Nursing Care of the Older Adult kaplan study guide – Flashcards
Unlock all answers in this set
Unlock answersquestion
Advanced Directives
answer
Documents that express specific end of life decisions. * living will *durable power of attorney for health care
question
Durable Power of Attorney for Health Care
answer
Transfers authority to make health care decisions to a health care agent. *applies only when patient is unable to make decisions for themselves.
question
Living Will
answer
Document that informs the physician that the individual wishes to die naturally instead of using life-prolonging measures and equipment. *2 physicians must agree.
question
DNR
answer
Do Not Resuscitate. Do not attempt to resuscitate the patient.
question
Dementia
answer
A slow, insidious process that results in the progressive loss of cognitive function. * caused by damage to the cerebral cortex
question
Early Signs of Dementia
answer
Forgetfulness Decreased judgment loss of spontaneous emotional response decreased ambition decreased mental abilities
question
Advanced signs of Dementia
answer
inability to communicate loss of contact with the environment total physical dependency total incontinence
question
Delirium
answer
Disturbances in cognition, attention, memory, and perception. Caused by a physiological process that affects ANS
question
Symptoms of Acute delirium
answer
Rapid mood swings Disorganized sleep signals Tremors Rapid speech patterns Loss of attention Rapid onset; lasts hours or days
question
Nursing Interventions for Dementia
answer
Designed to maximize level of funtion Environment modification, activity based therapies Communication Strategies
question
Nursing Interventions for Delirium
answer
Treat pathologic condition Administer fluids, nutrition, oxygen, medications, etc. Control environmental stressors, maintain safety, etc.
question
Sundowning Syndrome
answer
Agitated behaviors of dementia that are worse later in the day
question
Conditions That Cause Delirium
answer
uncontrolled pain infection metabolic disturbances vitamin deficiences uremia, hypoxia hypercalcemia endocrine imbalance myocardial infarction constipation drug toxicity drug withdrawal
question
Depression
answer
Disorder that changes feelings or mood. Hopelessness, sadness, blue acute, reccurent, chronic
question
Signs of Depression
answer
Neglected self care, agitation, stopping normal routines, weight changes, sleeping changes, decreased energy, isolation, etc.
question
Effects of Institutional Placement
answer
Damages self-worth by stripping adult of personal belongings
question
Effects of Loss of Loved Ones
answer
Often feel as though there is no reason for living Loss of emotional support No sources of positive feedback that nourish self worth
question
Body Image Disturbances
answer
Refuses to look at changed body part Unwilling to discuss with others Refuse to participate in own care/rehabilitiation
question
Nursing Interventions For Body Image Disturbances
answer
Identify adult's perception of self Establish a trusting relationship Provide care in non-judgmental manner Encourage to look and touch affected area Focus on abilities, not disabilities Dress in manner that deemphasizes body changes Carefully groomed Coordinate rehabilitative care
question
Symptoms of Low Self Esteem
answer
Disinterested and out of control unkempt or disheveled Slump or slouch Avoid social contact
question
Nursing Interventions for Low Self Esteem
answer
Express feelings and concern Demonstrate acceptance of older adults as people Encourage participation in self-care Provide opportunites for reminiscense Encourage family to participate
question
Relocation Stress Syndome
answer
The physiologic or psychological stress that occurs when a person is transferred from one environment to another.
question
Nursing Interventions for Relocation Stress Syndrome
answer
Encourage verbalization of feelings Discuss reasons for move Include adult in care planning Encourage positive attitude Maintain continuity of care Encourage use of familiar objects
question
Alcohol and Substance Abuse
answer
A response to dealing with stress Baby Boomers expected to increase rates 1/3 addictions occur later in life
question
Suicidal Idealation
answer
Expression of plan for suicide.
question
Internal Role Conflict
answer
Occurs when demands of multiple roles and relationships must be met at the same time.
question
Phases of Grieving
answer
1. Shock and numbness (2 weeks) 2. Searching and Yearning (2 wks to 4 months) 3. Diorientation (4 to 7 months) 4. Reorganization (up to 18 to 24 months)
question
Shock and Numbness Symptons
answer
Disbelief, anger, denial, guilt
question
Searching and Yearning
answer
Despair, apathy, depression, anger, guilt, hopelessnes, self-doubt
question
Disorientation
answer
Depression, guilt, disorganization
question
Reorganization
answer
Sense of release, decreased sense of obsession with loss, renewed hope and optimism
question
Cardiovascular Symptons of Stress
answer
*racing heart *Elevated pulse rate *Increase BP *cold, clammy hands
question
Respiratory Symptoms of Stress
answer
Increase rate and depth Hyperventiliation Acid-base balance compromised
question
Musculoskeletal Symptons of Stress
answer
Increase blood glucose level Increased muscle tension Complaint of tension headaches, teeth grinding, backaches
question
Gastronintestinal Symptoms of Stress
answer
Decreased peristalsis Loss of appetite, nausea, abdominal distention Vomiting, heartburn, ulcers
question
Urinary Symptoms of Stress
answer
Decreased urine production Increased urine frequency
question
Common Coping Mechanisms
answer
Repression Denial Rationalization Intelectualization Displacement Suppresion Projection Substitution
question
Problem-focused Coping Strategies
answer
Attempt to change or eliminate the stressful event or threat.
question
Economic Values of Older Adults
answer
Financial independence is important Affected by the depression "waste not, want not"
question
Nursing Interventions for Spiritual Distress
answer
Determine spiritual practices/restrictions Identify signifcant spiritual support persons Determine how you can meet their needs Provide opportunities for them to express spiritual thoughts Determine spiritual objects that can be used Provide opp. for spiritual guidance Encourage contact with spiritual counselor
question
Orthostatic hypotention
answer
A sudden drop in blood pressure that occurs when a person changes from a laying to a sitting or standing position
question
Health Screenings
answer
Used to identify older individuals who are in need of further, more in-depth assessment Not designed to provide treatment Used to refer to appropriate resource May focus on a single health concern; not comprehensive
question
Health Assessment
answer
Time consuming and done by professional Includes collection of all important health-related data Used to formulate nursing diagnosis and plan patient care
question
Health Interview
answer
Prepare the physical setting Establish rapport Structure the interview Obtain health history Physical assessment
question
Maturbation
answer
Normal and common Distraction used to reduce incidence of public masturbation Or take confused person to room to provide privacy Nurse should not overreact to behavior.
question
Sexual Practice of Males
answer
Delayed reaction to sexual stimuli Orgasm takes longer to achieve and has shorter duration Time between orgasms increases Orgasms might not be achieved every time
