Geriatrics Study Guides 1-4 for Final

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Abuse/neglect by family and caregivers-: intentional or non intentional. Due to high stress levels of continual demands. Advance directives and Living Will-: legal documentation that specifies type of care and treatment individual desires when they cannot speak for themselves. Two types- durable power of attorney- appoints someone to make Decisions only when person is unable to. Living will- informs the physician that the individual wishes to die naturally. Prohibits life prolonging measures. Two physicians must agree in writing.

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Economics of aging-: income is not an accurate measure. They have more discretionary income. Erickson's theory-: integrity vs despair Flu and pneumonia shots-: flu every year in fall so the level of immunity is high before the risk of exposure. Pneumonia shots given every 5 years.

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Folic acid anemia-: poor nutrition, alcohol abuse, crohns Free radical-: free radicals normally appear in the body. They are unstable molecules produced by exposure to radiation and pollution.

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Age cohort-: a group of people born within a specified time period. Ex. Baby boomers Ageism-: extreme gerontophobia. The disliking of aging and older people based on the belief that aging makes people unattractive, unintelligent, and unproductive.
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Gene theory-: activation of one or more harmful genes. Gerontophobia-: the refusal to accept older adults into the mainstream of society. Glaucoma-: test anyone over age 40. Tunnel vision and eventually blindness occurs. Can be treated if no damage is done. Housing arrangements-: more than 2/3 older adults live independently in a family setting. How can you encourage physical activity in a wheelchair bound patient?: encourage them to move their arms and feet whenever possible.

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Angina pectoris-: chest pain. Causes vague gi symptoms. No oxygen to muscle causes the pain. Baby boomers-: born after WWII between 1946 and 1964. Makes up 1/3 of Americans today. Benign prostatic hyperplasia-: urinary retention due to prostate enlargement Can you trim diabetic toenails?: NO!!!! Cataracts-: common. Clouding of the eyes. Vision in bright light or glare may be particularly difficult. CHF-: caused by many disorders such as mi, htn, valvular disease, cardiac infection. Congested lungs, shortness of breath. (left side failure) edema weight gain rt side failure. Paroxysmal nocturnal dyspnea sudden night difficulty breathing.

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How do we assess skin conditions in different ethnic groups?: Check nail beds & mucous membranes. Skin will be purple instead of red in people with darker skin when bedsores are present.

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How do we position our patients for better breathing?: position them as upright as possible. High Fowlers How much urine does the geriatric bladder hold?: 150200 ml How often do we bathe geriatric patients?: 1-2 times a week Hypothyroidism-: is commonly overlooked in older people due to s/s: cold intolerance, dry skin, dry and thin body hair, constipation, depression, depression, and lack of energy.

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COPD-: sob, common in people with a history of exposure to environmental pollutants or a history of smoking. Combination of 3 conditions: asthma, emphysema and chronic bronchitis.

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Define activity intolerance:: a state in which a person has insufficient physiological or psychological energy to endure or complete necessary or desired daily activities.
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Define Insomnia:: Chronic inability to sleep or to remain asleep throughout the night; wakefulness; sleeplessness.
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Iron deficiency anemia-: too little iron in the diet. Loss of blood. Bleeding ulcers. Know how integumentary changes effect the elderly.: Skin tear prone. Prone to decubs bruising. Dry itchy loss of adipose tissue- cold intolerance, wrinkles, pallor.

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Define Pruritis: Itching; an uncomfortable sensation leading to the urge to scratch, which may result in a secondary infection.
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Define Sleep Apnea:: "without wind" & at night. 3 typesObstructive, central, and mixed sleep Define: Constipation: hard, dry stools that are difficult to pass Define: Gingivitis: Inflammation of the gums Define: Halitosis: Bad breath Define: Impaction: the presence of a mass of hardened feces that is trapped in the rectum and cannot be expelled, is a result of nrelieved constipation.
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Know nursing interventions for differing eye disorders we discussed.: Eye drops, regular checkups. Left side damage due to stroke-: language behavior changes mood changes high fall risk Maximum amount of time patient should lie in one position?: 2 hours Medicare-: government program for those over 65. Part A pays only after deductible.hospital. Most commonly reported environmental factor that disturbs sleep?: excessive noise, light, activity, or other distracting stimuli.

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Degenerative joint disease-: includes osteoarthritis, which is the most common. Jobs that involve placing a high amount of physical stress on certain joints are likely to experience changes in these joints later in life.

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Discretionary income-: money left over after paying for necessities.

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Myocardial infarction-: heart attack.chest pain, narrowing due to atherosclerosis sob gi tract upset Name some physical changes the elderly experience that slow them down.: decreased muscular strength, joint inflexibility, decreased agility, decreased dexterity, decreased stamina.

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Should you massage redness?: NO!!!!! massage around to encourage blood flow but never on! Tia/cva (stroke)-: Tia small strokes don't cause permanent damage. Cva either cerebral infarct (embolus or thrombus) or cerebral insufficiency (restricted blood flow)

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Toileting schedule:: begin by scheduling toileting at 2 hr intervals and gradually increase as is tolerated. What are scabies?: Contagious disease caused by a mite, characterized by intense itching of the skin and excoritaion from scratching.

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Newman's theory-: defines the tasks of aging. Adjusting to decreased physical strength. Redirecting energy into new roles. Retirement grandparenting finding new friends and widowhood. Accepting ones own life developing a point of view about death.
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Osteoarthritis-: most common, cause unknown. breakdown of joint cartilage. wear and tear Osteoporosis-: excessive calcium loss, increase in fractures, can be spontaneous Porous bones.

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What are Shingles?: they are caused by the same virus that causes chickenpox and can be spread to people who have not had chickenpox.

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What are some foods that older adults prefer that would add fiber to their diet?: cereals, whole wheat breads, bran muffins, and prunes

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Parkinson's disease-: degenerative disorder of cns s/s tremors rigidity, slowed movements, decreased eye blinking, loss of center of gravity. It is important to minimize frustration, emotional upset, stress, and fatigue.
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What are some functional problems related to toileting?: can't recognize a toilet, can't get zipper or button open, toilet is too far to get to in time, physically unable to get to bathroom.

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Paroxysmal nocturnal dyspnea-: sudden attacks of sob during the night.

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What are some high risk areas for skin areas for skin breakdown?: Ischium, Ear, Heel, Elbows, Scapula What are the names of the skin assessments scales?: Braden and Norton Scales What common vital changes might occur when walking a patient?: Tachycardia, blood pressure changes (orthostatic hypotension), dizziness, lightheadedness, fatigue, angina, respiratory changes?

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Part B, Part C and Part D Medicare-: Part B pays 80% of physicians charges after deductible. Part C must be eligible for a & b. Pays through private insurance. Part D must be eligible for a & b and is prescription drug coverage.
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Pernicious anemia-: a lack of intrinsic factor that causes a decrease in the absorption of b12. Presbycusis-: alteration in hearing. Lose the ability to perceive higher frequencies.

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What do we do on off days?: sponge baths, face, axilla and perineum care, oral care. What is a foot specialist called?: Podiatrist What is the first sign noticed by the elderly that they are experiencing some change in their ability to perform activity?: Decrease in their rate or speed

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Pressure ulcer stage 2: abrasion, blister, or shallow crater. Pressure ulcer stage 3: necrosis of subcutaneous tissue may extend down to, but not through underlying fascia. Deep crater with or without undermining adjacent tissue.
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Pressure ulcer stage 4: tissue necrosis, damage to muscle, bone or supporting structures.
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What is the most significant issue that aging parents and their children must face?: Loss of independence. What methods/equipment could you use to help your patient breathe better?: sit upright as possible, pursed lip breathing, oxygen, spirometers, plenty of fluids, stress reducing techniques?

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Pressure ulcers stage 1: intact nonblanchable erythemia skin. Pruritis-: itching Rheumatoid arthritis-: chronic disease that causes inflammation of the joints and surrounding tissues.. Cause unknown. Autoimmune disorder. Ra at any age. Women affected more than men.
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What physical activity can you help your patient participate in while performing ADL's such as bathing?: perform PROM with daily care

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Right side damage due to stroke -: poor judgement inappropriate responses disoriented high fall risk. S/S of anemia-: pale skin, fatigue, irritability, weakness, sob, brittle nails, pica, decreased appetite, headache Self neglect-: failure to provide for self because of a lack of ability or lack of awareness. Senile lentigo-: age spots Senile purpura-: bruising. Walls of capillaries become fragile and may hemorrhage causing red and brown areas. Shingles, also known as Herpes zoster....: is not related to the sexually transmitted herpes virus disease called herpes genitalis.
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What position do you take when walking a patient?: slightly behind the patient holding on to one arm with your hand and firmly grasping the middle of their back (gown, gait belt, etc.) with the other hand. What problems can ocur with digital disimpaction?: loss of consciousness due to vagal response What type of injuries could an enema cause?: damage of the rectal mucosa and contribute to electrolyte imbalance When a person complains of pain, using the nursing process what is the first thing we should do?: Assess.

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When should you consider inserting a Foley?: after getting Dr's orders, post op pts, urinary retention, residual urine, when benefits ouweight the risks. Never for staff's convenience. Who should be included in planning your patient's care?: the patient, family members, other healthcare professionals such as PT, OT, ect. Why do elderly lose overall height?-: due to loss of the fluid in the disks between the vertebrae. Xerosis-: dry skin

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