Aging Lectures Combined NURN 153 Exam 3

What is the difference between gerontology and geriatrics?

Gerontology studies normal aging; geriatrics focuses on diagnosing and treating diseases in older adults.

What is the main goal of gerontological nursing?

Promote healthy aging, independence, maximum functioning, safety, and quality of life.

What should a comprehensive older-adult assessment include?

Physical, cognitive, functional, emotional, social, cultural, and spiritual status; establish the patient's baseline.

How does the nurse apply the clinical judgment model to an older adult?

Recognize cues, analyze them, prioritize problems, plan solutions, act, and evaluate the response.

An older adult becomes suddenly confused. What is the priority?

Treat it as an acute change: ensure safety, assess vital signs/oxygenation and possible causes, and promptly report it.

How should a nurse communicate with an older adult who has hearing loss?

Face the patient, reduce noise, speak clearly without shouting, allow time, and check hearing aids.

How should nurses address cultural and spiritual differences?

Ask about individual beliefs and preferences, avoid assumptions, respect decisions, and offer desired spiritual support.

What is ageism, and how should a nurse prevent it?

Age-based stereotyping or discrimination; respect abilities, independence, dignity, and the patient's own choices.

What is the stochastic (error) theory of aging?

Aging occurs partly from accumulated random cellular damage or errors over time.

What is the nonstochastic theory of aging?

Aging follows biological processes influenced by genetic programming.

How do disengagement theory and activity theory differ?

Disengagement proposes social withdrawal with age; activity theory links meaningful involvement with well-being.

What does continuity theory say about healthy aging?

Older adults adapt by maintaining familiar habits, values, relationships, and interests when possible.

What is Erikson's developmental task in older adulthood?

Ego integrity versus despair: reflecting on life with acceptance and satisfaction or regret and hopelessness.

How can a nurse help an older adult develop ego integrity?

Encourage reminiscence, celebrate achievements, respect life experiences, and support meaningful roles.

What are positive versus negative adaptations to aging?

Positive: staying active, accepting help, using aids. Negative: isolating, denying limitations, or avoiding needed care.

What psychosocial concerns should be assessed after retirement or loss?

Loneliness, grief, finances, changing family roles, support systems, mood, and sense of purpose.

What is the key difference between normal aging and disease?

Expected gradual physiological change may be normal; new symptoms, major functional decline, and illness are not.

Which cardiovascular changes are expected, and what is concerning?

Less elastic vessels and reduced cardiac reserve may occur; new chest pain or symptomatic hypotension is not normal.

Which respiratory aging changes increase infection risk?

Reduced cough reflex, less lung elasticity, and stiffer chest wall impair airway clearance.

Which musculoskeletal changes accompany aging?

Reduced muscle mass/strength, joint flexibility, and bone density; assess fall and fracture risk.

Why are older adults vulnerable to medication buildup?

Kidney filtration often declines with age, reducing elimination of many drugs.

What skin changes are expected with age, and what is abnormal?

Thinner, drier, less elastic skin is common; open sores, pressure injuries, and infected wounds are abnormal.

Which vision and hearing changes are common with aging?

Reduced near vision, slower adjustment to light, and difficulty hearing high-frequency sounds.

What teaching reduces safety risks from sensory decline?

Use adequate lighting, glasses/hearing aids, clear pathways, and regular vision/hearing assessments.

Which gastrointestinal changes are common with aging?

Reduced saliva and slower intestinal movement can increase dry mouth and constipation risk.

Why should nurses monitor older adults' food and fluid intake?

Reduced taste, appetite, and thirst may contribute to dehydration, malnutrition, and weakness.

How does immune aging affect the presentation of infection?

Reduced immune response and lower temperature response may mean serious infection occurs without a high fever.

Is urinary incontinence a normal part of aging?

No. Age-related bladder changes can raise risk, but incontinence needs assessment and treatment.

Is significant memory loss or dementia a normal aging change?

No. Mild slowing may occur, but persistent cognitive decline and dementia are pathological.

What health teaching promotes healthy aging?

Regular activity, strength/balance exercise, adequate nutrition/fluids, oral care, vaccines, screenings, and social connection.

What are ADLs, and what does DEATH stand for?

Basic self-care: Dressing, Eating, Ambulating, Toileting, Hygiene.

What are IADLs, and what does SHAFT stand for?

Complex independent-living tasks: Shopping, Housekeeping, Accounting, Food preparation, Transportation.

What do the Katz ADL Index and Lawton IADL Scale assess?

Katz measures basic self-care independence; Lawton measures complex tasks needed to live independently.

What does the Timed Up and Go (TUG) test assess?

Functional mobility and fall risk by observing standing, walking, turning, and sitting.

What are Mini-Cog and MMSE used to screen for?

Possible cognitive impairment; results guide further evaluation rather than establish a diagnosis alone.

What is the Geriatric Depression Scale (GDS)?

A screening tool for depressive symptoms in older adults; it is not a definitive diagnosis.

What is a comprehensive geriatric assessment (CGA)?

Team-based review of function, cognition, mood, mobility, nutrition, medications, support, and care goals.

What does the SPICES assessment stand for?

Sleep disorders; Problems eating; Incontinence; Confusion; Evidence of falls; Skin breakdown.

What should the nurse assess for S and P in SPICES?

Sleep quality/night waking; appetite, chewing/swallowing, feeding ability, and weight changes.

What should the nurse assess for I and C in SPICES?

Urinary/bowel leakage and toileting ability; changes in orientation, memory, and attention.

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.

What is human development in the aging concept?

The physical, psychosocial, and cognitive changes that occur throughout the human lifespan.

Why should nurses examine their personal attitudes toward aging?

Beliefs and feelings affect care; treat each older adult as a unique person with respect.

What shapes an individual's view of aging?

Self-image, adjustment patterns, experiences, culture, religion, and personal values.

What normal skin changes occur with aging?

Drier, less elastic skin; wrinkles, age spots, reduced sweating, and increased risk of skin tears.

Why do older adults have more difficulty regulating body temperature?

Reduced sweating, fat insulation, skin sensitivity, and efficiency of hypothalamic regulation.

What teaching and nursing precautions protect aging skin?

Use sunscreen, protect from heat/cold, moisturize, avoid excessive bathing, and prevent tape-related skin injury.

What cardiovascular changes occur with normal aging?

Less elastic vessels, decreased stroke volume, increased vascular resistance, and valve changes.

What common cardiovascular problems affect older adults?

Hypertension, heart disease, and stroke; also assess for falls and activity intolerance.

What teaching supports cardiovascular health in older adults?

Exercise as tolerated, maintain a healthy weight, avoid smoking, limit fatty foods, and reduce stress.

What respiratory changes occur with aging?

Weaker respiratory muscles, lower vital capacity, fewer alveoli, and reduced gas exchange.

What teaching helps prevent respiratory problems in older adults?

Encourage exercise, rest, deep breathing, fluids, smoking cessation, vaccines, and avoiding respiratory infections.

What gastrointestinal changes occur with aging?

Slower peristalsis, less saliva and digestive enzymes, weaker gag reflex, gum atrophy, and reduced taste.

Is constipation normal aging, and what teaching helps prevent it?

No. Aging may increase risk; encourage fluids, fiber, and a regular toileting schedule; use laxatives cautiously.

What nutrition and oral-care teaching supports older adults?

Brush and floss, get dental care, eat small frequent meals, and choose high-fiber, low-fat foods.

What urinary system changes occur with aging?

Fewer nephrons, less renal blood flow/filtration, reduced bladder capacity and tone, and weaker sphincter control.

What urinary problems are common in older men and women?

Men: urinary retention from prostate enlargement. Women: stress incontinence; infection is also a concern.

What nursing interventions help with age-related urinary problems?

Monitor output, support fluids, schedule toileting, use easy-to-remove clothing, teach pelvic floor exercises, and provide skin care.

What musculoskeletal changes occur with aging?

Height and muscle loss, kyphosis, more brittle bones, cartilage changes, and reduced joint flexibility.

What is sarcopenia, and why does it matter?

Age-related muscle loss that contributes to weakness, poor balance, mobility problems, and falls.

What teaching reduces fracture and fall risk?

Weight-bearing/resistance exercise, home safety, fall prevention, calcium, vitamin D, and smoking cessation.