geri exam 1+ 4 (final)

What is the pathology of osteoarthritis (OA)

Erosion of joint cartilage- not muscle or a metabolic bone disease

Hendrich II Fall Risk Model

fall risk assessment tool, identifies adult patients who are at high risk for falling

What factors does the Hendrich II Fall Risk Model test?

1. Confusion/disorientation

2. Depression

3. Altered elimination (urgency, incontinence)

4. Dizziness/vertigo

5. Male sex

6. Anticonvulsant medications

7. Benzodiazepine medications

8. Get-up-and-go test

What does a Hendrich II Fall Risk score change from 3 to 7 indicate

A significantly higher fall risk

What should the nurse do if a patient's Hendrich II score increases?

Immediately revise the plan of care

What is the PULSES tool used for

Assessing general functional performance, ability for a patient to live independently, mobility, and self-care

PULSES tool stands for

1. Physical condition

2. Upper limb function

3. Lower limb function

4. Sensory components

5. Excretory functions

6. Support factors

PULSES tool maximum scoring

24

Lower score on the PULSES tool means the patient is very….

independent

Higher score on the PULSES tool means the patient…

Needs more care

A score of >5 indicates high or low for falls

High risk

What is the PLISSIT model used for

Assessing /addressing client sexuality

What is the Braden Scale used for?

Predicting pressure injury (pressure ulcer) risk

What is veracity?

Ethical principle of telling the truth

What is autonomy?

Respecting the patient's right to self-determination and independent decision-making

Beneficience

Acting in the best interest of the patient to promote good

Fidelity

Keeping promises and remaining faithful to professional obligations

Is it legal and ethical to administer pain medication to a dying patient even if it may safely accelerate death?

Yes, under the Doctrine of Double Effect.

What is a living will?

A document allowing patients to state their healthcare wishes in advance if they become incapacitated

What should the nurse do if a frail patient is unresponsive and pulseless with an Advance Directive but no MOLST or DNR?

Begin resuscitation immediately.

What are expected physiological changes at the end of life?

Confusion, refusing food, and sleeping most of the day

What is the FICA Spiritual History Tool used for?

Assesses spiritual history and distress

What is the PAINAD Scale used for?

Assessing pain in older adults with advanced dementia who cannot communicate verbally

What is the WHO Analgesic Ladder?

A guide for pain management

According to the WHO Analgesic Ladder, what is appropriate for mild to moderate bone/joint pain (6/10)?

A non-opioid combination such as acetaminophen or aspirin before advancing to opioids

Is acetaminophen 800 mg every 6 hours a safe dose?

Yes- It totals 3,200 mg/day, which is below the adult maximum of 4,000 mg/day

What is the priority nursing diagnosis for a terminally ill patient who cannot read, speak, or understand English?

Inadequate verbal communication

Approximately how many LGBTQI older adults live in the United States?

more than one million

LGBTQI older adults are _______ more likely to live alone

2x

Does sexual interest disappear with aging?

No; desire and interest usually persist

With aging, sexuality priority often shifts toward…

companionship

What remains an important component of sexuality in older adults?

Touch and closeness

How does maintaining sexuality affect older adults?

Improves mood and life satisfaction

What are normal vaginal changes with aging?

vaginal thinning and shortening

What lubrication change occurs with aging?

Delayed lubrication - may cause pain

how should new-onset pain during intercourse in older women be managed?

water-soluble lubricant

What anatomical changes normally occur in older females?

Cervix descension and labia atrophy

What causes cervix descension and labia atrophy with aging?

Estrogen loss after menopause

What hormone normally decreases in aging men?

Testosterone

How do erections normally change with aging?

They become weaker and require more direct stimulation

How does orgasm normally change with aging?

Fewer contractions and a longer refractory period

Which sexual change is pathological rather than normal aging?

Total impotence / erectile dysfunction

Which musculoskeletal changes are considered normal aging?

Decreased bone density and increased fracture risk

Which musculoskeletal changes are pathological?

Severe muscle weakness, frequent falls, joint inflammation, and total impotence

What hormonal changes can affect sexuality?

• Perimenopause

• Menopause

• Andropause

How does nicotine affect sexuality?

It constricts blood flow to pelvic organs

How does COPD affect sexuality?

Causes hypoxia and severe shortness of breath

How does arthritis affect sexuality?

Causes pain, stiffness, and limited flexibility

How does urinary incontinence affect sexuality?

Causes embarrassment and interferes with intimacy

How can dementia affect sexuality?

Hypersexuality or loss of sexual desire

What trend is seen with HIV/AIDS in adults over age 50?

Cases are increasing

Why are older adults at increased HIV risk?

Less safe sex practices and avoidance of HIV testing due to stigma

Which older adult populations have the highest HIV risk?

Black and Hispanic older adults

How often should nurses assess sexual wellness?

Every assessment

What does the "P" in PLISSIT stand for?

Permission to discuss sexuality

What does the "LI" in PLISSIT stand for?

Limited Information

What does the "SS" in PLISSIT stand for?

Specific suggestions

What is the purpose of Limited Information in PLISSIT model?

Address sexual function and provide education

What does "IT" stand for in PLISSIT?

Intensive therapy if needed

What rights do Long Term Care residents retain?

Full self-determination

What privacy rights must long term care facilities provide?

Privacy for intimacy

What is the top nursing diagnosis related to altered sexual function?

Ineffective Sexuality Pattern.

What nursing diagnosis is used when sexual function is impaired?

Sexual dysfunction

What nursing diagnosis is appropriate for a patient who wants more education about sexuality?

Readiness for Enhanced Knowledge.

Ageism

Prejudice/stereotyping/discrimination against people based on their age

What is the focus of Healthy People 2030 for older adults?

Reducing health problems and improving quality of life

Where do most older adults in the United States live?

Independently in their own homes or with family.

Do most older adults live below the poverty line?

No

According to Rowe and Kahn's model, what defines successful aging?

Adaptation, meaning, and continued engagement.

What Healthy People 2030 strategies help improve health in older adults?

Decrease hospital admissions, reduce falls, and prevent pressure injuries.

What trend is expected regarding homelessness among older adults?

The number of homeless older adults is expected to increase

What is ethnogeriatrics?

The study of aging in racial and ethnic minority populations, including cultural beliefs, practices, and health disparities

What do decreased hemoglobin and hematocrit levels usually indicate?

Blood loss

Why might a dehydrated patient have elevated hemoglobin and hematocrit?

Fluid loss causes hemoconcentration

What intervention is expected for a patient with nausea, vomiting, and dehydration

IV fluids as prescribed

What is the Functional Consequences Theory?

theory based on Florence Nightingale's principles that focuses on the interaction between age-related changes and risk factors to plan care

What are PULSES and SPICES used for?

Assessing function and identifying common geriatric syndromes

What is rectangularization of the survival curve?

Increasing the number of people who live longer, healthier lives before experiencing illness

What interventions contribute to rectangularization?

vaccinations, early cancer detection, and smoking cessation

What does the Disengagement Theory propose?

Older adults naturally withdraw from society and social roles

What is the Free Radical Theory?

Aging results from accumulated cellular damage caused by free radicals

What is the Immunological Theory of aging?

Aging occurs because the immune system gradually declines

What are the core principles of gerontological nursing?

Person-centered and holistic care

What is primary prevention?

Preventing disease before it occurs (e.g., vaccines, exercise, smoking cessation)

What is secondary prevention?

Early detection and treatment of disease (e.g., mammograms, colonoscopies, blood pressure screening)

What is tertiary prevention?

Reducing complications and improving quality of life after disease develops (e.g., rehabilitation, diabetes management)

What is the Transtheoretical Model of behavior change?

A model describing stages people move through when changing behaviors

What are the stages of the Transtheoretical Model?

Precontemplation, Contemplation, Preparation, Action, Maintenance, and sometimes Relapse