Safety
List 5 nursing interventions to prevent falls in the home and/or facility setting.
Bed locked
Bed in low position
Call light within reach
Remove throw rugs
Non-skid footwear
List 5 techniques for effective communication with a patient suffering from dementia.
•Do not dismiss as “totally confused”
•Identify key words or ideas
•Do not reprimand – aggressive or offensive language
•Body language, mood, sincerity tell all
•Respond to emotion, not words
•Ask simple, direct questions
•Understand yes/no?
•One Step Instructions
•Gestures
•Give 2 options
What is the difference between ADLs and IADLs?
ADLS=activities of daily living...tasks to meet basic needs
IADLs=independent activities of daily living...complex tasks needed for community living
List 3 myths associated with aging.
Forgetful, immobile, aren't interested in activities, can't hear, can't see
People with low health literacy are more likely to....(list three items)
Have chronic medical diagnoses, avoid important appointments or tests, have higher rates of hospital and emergency room visits
List 4 things you would check during a home assessment of a patient/client.
Home assessments: base for assessing relationship between the older adult and their environment
Identify fall risks, safety, proper lighting, and temperature regulation of environment
List two medications often prescribed to newly diagnosed patients with Alzheimer's Disease.
Namenda, Aricept
Describe the difference between palliative care and hospice care
Palliative....palliative, comfort,curative and treatment together
Hospice...goal is to give patient a good death, comfort, no focus on treatment
What are 5 physical signs of impending death?
Cardiovascular changes -Increased heart rate-- Later slowing , weakening of pulse
Irregular rhythm, Decreased BP
•
Respiratory changes -Irregular breathing that gradually slows
Cheyne-Stokes respiration alternating apnea and deep, rapid breathing
Inability to cough or clear secretions -- Grunting, gurgling, or noisy congested breathing (“death rattle”)
•
GI changes – Slowing of digestive tract and possible cessation of function
Accumulation of gas, Distention and nausea, Loss of sphincter control
Urinary changes - Gradual decrease in urinary output, Incontinent of urine
Unable to urinate
•
SKIN Mottling on hands, feet, arms, and legs, Cold, clammy skin
Cyanosis of nose, nail beds, knees, “Waxlike” skin when very near death
MS Gradual loss of ability to move, Trouble holding body posture and alignment
Loss of facial muscle tone
Sagging of jaw; Difficulty speaking; Loss of gag reflex
Swallowing can become more difficult
•More withdrawn and sleeping more
List 3 health promotion interventions the nurse can facilitate to improve a patient's vision.
Vitamins, sunglasses to protect against UV damage, screen for diabetes, blood pressure screening
Ability to open containers
Ability to see containers
Health literacy
Ability to administer via the proper route
What are the four types of dementia?
Alzheimer's, Lewy Body, frontotemporal, vascular
Taking vitamin D and calcium supplements can be an effective way of preventing bone loss in the older adult. What is the recommended daily intake for vitamin D and calcium supplements?
Vitamin D 800-2000IU
List 5 reasons why drug reactions are more common in older adults.
the adverse drug reactions that are likely to occur in the older adult d/t:
Increased numbers of medications
●Frailty
●Malnourishment or dehydration
●Multiple illnesses
●An illness that interferes with cardiac, renal, or hepatic function
●Cognitive impairment
●History of medication allergies or adverse effects
●Fever, which can alter the action of certain medications
●Recent change in health or functional status
●Medications in any of the following categories: anticoagulant/antiplatelet, antidiabetics, nonsteroidal anti-inflammatory drugs, and central nervous system drugs
Wellness in the older adult focuses on what four aspects?
Rather than having a narrow focus on physical health and functioning, wellness-focused nursing considers the older adult’s physical, mental, social, and spiritual well-being
List 5 of the 7 types of abuse/neglect.
•Physical abuse
•Sexual abuse
•Emotional or psychological abuse
•Neglect
•Abandonment
•Financial/material abuse/exploitation
•Self-neglect
List risk factors of vascular dementia.
Factors such as high blood pressure, history of heart attack or strokes, diabetes, smoking, high cholesterol raise risk of vascular dementia
List 5 nursing interventions the nurse could implement to improve the quality of life of a patient suffering from osteoarthritis.
NSAIDS
Flexibility training
Diet
Weight loss
Tobacco cessation
What are the three types of hearing loss? What one is the most common?
Sensorineural
Conductive
Mixed
List 4 health promotion activities the nurse can implement when caring for older adults...
BP screening, exercise classes, flu and pneumonia vaccinations, health education, risk reduction interventions
Discuss orthostatic hypotension and postprandial hypotension. What are some similarities and differences?
Postprandial hypotension is an excessive decrease in blood pressure that occurs after a meal. Dizziness, light-headedness, and falls may occur. Doctors measure blood pressure before and after a meal to diagnose postprandial hypertension. Eating small, low-carbohydrate meals frequently may help. Age-related changes.
Orthostatic hypotension is a form of low blood pressure caused by blood vessels failing to constrict when the body takes an upright position. It is usually a symptom of an underlying disorder rather than a disease in itself. The incidence of orthostatic hypotension increases with age.
List three geriatric syndromes
Falls, frailty, malnutrition, urinary incontinence, functional decline, pressure ulcers, cognitive impairment, and delirium
List the 4 major types of pain and what they mean.
Chronic- lasts longer than 3-6 months
Acute - responds to NSAIDS or opioids
Nociceptive -damage to somatic or visceral tissue
Neuropathic-damage to CNS or peripheral nerve
Why would an older adult have difficulty seeing at night or in low-lighting environments?
Cornea-thickened and lipid deposits...less light can enter eye
Iris-muscle weakens so less ability to constrict pupil
What factors contribute to the complexity of providing care to older adults?
Polypharmacy
Several chronic health conditions