pending spesis.
Hearing: High-frequency hearing loss (presbycusis) is common.
Vision: Person exhibits increased glare sensitivity, decreased contrast sensitivity, and need for more light to see and read.
P. 98 Table 8.1
Name the potential effect of the following three common drug-food interactions: Fiber & Digoxin; any food & antibiotics; and citrus juice & calcium channel blockers.
Absorption of drug into fiber, reducing drug action; reduced absorption rate of drug; gastric reflux exacerbated
P. 118 Table 9.4
What are four adaptations for safer driving for older adults?
Wider rear-view mirrors; pedal extensions; less complicated, larger, and legible instrument panels; GPS devices
P. 231 Box 16.6
Identify four atypical symptoms of Gastroesophageal reflux disease in the older adult.
Persistent cough, exacerbations of asthma, laryngitis, and intermittent chest pain.
P. 139
For tips for best practice in maintaining hydration, what are five aspects to plan for at-risk individuals?
Have fluid rounds midmorning and midafternoon; provide two 8-oz glasses of fluid in the morning and evening; provide modified fluid containers based on the resident's abilities; make fluids accessible at all times; allow adequate time and staff for eating or feeding; encourage family members to participate in feeding and offering fluids.
P. 151 Box. 11.4
In the mnemonic FANCAPES, what does each letter represent?
F: Fluids
A: Aeration
N: Nutrition
C: Communication
A: Activity
P: Pain
E: Elimination
S: Socialization and Social Skills
P. 99-100
Identify four herbs to avoid when taking any anticoagulant.
Echinacea, garlic, gingko, ginseng, green tea
P 119 Box 9.4
Once diagnosed with Dementia, driving evaluations should occur every _____ months?
Six
P. 232
Identify five risk factors for dysphagia.
CVA, Parkinson's, Neuromuscular disorders, Dementia, TBI, aspiration pneumonia, and poor dentition.
P. 140 Box 10.7
What are three ways to promote a healthy bladder?
Drink 8-10 glasses of water before 8 pm; empty bladder completely; get regular physical exercise.
P. 159 Box 12.1
The MMSE is used to screen and monitor what five aspects?
Orientation, short-term memory and attention, calculation ability, language, and visuospatial proficiency.
P 101
Identify six potential anticholinergic side effects in older adults.
Memory impairment, confusion, hallucinations, dry mouth, blurred vision, constipation, nausea, urinary retention, impaired sweating, tachycardia, hospitalization, and falls
P 122 Box 9.9
What does the mnemonic, SafeDrive, stand for?
Safety record; attention skills; family report; ethanol use; drugs; reaction time; intellectual impairment; vision and visuospatial function; and executive functions
P. 233 Box 16.9
Identify six symptoms of dysphagia and possible aspiration.
Difficult, labored swallowing; drooling; copious oral secretions; coughing, choking at meals; difficulty chewing; wet or gurgling voice
P. 130 Box 10.8
What are the five types of urinary incontinence?
Stress, urge, overflow, functional, and mixed
P. 161 Table 12.1
For the Global Deterioration Scale, what are the two midstages and what are the signs and symptoms?
Stage 5: Moderately severe cognitive decline; People in this stage have major memory deficiencies and typically require some assistance to pick out the proper clothing to wear for the season and /or the activities of the day.
Stage 6: Severe cognitive decline (middle dementia); People in stage 6 require assistance to carry out daily activities. They start to forget the names of close family members and have little memory of recent events.
P 103 Table 8.2
One side effect of SSRIs that does not result in time is what?
Sexual dysfunction
P 122
What are the three benefits of Telehealth?
Managing medical problems in the home or other setting, reducing health care costs, and promoting self-management of illness, particularly in rural and underserved areas.
P. 234
Identify seven tips for best practice for prevention aspiration in patients with Dysphagia: Hand feeding.
30 minute rest period before meals; sit at 90 degrees; alternate solid and liquids; follow speech therapy recommendations; monitor temperatures; visually check the mouth for pocketing; check for food under dentures
P. 141 Box 10.9
Identify five indications for the use of an indwelling urinary catheter.
Presence of acute urinary retention or bladder outlet obstruction; need for accurate measurement of urinary output; perioperative use for selected surgical procedures; assistance in healing of open sacral or perineal wounds; requirement for prolonged patient immobilization.
P. 165 Box 12.7
Identify four examples each of quality measures highly relevant to persons receiving care in skilled nursing facilities related to both short-stay residents (4) and long-term stay residents (4).
What is:
Short-stay: Rate of successful return to home or community; rate of potentially preventable hospital readmission 30 days after discharge; new antipsychotic medication; and had an emergency room visit
Long-term stay: One or more falls with a major injury; developed bowel or bladder incontinence; are physically restrained; shows depressive symptoms
P 106 Box 8.10
Thiazide diuretics and NSAIDS will do what to the serum lithium level?
P. 123
Identify one example of each element of an elder-friendly community: addresses basic needs; optimizes physical and mental health and well-being; promotes social and civic engagement; and maximizes independence for frail and disabled.
Provides appropriate and affordable housing; promotes healthy behaviors; fosters meaningful connections; mobilizes resources to facilitate living at home
P. 236 Fig 16.2
What are four tips for best practice for improving nutritional intake in hospitals, and four tips for best practice in improving nutritional intake in long-term care?
P. 145 Box 10.11 and 10.12
What is the ABCDE in the prevention of CAUTI?
Adherence; Be sure to use protocol; Condom catheters; Do not use indwelling catheter unless you must; Early removal of the catheter
P. 168 Box 12.8