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Age-Related Differences in the Older Adult
Dementia
Delirium
Pain
Delirium & Dementia
100
This clinical presentation includes: increased protein in urine, possible dehydration, decreased creatinine clearance, increased serum creatinine and BUN, decreased excretion of toxins and drugs....
What are the normal clinical manifestations of the older adult's kidney? Lewis page 104
100
Your assessment findings are: subjective complaint of memory loss by patient, objective evidence of memory impairment, decline in function, and has retained ability to complete ADLs
What is mild cognitive impairment?
100
A screening instrument that is effective in identifying the presence of delirium
What is the confusion assessment method (CAM)?
100
One part of your pain assessment includes: recognition & words and description of pain by patient
What is the perception of pain? Lewis page 153
100
You assess that Mr. Yasir gets very restless about 5 pm every day of the week.
What is sundowning? Lewis, page 1752 Daily Double: What are several non-pharmacolgical nursing interventions to manage this behaviour?
200
Assessment findings include: height diminshed by 2.5 to 10 cm, nose and ears lengthen, kyphosis, pelvis widens ...
What are the normal clinical manifestations of the older adult skeleton?
200
Your assessment findings include: pacing, wandering, exit seeking, constant requests for help, grabbing on to people, screaming, sexual disinhibition, hoarding...
What is behavioural symptoms of dementia? Lewis page 1744
200
Your assessment includes: a disturbance of consciousness with a reduced ability to focus, a change in cognition in the last 24 hours
What is delirium? Lewis page 1737
200
What is the instrument called that scores the following behaviors: breathing and vocalization, negative vocalization, facial expressions, body language, consolability
What is PAINAD - Pain Assessment in Advance Dementia? What is the difference between a pain behavior score out of 10 and a pain intensity score out of 10?
200

You assess that Mr. Yasir is receiving multiple psychoactive medications, takes a total of 18 different kinds of medications and uses alcohol

What are the medication risk factors for delirium? 

300
Assessment findings include: increased dependence on the atrial contractions, loss of fibres in the His Bundle, mitral valve stretching, ventricles slow to relax....
What are the normal age related changes to the cardiac rate and rhythm of the older adult? Lewis page 103
300
Your assessment findings include: anxiety depressed mood, psychosis & sleep disturbances
What are the psychological symptoms of dementia? Lewis page 1744
300
Your delirium nursing diagnosis is based on the following assessment findings: lethargy, drowsiness & decreased motor activity with in the last 24 hours
What is hypoactive delirium?
300
This type of pain processes noxious stimuli through an intact nervous system, usually responds to opioids or physical modalities
What is nociceptive pain? Lewis page 160 What are the two kinds of nociceptive pain and define each one?
300
Your health assessment finds: onset is variable, duration is variable, can be worse in the morning and improves during the day, no change in LOC, difficulty concentrating, memory intact, loss of pleasure
What is depression? Daily Double: What are some scales to use to assess depression?
400
Assessment findings include: respiratory muscles atrophy, rigidity of thoracic wall increased, ciliary action decreased
What is the normal age related changes to the respiratory system of the older adult? Lewis page 103
400
Your nursing actions are guided by the following: know the person beyond the symptoms, recognize retained abilities, manipulate the social and physical environments to meet the patient's unique needs, relate in a way with the patient to enhance feelings of support being valued,...
What are the nursing care principles for patients with dementia? Lewis page 1747 RNAO, 2004
400
The following nursing actions: judicious use of medication, prevention of infections, prevention of electrolyte imbalance, assessment of treatment of pain, use of sensory aids, prevention of constipation, adequate nutrition
What are the strategies to eliminate or minimize delirium? Lewis page 1739
400
Nurses who improve patients' experiencing pain to enhance self-efficacy or achieve selected goals, reduce pain, & improve perceived quality of life.
What is pain self-management? Lewis page 175 Daily Double: What interview skill is best used by nurses to promote a changes in behaviour?
400
Your assessment findings note in Mr. Yasir the following: stroke, type 2 diabetes, hyperlipidemia, hypertension, obesity, history of depression....
What are the modifiable risk factors for Alzheimer's Disease?
500
Three or more of the following assessment findings are present: unplanned weight loss, weakness, poor endurance, slowness, or low activity
What is frailty? Lewis page 107
500
The part of the nursing process includes: uses assistive devices correctly, controls agitation and restlessness, uses well-fitting shoes, uses eye glasses, experiences no injury
What are the expected patient outcomes for the nursing diagnosis risk for injury related to impaired judgement..
500
First line of medication therapy for severe agitation. Start with low dose of 0.25 to 0.5 mg once or twice a day, slow titration upwards. Adverse effects include: sedation, hypotension, extrapyramidal movements of face, trunk & arms.
What is Haloperidol?
500
The patient state when the need for increasing or increase more frequent doses of opioids to maintain analgesic effect
What is tolerance? Lewis page 176 Daily Double: What are seven clinical manifestations of withdrawal from opioids?
500
Your health history of Mr. Yasir includes: a low income, reduced cognitive capacity, living alone
What are the factors of the older adult who is homeless? Lewis page 107