Management of the Older Adul

What's a main assessment focus for older adults' daily tasks?

Assess self-care (ADLs/IADLs) for best functioning

What 4 key statuses should nurses assess in older adults?

Functional, Cognitive, Environmental, Social.

What other critical areas besides functional status should nurses assess in older adults?

Meds (polypharmacy), psychosocial support, fall risk/safety, cognitive/sensory screening, physical exam.

How can nurses prevent falls in hospitalized older adults?

Fall risk signs, low/locked bed, call bell close, non-slip socks, assistive devices, hourly checks.

How can older adults' homes be made safer to prevent falls?

Remove rugs/clutter, grab bars, night lights, proper footwear, review meds, use aids (glasses/hearing), balance exercises.

What CV health advice is key for older adults?

Promote CV health, monitor perfusion, note HTN/orthostatic hypotension.

What respiratory education is vital for older adults?

Encourage deep breathing/mobility (pneumonia risk), use incentive spirometry, longer recovery from infections.

What skin care advice should nurses give older adults?

Moisturize/protect daily, avoid strong adhesives, frequent repositioning (pressure injury risk).

What GI education is important for older adults?

Hydration, fiber, monitor for constipation (especially with pain meds).

What GU advice should nurses give older adults?

Toileting routines, hydration (bladder capacity, residual urine, UTI/incontinence risk).

What musculoskeletal patient education is crucial for older adults?

Fall prevention, safe mobility, assistive devices, monitor gait/fear of falling.

What should nurses promote regarding older adults' reproductive health?

Safe intercourse, monitor changes/STIs.

How does recovery from respiratory illness differ for older adults?

May need more time, use incentive spirometry, decreased elasticity/cough reflex.

How might a UTI appear in an older adult?

Atypical symptoms; look for confusion or falls.

What's a key nursing consideration for nervous system assessment in older adults?

Allow time for response, use large print, reduce distractions (slower processing/reflexes).

What are key nursing actions for older adults' medications?

• Review medication history, including OTC and herbal products

• Assess patient’s understanding of their medications

• Evaluate adherence and identify any barriers (e.g., cost, forgetfulness)

• Use Beers Criteria to check for potentially inappropriate medications

• Monitor for side effects and adverse drug reactions

How does aging affect drug metabolism in the GI system?

Decreased liver function leads to slower metabolism, caution with hepatically metabolized drugs.

Name types of elder abuse.

Physical, emotional, sexual, neglect, financial exploitation.

What are key assessment tips if elder abuse is suspected?

Private interview, know reporting mandates, build trust, early detection, connect to resources.

What's the priority if an 81-year-old has bruises and avoids eye contact with a caregiver?

Report findings per protocol for suspected abuse.

How might depression uniquely appear in older adults?

Common but not normal; can present as fatigue, irritability, withdrawal.

What tools screen for depression in older adults?

PHQ-2 or PHQ-9.

What is ageism?

Prejudice/discrimination based on age.

Give examples of ageism in healthcare.

Just getting old," infantilizing language, assuming interests/treatment preferences.

Onset: delirium vs. dementia?

Delirium: sudden (hours-days); Dementia: gradual (months-years)

Course: delirium vs. dementia?

Delirium: fluctuates; Dementia: progressive, steady decline.

Is delirium reversible?

Often, if underlying cause treated (e.g., infection, meds).

What's a hallmark cognitive sign of delirium?

Severely impaired attention.

A 76-year-old alert on admission becomes confused. What suggests delirium over dementia?

Confusion developed suddenly and fluctuates daily.

What tools assess basic cognition in older adults?

Orientation (A&O x4), MMSE, Mini-Cog.

What's a nursing consideration when assessing cognition in older adults?

Distinguish normal aging from delirium/dementia signs.

Normal CV changes with age?

Less elastic heart/arteries, calcium/fat deposits (HTN), less efficient CV system.

Normal respiratory changes with age?

Decreased lung elasticity/chest compliance, decreased cough reflex, less gas exchange.

Normal integumentary changes with age?

Thinner, drier, fragile skin; less subcutaneous fat; slower wound healing.

Normal GI changes with age?

Slower motility (constipation), decreased saliva/gastric acid, less liver function (slower drug metabolism).

Normal GU changes with age?

Decreased bladder capacity, increased residual urine, decreased thirst.

Normal musculoskeletal changes with age?

Decreased bone density/muscle mass, less joint flexibility/strength, slower reaction time.

Normal reproductive changes with age (male/female)?

Slower sexual response. Males: less firm testes, less sperm. Females: vaginal narrowing, less secretions/elasticity.

Normal nervous system changes with age?

Slower processing/reflexes, more vulnerable to delirium, less brain volume/blood flow.

Normal sensory changes with age?

Decreased vision, hearing, taste, smell, touch sensitivity.