Exam 3: Older Adult Population

Chronological Age

________ = the number of years lived.

Functional Age

________= how well a person functions physically, psychologically, and socially.

Perceived

________ = how old a person appears to be.

C. Functional

________ age is most useful for planning nursing care.

A. Perceived

B. Chronological

C. Functional

D. Actual

The nurse is stereotyping the patient based on ethnicity. Instead, the nurse should ask the patient about any dietary preferences (REMEMBER: ASK, DO NOT ASSUME)

A nurse assumes that a patient will follow a particular dietary practice due to their ethnicity.

Why is this wrong, and what should the nurse do instead?

use a qualified interpreter

A nurse receives an admission, and it is noted that the patient does not speak English. What should the nurse do?

Disengagement

(disengage = withdraw)

________ theory states that older adults typically withdraw from society, allowing them time to reflect on life and be free from societal roles.

Activity

(activity = stay active)

________ theory describes the importance of continued involvement in activities related to aging.

Continuity

(continuity = keep doing what you’ve done)

________ theory states that people tend to maintain patterns developed throughout life.

A. Disengagement theory

An older adult retires, reduces social involvement, and spends more time reflecting on their life. What theory of aging is this?

A. Disengagement theory

B. Wear and Tear theory

C. Activity theory

D. Continuity theory

B. Continuity theory

An older adult who has always enjoyed gardening continues gardening after retirement. What theory of aging is this?

A. Disengagement theory

B. Continuity theory

C. Programmed theory

D. Activity theory

C. Activity theory

A 70-year-old continues volunteering, exercising, attending church, and maintaining friendships despite retiring a few months ago. What theory of aging is this?

A. Continuity theory

B. Functional theory

C. Activity theory

D. Continuity theory

Integrity vs Despair

(fulfillment + meaning vs regret + dissatisfaction)

Older adults (65+) are in what stage of Erikson’s psychosocial development?

Sudden changes are not a result of normal aging and should be investigated for underlying cause.

• infection

• delirium

• medication side effect

• dehydration

• hypoxia

An 86-year old arrives at the ED with a sudden onset of confusion and weakness. The nurse says that “the patient is old, so confusion is expected.”

Why is this interpretation incorrect?

• short-term memory decline

• decreased attention

• learning can still occur

• basic intelligence is maintained

• personality generally remains consistent

Normal cognitive changes related to aging = ________

• Short-sessions

• Written instructions

• Repetition

• Teach-back

• Distraction reduction

• Allow extra time

What teaching methods are effective for educating older adults?

• Cardiac output ↓

• Stroke volume ↓

• Peripheral resistance ↑

---

Need to:

• monitor BP + HR

• monitor response to activity

• watch for fatigue

• allow adequate rest

Normal age-related Cardiac Changes

Decreased…

• lung expansion

• elasticity (recoil)

• cough effectiveness

• gas exchange

---

Need to:

• monitor respiratory status

• encourage deep breathing

Normal age-related Respiratory Changes

declines

Immune response _______ as we age.

signs of infection in older adults may be subtle, and fever should not be relied on alone as an indicator.

Be careful when monitoring older adults for infection because ________.

lower

Older adults have a _______ baseline temperature.

older adults have a reduced ability to respond to heat / cold

A temperature that looks “normal” may actually represent a significant change in an older adult because ________.

dehydration

In older adults, total body water decreases, which increases the risk of ________.

A. True

Older adults are still capable of learning.

A. True

B. False

C. Functional age

---

Functional age reflects the older adult's physical, psychological, and social functioning, making it more useful for determining care needs than chronological age.

The nurse is completing an initial assessment of two older adults who are both 82 years old. Patient A independently manages medications, prepares meals, drives, and participates in community activities. Patient B requires assistance with bathing, dressing, medication management, and ambulation.

Which concept should the nurse use when determining the level of care each patient requires?

A. Chronological age
B. Perceived age
C. Functional age
D. Life expectancy

B. Activity theory

---

Activity theory = continued involvement promotes adjustment and satisfaction in later life.

Quick distinction:

• Disengagement → withdraw from society

• Activity → stay involved and active

• Continuity → maintain lifelong patterns

• Integrity vs. despair → reflect on life with satisfaction vs. regret

A 79-year-old recently retired from a career as a teacher. She continues volunteering at the local library, attends an exercise class three times a week, maintains close friendships, and participates in community activities. She tells the nurse, "Staying busy and connected makes me feel fulfilled."

Which theory of aging is best illustrated?

A. Disengagement theory
B. Activity theory
C. Continuity theory
D. Erikson's integrity vs. despair

A. Ask the patient to explain the practices and their importance.

B. Ask which family members the patient wants involved in healthcare decisions.

D. Use a qualified interpreter if a language barrier exists.

F. Individualize the plan of care based on the patient's stated preferences.

An older adult tells the nurse that they follow several traditional health practices that are unfamiliar to the nurse. Which actions should the nurse take? Select all that apply.

A. Ask the patient to explain the practices and their importance.

B. Ask which family members the patient wants involved in healthcare decisions.

C. Research the patient's ethnic background to make assumptions about which practices they are likely to follow.

D. Use a qualified interpreter if a language barrier exists.

E. Avoid discussing the practices because questioning cultural beliefs could offend the patient.

F. Individualize the plan of care based on the patient's stated preferences.

C. Continuity theory

---

The key phrase is "like I always have."

• Continuity → maintains patterns/interests from earlier life

• Activity → continued involvement generally promotes adjustment

• Disengagement → withdrawal from society

• Integrity → reflecting on one's life with satisfaction

An 81-year-old tells the nurse, "I've always enjoyed gardening and spending time with my family. Even though I'm retired now, I still garden every morning and host Sunday dinners like I always have."

Which theory of aging is best demonstrated?

A. Disengagement theory
B. Activity theory
C. Continuity theory
D. Erikson's integrity vs. despair

C. The client develops sudden confusion that began this morning.

---

🚨 Sudden cognitive or functional change is NOT normal aging.

The nurse is assessing an 84-year-old client during a routine visit. Which finding should the nurse recognize as requiring further investigation rather than being attributed to normal aging?

A. The client takes longer to recall a person's name.

B. The client prefers going to bed earlier and awakening earlier.

C. The client develops sudden confusion that began this morning.

D. The client requires additional time to learn new information.

C. Integrity

---

Integrity = the older adult looks back on their life and feels satisfaction, meaning, and acceptance.

Despair = regret, dissatisfaction, and feeling that life lacked meaning.

An 80-year-old tells the nurse:

"When I look back at my life, I know I made mistakes, but overall I'm proud of the person I've become. I have no major regrets and feel that my life had meaning."

Which developmental outcome is the patient demonstrating?

A. Despair

B. Disengagement

C. Integrity

D. Continuity

C. The patient may have an infection despite the absence of a high fever.

---

Older adults may have subtle or atypical signs of infection.

A lower baseline temperature and reduced immune response mean that an older adult may not develop a classic high fever. New confusion or restlessness can be an important change from baseline.

The nurse is caring for an 86-year-old admitted with pneumonia. The patient's temperature is 98.1°F (36.7°C), but the nurse notices that the patient has become newly restless and confused compared with their baseline.

What is the nurse's priority interpretation?

A. The patient's temperature indicates that infection is unlikely.

B. Restlessness and confusion are expected findings in advanced age.

C. The patient may have an infection despite the absence of a high fever.

D. The patient's cognitive changes are most likely caused by normal aging.

C. Help her identify and participate in social groups or activities that are meaningful to her.

---

Loss of social connections and increased loneliness are important issues for older adults, so the nurse should help them locate and participate in social groups.

An 82-year-old recently lost her husband and reports that she has stopped attending her usual social activities. She says, "I don't really have anyone to spend time with anymore." Which nursing intervention is most appropriate?

A. Encourage her to spend more time alone so she can adjust to the loss.

B. Explain that social withdrawal is an expected and unavoidable part of aging.

C. Help her identify and participate in social groups or activities that are meaningful to her.

D. Encourage her to avoid discussing her husband so she can move forward.

B. An 84-year-old whose daughter reports that he has become suddenly confused and unusually weak since yesterday.

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Sudden confusion + sudden weakness = acute change from baseline.

That is not normal aging and could indicate something serious such as:

• Infection

• Delirium

• Medication effect

• Dehydration

• Hypoxia

The nurse is assessing four older adults. Which patient should the nurse assess first?

A. A 78-year-old who reports needing more time to learn how to use a new smartphone.

B. An 84-year-old whose daughter reports that he has become suddenly confused and unusually weak since yesterday.

C. An 81-year-old who reports waking earlier than usual and taking an afternoon nap.

D. A 76-year-old who reports being satisfied with her life but occasionally reflecting on past decisions.