Aging Part 3 Lecture NURN 153 Exam 3

What should the nurse assess for E and the last S in SPICES?

Recent falls, unsteadiness, bruises; skin redness, wounds, and ability to reposition.

What is the nurse's next step when SPICES identifies a problem?

Investigate causes, intervene early, coordinate referrals as needed, and reassess outcomes.

Why are geriatric syndromes called multifactorial?

Several interacting problems—mobility, cognition, disease, medications, and environment—contribute to one syndrome.

What common conditions are considered geriatric syndromes?

Falls, delirium, incontinence, frailty, malnutrition, pressure injuries, and functional decline.

What is a fall, and why is a past fall important?

An unintentional move to a lower level or ground; a previous fall signals increased future risk.

Which factors contribute to an older adult's fall risk?

Poor vision/hearing, weakness, arthritis, dizziness, medications, cognitive changes, and environmental hazards.

An older patient starts a BP medication and reports dizziness. What should the nurse do?

Assess orthostatic symptoms and medication effects; assist with mobility and institute fall precautions.

What fall-prevention interventions are priorities?

Clear clutter, provide lighting and footwear, place essentials within reach, assist ambulation, and review medications.

After an older adult falls, what should the nurse assess first?

Immediate safety and injuries: responsiveness, breathing, pain, head injury, vital signs, and ability to move.

What does CATASTROPHE prompt nurses to review after a fall?

Caregiving/home, alcohol, treatment/meds, affect, syncope, dizziness, cognition, eyes, pain/mobility, hearing, hazards.

What is frailty, and what are its five key features?

Reduced physiological reserve; weakness, slowness, low activity, low energy/exhaustion, and unintended weight loss.

Why is frailty concerning during hospitalization?

It increases vulnerability to falls, disability, deconditioning, complications, and loss of independence.

What nursing interventions help an older adult with frailty?

Monitor nutrition/weight, encourage safe activity and strength work, prevent falls, and collaborate with PT/OT.

How do sarcopenia and osteoporosis differ?

Sarcopenia is loss of muscle mass/strength; osteoporosis is reduced bone density and increased fracture risk.

What should the nurse do for an older adult with incontinence?

Assess type/cause, medications, mobility, and toileting needs; use scheduled toileting and protect skin.

Why are older adults prone to pressure injuries?

Thin skin, poor mobility, incontinence, poor nutrition, and reduced ability to reposition increase risk.

How do delirium, dementia, and depression differ?

Delirium is acute/fluctuating; dementia is usually gradual/progressive; depression involves persistent low mood or lost interest.

What are common signs of delirium?

Sudden changes in attention, awareness, and thinking; may be restless (hyperactive) or unusually quiet (hypoactive).

What is the priority when delirium is suspected?

Assess for reversible causes such as infection, hypoxia, dehydration, or medications; ensure safety and report promptly.

How should the nurse support a patient with dementia?

Use simple cues and routines, allow time, maintain safety, and support familiar caregivers and remaining abilities.

Why is depression in an older adult important to identify?

It is not a normal aging change; it can cause withdrawal, poor appetite, sleep changes, and functional decline.

What are atypical signs of illness or infection in older adults?

New confusion, falls, weakness, decreased function/intake, or no fever despite infection.

What early finding may suggest pneumonia in an older adult?

Increased respiratory rate, even with few other symptoms; monitor oxygenation and new confusion.

An older patient has no fever but is newly confused and breathing faster. What should the nurse do?

Suspect acute illness; promptly assess vital signs, oxygenation, and other infection clues and notify the provider.

How do multiple chronic illnesses complicate older-adult care?

They can limit ADLs, worsen each other, increase medication burden, and raise hospitalization risk.

What is dysphagia, and who is at increased risk?

Difficulty swallowing; risk increases after stroke and with Parkinson's, neurological disorders, or impaired alertness.

What symptoms should make the nurse suspect dysphagia?

Coughing/throat clearing with meals, wet voice, difficulty swallowing, food avoidance, or unexplained weight loss.

What is silent aspiration?

Food or liquid enters the airway without a cough, so it can go unnoticed until complications appear.

What are major complications of dysphagia?

Aspiration pneumonia, choking, dehydration, malnutrition, anxiety, and reduced independence.

How should the nurse position a patient with dysphagia for meals?

Sit fully upright (about 90°), minimize distractions, supervise as needed, and remain upright after eating.

What feeding techniques reduce aspiration risk in dysphagia?

Offer small bites, slow the pace, and use the food texture/liquid thickness recommended after swallow assessment.

A patient coughs and develops a wet voice while eating. What is the first nursing action?

Stop oral intake, assess airway/breathing and oxygenation, and arrange prompt swallowing evaluation.

What is polypharmacy, and why is it significant in older adults?

Use of multiple medications; it raises risks of interactions, adverse effects, falls, and confusion.

How can aging alter medication effects?

Less renal clearance, altered body water/fat, and changes in metabolism may change drug levels and sensitivity.

What is the Beers Criteria list used for?

Identifying potentially inappropriate or higher-risk medications in older adults for clinician review.

Why might an older adult not take medications as prescribed?

Cost, confusion, poor vision, dexterity problems, complex schedules, adverse effects, or misunderstanding.

What nursing actions promote safe medication use?

Reconcile all drugs/OTC products, assess barriers, teach with teach-back, organize schedules, and reassess effects.

What are iatrogenesis and cascade iatrogenesis?

Iatrogenesis is unintended harm from care; a cascade occurs when one intervention triggers further complications.

What preventable hospitalization problems especially threaten older adults?

Medication reactions, delirium, infections, immobility, malnutrition, falls, incontinence, and pressure injuries.

What makes a safe transition of care for an older adult?

Nurse/team coordination, medication reconciliation, patient/family teaching, timely handoff, follow-up, and shared accountability; screen TCM needs.