N163 - Midterm

What is geriatrics?

Geriatrics is the branch of medicine that deals with the diseases and problems of old age

What is gerontology?

Gerontology is the scientific study of the process of aging and the problems of older adults

What is gerontologic nursing?

A nursing specialty involving assessment of health and function in older adults, plus planning and implementing care based on their identified needs

What is gerontic nursing?

The art and practice of nurturing, caring, and comforting older persons; focused on their overall well-being

What is a major focus of gerontology for nurses working with older adults?

Helping maintain the patient's independence and assessing what they can do for themselves

How does overall health affect living arrangements in older adults?

A person's health influences housing choice—housing should promote functional independence while also ensuring safety and social interaction

What are ADLs?

Activities of Daily Living—basic self-care tasks essential for overall health and function

How does education affect an older adult's health?

Low education levels may limit access to care, understanding of health issues, and the ability to follow medical recommendations

Why are many older adults still working past retirement age?

Due to changes in financial circumstances, many continue working to support themselves

How does income impact the health of older adults?

Reduced income can lead to cuts in health-related spending, impacting access to care and the ability to meet basic health needs

What is functional ability in older adults?

The capacity to carry out self-care tasks that maintain health and

What is ageism and how can nurses combat it?

Ageism is societal prejudice against older adults. Nurses should self-reflect and examine their own views to provide unbiased care

What should nurses reflect on when caring for older adults?

Their own biases or assumptions about aging to ensure respectful, individualized care

Why is a baseline assessment important in geriatric nursing?

It helps determine changes over time by documenting initial cognitive and physical functioning

What is the purpose of the nursing health history in older adults?

It's the first step of a comprehensive assessment, providing subjective insight into current and past health status

What is the purpose of the interview in geriatric nursing?

It forms the foundation of a therapeutic nurse-patient relationship focused on mutual concern for the patient's well-being

How can a nurse reduce anxiety during the patient interview?

By explaining the purpose and structure of the questions to help the patient feel more comfortable and willing to open up

Why is it important to ask patients how they want to be addressed?

It shows respect and promotes rapport, supporting patient-centered care

How can patient deficits affect the interview process?

Pain, fatigue, or other barriers can impair communication and data collection—these issues should be addressed first

Why is it important to assess how a client perceives their health?

Their perception affects how they report symptoms, cope with illness, and engage in care

Why should nurses ask about a patient's previous employment?

Some jobs may have exposed patients to health hazards, influencing current health conditions

Why assess for undetected illness when patients attribute symptoms to aging?

Saying "it's just old age" may hide treatable conditions that should not be dismissed

What is a functional status assessment?

It evaluates an older adult's ability to complete both basic ADLs and more complex activities for independent living

What are the Katz and Barthel Indexes used for?

They rank a person's performance in six functions: bathing, dressing, toileting, transferring, continence, and feeding

Which patients are at higher risk for decline in functional status?

Widowed individuals, those without support, or those needing 24-hour care in long-term care or assisted living

How do Katz and Barthel indexes help in nursing care?

They assist in creating individualized, client-specific nursing care plans

What is the leading cause of fatal and nonfatal injuries in older adults?

Falls are the leading cause of both fatal and nonfatal injuries in older adults.

What is the cornerstone of fall prevention and management?

Patient education is the cornerstone of fall prevention and management.

What must gerontologic nurses assess regarding patient beliefs?

They must explore patient beliefs and misconceptions about falling

Which patients are considered high fall risk?

Clients with Parkinson's disease or a history of syncope

Which patient is most at risk for serious injury from a fall?

• A client with mild osteoarthritis in both knees

• A client who uses a walker for ambulation

• A client with a platelet count of 20,000

• A client with a history of urinary incontinence

• A client with a platelet count of 20,000

• A client with a platelet count of 20,000! Indicates severe thrombocytopenia, placing the patient at high risk for bleeding with even minor trauma, including falls.

What nursing interventions help reduce age-related fall risks?

Encouraging slow position changes, assessing balance and strength, and evaluating frailty and functional limitations

Which physical traits place older adults at greatest risk for falling?

Frailty and physical functional limitations, including weakened musculoskeletal strength

What age-related vision changes may impact color perception?

Aging can reduce the ability to see colors, worsened by conditions like diabetes, glaucoma, and macular degeneration

What are driving safety concerns for older adults?

Slow reflexes and reaction time increase accident risk

What is presbyopia?

A condition where the lens loses the ability to focus on close objects due to decreased elasticity and thickening

How can presbyopia increase fall risk?

Poor near vision makes it harder to see step edges or small objects, increasing the chance of tripping

What visual aid can help prevent falls on stairs?

Painting the edges of steps in a contrasting color

What is retinal detachment and how does it occur?

Retinal detachment is when the retina's sensory layer separates from the pigmented layer, caused by trauma, aging, hemorrhage, or tumors

What are visual symptoms of retinal detachment?

Straight lines may appear wavy or crooked, and words on a page may look blurred

What is an appropriate nursing diagnosis for retinal detachment?

High risk for injury related to altered sensory perception

What is cerumen impaction?

A reversible, often overlooked cause of conductive hearing loss due to earwax buildup

What is tinnitus?

A subjective sensation of noise in the ear, described as ringing, buzzing, or hissing

What should you ask patients reporting ringing in their ears (tinnitus)?

Inquire about prescription medications (e.g., aminoglycosides) and hearing aid use

What do hearing aids do?

They amplify sound but do not improve the ability to hear or process sound

How should nurses communicate with a hearing-impaired patient?

Speak clearly and directly, facing the person to facilitate lip-reading and understanding

What is xerostomia?

Xerostomia, or dry mouth, is a subjective sensation of abnormal oral dryness

What risks are associated with dry mouth in older adults?

Increased risk of respiratory infections, impaired nutrition, and reduced communication ability

How can nurses minimize the effects of xerostomia?

By providing appropriate fluids with meals

How can nurses help reduce the impact of impaired immune function in older adults?

By discussing the need for yearly flu shots and infection control strategies

What are strategies to prevent nosocomial spread of influenza?

Early identification and grouping of infected patients, hand hygiene, and use of barrier precautions

What is an atypical presentation of disease in older adults with UTIs?

Confusion may be the only or primary symptom instead of typical urinary symptoms

What is the most common type of incontinence in older adults?

Urge incontinence, often associated with an overactive bladder

What is stress incontinence?

Involuntary urine loss following increased intra-abdominal pressure, common in women

What is overflow incontinence?

Urine leakage due to pressure from a chronically full bladder exceeding urethral resistance

What is functional incontinence?

Urine loss caused by physical, mental, or environmental barriers to timely toileting

What is mixed incontinence?

A combination of two or more types of incontinence: stress, urge, overflow, or functional

Can incontinence be treated or cured?

Yes, with appropriate interventions based on identifying and addressing contributing factors

Why must treatment plans for incontinence consider cognitive status?

Because cognitively impaired individuals rely on caregivers to maintain bladder

What is psoriasis?

An autoimmune disease affecting ~2-3% of the global population and ~2.2% of the U.S. population

How do antibiotics increase the risk of candidiasis?

They disrupt normal flora, making the patient more susceptible to fungal infections like candidiasis

Why is oral care and frequent skin monitoring important in older adults?

For prevention and early detection of conditions like infections or skin breakdown

What is an important nursing care tip for herpes zoster?

Keep the rash clean to prevent secondary infections

What is a clinical hallmark of melanoma?

An irregularly shaped mole, papule, or plaque that changes, especially in color.

What is pruritus?

An intense itching sensation often caused by dry skin (xerosis)

What is a nursing diagnosis related to pruritus and scratching?

Potential for infection resulting from impaired skin integrity

What should the evaluation of pruritus-related interventions focus on?

Symptom relief, preventing complications, and identifying the underlying cause

What nursing advice is given to relieve pruritus?

Apply emollients like Lubriderm or Eucerin and avoid scratching the skin

What causes arterial ulcers and where are they located?

Caused by arterial insufficiency, usually found on toes, feet, or lower leg, with shiny, cool, hairless skin and irregular wounds

What causes venous ulcers and where are they located?

Caused by venous hypertension, usually on the medial lower leg, shallow or flat with irregular shapes

What causes diabetic foot ulcers and where are they found?

Caused by neuropathy, located on the plantar foot, often circular, deep, and painful with reduced sensation

What are the two primary scales for pressure injury risk?

Norton Scale and Braden Scale

What score on the Norton Scale indicates pressure injury risk?

A score of 16 or lower

What Braden Scale score indicates high risk for skin breakdown?

A score below 18; 13 indicates high risk for pressure ulcers

What is a key intervention for a low Braden Scale score?

Turn the client frequently to relieve pressure and reduce risk of skin breakdown

How does turning and placement help in pressure injury prevention?

It reduces the effects of pressure but not its intensity; recommended every 2 hours by AHRQ guidelines

What is sleep latency and how does it change with age?

Sleep latency is the delay in sleep onset; it increases with age. Over 30% of women take more than 30 minutes to fall asleep, compared to under 15% of men

What causes increased napping and decreased nighttime sleep in older adults?

Age-related changes in circadian sleep regulation contribute to more daytime naps and less nighttime sleep

What sleep pattern changes are common in older adults?

They report longer times to fall asleep both at bedtime and after nighttime awakenings

What occurs during sleep apnea?

Repeated episodes of respiratory cessation during sleep, lasting from 10 seconds to 2 minutes

What are common signs and symptoms of sleep apnea?

Waking with headaches or sore throat, loud snoring, and gasping for air during sleep, often reported by family

What nonpharmacologic therapies are recommended for promoting sleep in older adults?

Relaxation techniques, stimulus control, sleep restriction therapy, and cognitive behavioral therapy

Why should tranquilizers and sedative hypnotics be avoided in older adults?

They are listed on the 2015 Beers Criteria as potentially inappropriate medications for promoting sleep in older adults

How can nurses support uninterrupted sleep in hospitalized older adults?

By assessing the patient 2 hours early and adjusting schedules to allow at least 4 hours of uninterrupted rest

Which age group of men reports the highest rate of depressive symptoms?

Men over age 85 report nearly double the rate of depressive symptoms compared to men aged 65-74

What medical conditions are commonly associated with depression in older adults?

HALVAMS

H – Hepatitis

A – AIDS

L – Lupus

V – Vitamin deficiencies

A – Anemia

M – Multiple sclerosis

S – (Hypo)thyroidism

Where can delirium occur in older adults?

In homes, assisted living, nursing facilities, and hospitals

Why might delirium in a community setting lead to hospital admission?

Because it often signals a serious underlying illness that requires immediate medical attention

What is the nursing priority in managing delirium?

Identify and treat the underlying cause of the delirium

How is delirium different from dementia?

Delirium has an acute onset, whereas dementia develops gradually over time

What are common interventions to prevent delirium in hospitalized older adults?

Maintaining orientation, ensuring proper hydration, promoting sleep, managing pain, and minimizing unnecessary medications

What medications can mimic symptoms of dementia?

Sleeping pills, tranquilizers, and pain medications

Why should a client's medications be reviewed for cognitive changes?

Some drugs, like Ambien, can affect cognition, necessitating review when changes are noted

What is dementia, and what is the most common type?

Dementia is a later-life condition caused by neurologic disease; Alzheimer's disease is the most common form

How does reality orientation help patients in early-stage dementia?

It supports memory and helps maintain independence; pictures may be more effective than written signs as dementia advances

What is the only definitive method to diagnose Alzheimer's disease?

Autopsy remains the gold standard for diagnosis

How can drugs negatively impact older adults?

They may affect cognition, emotion, mobility, continence, and other essential functions

Are drug-food interactions a concern in older adults?

Yes, although less common than drug-drug interactions, they can still alter a drug's metabolism or effect

What are drug-disease interactions?

When a drug worsens an existing condition or interferes with recovery, making it inappropriate for patients with specific illnesses

Why is it important to know a drug's side effects and required labs?

Especially for older adults, to monitor for complications and safely introduce new medications