Geriatric Nursing Exam 1

signs and symptoms of anemia

Fatigue Shortness of breath Worsening angina/ chest pain Developing or worsening peripheral edema Falls Increased hospitalizations Joint pain Dizziness and mental status changes Confusion, depression, and agitation

PULSES profile

Measures general functional performance in mobility and self-care, medical status, and psychosocial factors; looks at general function (from a more musculoskeletal perspective)

SMART goals

Specific, Measurable, Attainable, Realistic, Timely

programmed theories

the view that aging is the result of genetics

evaluation of environment

- Functioning is influenced by the context of the client's environment - Assessment should be done with the thought of the patient using the environment and what they will be doing in the environment - Client-centered - Know their roles

Roles of Gerontological Nurse

- advocate - educator - manager - consultant - researcher

Erikson's Developmental Theory

-A psychological theory that includes eight stages of life. -older adults are in the "Integrity versus despair" category -->during this stage, the older adult will become preoccupied with acceptance of eventual death without becoming morbid or obsessed with these thoughts -->Older persons who have not achieved ego integrity may look back on their lives with dissatisfaction and feel unhappy, depressed, or angry over what they have done or failed to do

Characteristics of the The Culturally Skilled Institution

-Adequate interpreter services and availability of translated forms -Diversity of policy making board and staff -Use of cultural guides or cultural brokers -Training of staff for intercultural interactions -Multicultural expertise in ethics committees -Institutional multicultural task force to identify needs and recommend innovations

Problems with History Taking in the Geriatric Client

-Age (longer story to tell, Need to pick out right qs) -Memory (may not be as sharp) -Tendency to under report (Ask right qs) -Communication difficulties (hard of hearing, stroke (aphasia), can impact this)

aspects of a client's Psychological history

-Any history of past mental illness -Any hospitalizations or outpatient treatments for psychological problems -Current and past stress levels and coping mechanisms -Current and past levels of alcohol or recreational drug use -Medications taken for anxiety, insomnia, or depression -Identification of any problems with memory, judgment, or thought processing -Any changes in personality, values, personal habits, or life satisfaction -Identification of feelings regarding self-worth and hopes for the future -Feelings of appropriate emotions related to present life and health situations (feelings of sadness regarding losses, etc.) -Presence of someone to love, support, and encourage the older patient -Feelings of hopelessness or suicidal ideation

Goals of Healthy People 2020

-Attain high, longer lives free of preventable disease, injury, and premature death. -Achieve health equity, eliminate disparities, and improve the health of all groups. -Create social and physical environments that promote good health for all. -Promote quality of life, healthy development, and health behaviors across all life stages.

Qualities of the Culturally Skilled Provider

-Awareness of one's personal biases and their impact on practice -Strong knowledge base in cultural diversity and risk factors for disease by ethnic population among older adults -Ethnically appropriate methods of showing respect

Nursing Interventions for Altered Health Maintenance Goals

-Become physically active -Make smart food choices -Get regular health screenings -Follow your healthcare provider's recommendations to manage chronic health conditions and risks to your health -Participate in activities you enjoy

Myths of Aging

-Being old means being sick -Most older people are set in their ways and cannot learn new things or take up new activities -Health promotion is wasted on older people -Older adults do not pull their own weight and are a drain on societal resources -Older people are isolated and lonely -Older people have no interest in sex

Characteristics of Competency

-Can comprehend information (understand) -Understands options provided by provider (reason) -Evaluate risks and consequences (problem solve) -Communicate that decision (decision making)

wear and tear theory

-Cells and organs have vital parts that wear out after years of use. -Abusing or neglecting one organ or body system can stimulate premature aging and disease -gradually deteriorates and finally wears out

Difficulties with Physical Examinations in the Geriatric Client

-Comorbidities -Polypharmacy → taking multiple medications typically from a variety of providers -Lack of standards → no specific geriatric lab value standards -Altered disease presentation (ex: UTI may present differently than an adolescent) -Normal aging changes

Standards of Health Insurance Portability and Accountability Act (HIPPA)

-Confidentiality-->Only the right people can see protected information. -Integrity-->The information is supposed to be without alteration or destruction. -Availability-->The right people can see it when needed -The information is protected against reasonably anticipated threats and hazards to its security or integrity -The information is protected against reasonably anticipated uses and disclosures not permitted by privacy rules. -The provider will ensure compliance by the agency workforce

Benefits of Healthy Aging

-Creativity and confidence are enhanced -Coping ability increases -Gratitude and appreciation deepen -Confidence increases with less reliance on the approval of others -Self-understanding and acceptance increase -Opportunity to enjoy more time with family and friends arises

Contextual Variables Affecting Holistic Geriatric Assessment

-Evaluation of the environment -Accuracy of the health history -Social history -Psychological history -Home environment -Culture and education

Most Common Causes of Disability in the United States

-Heart Disease and Stroke -Diabetes Care -Arthritis and related conditions -Obesity -Smoking-related illness (most expensive) -Alcohol abuse

Important Geriatric Assessment Points

-Level of acculturalization -Cross-gender assessment -Presence of family members -Who is the decision maker? -Dementia and depression stigmatized in many cultures -What types of treatments are culturally acceptable? -What types of treatments are culturally acceptable?

Reasons for Decreased Hemoglobin/ Hematocrit Values in the Elderly

-Malnutrition (can then cause anemia) -Source of bleeding -Hypovolemia -Diarrhea -Kidney disease

What does it mean to become older?

-More likely to be hospitalized -Many have multiple coexisting and complex medical problems -Many take multiple medications -Most vulnerable to iatrogenic events -Many physical changes

Role of Nurse in Patient and Family Teaching

-Nurses assume the role of teacher and coach, teaching the key concepts of gerontology and gerontological nursing

Reasons for Interdisciplinary Collaboration to Improve Care

-Older adults may face a multitude of complex problems requiring assessment and intervention from various healthcare professionals -Assembling a group of knowledgeable providers can enhance problem solving and the delivery of healthcare -Coordination of services can be enhanced by various professionals working together -The patient will have access to a comprehensive and integrated care plan -Care can be safer for patients, more cost effective, and efficient -Healthcare professionals can feel supported and encouraged by the input and collaboration from other professionals. -can decrease feelings of burnout when caring for older patients with complex health needs

Effects of ethnocentrism

-Own beliefs empower misinterpretation and miscommunication -Stereotypes can guide practitioner behavior toward the older adult -We must understand how others look at healthcare and the origin of disease in their bodies

aspects of a client's social history

-Past occupation and retirement status -family history (helpful to construct a family genogram) -Present and former marital status, including quality of the relationship(s) -Identification of family members, with designation of level of involvement and place of residence -Living arrangements -Family dynamics -Family and caregiver expectations -Economic status, adequacy of health insurance -Social activities and hobbies -Mode of transportation -Community involvement and support -Religious involvement and spirituality

residential care facilities

-Previously called rest homes -large private homes have been converted to provide rooms for residents who can provide most of their own personal care, but may need help with laundry, meals, and housekeeping -Supervision and health monitoring are usually provided

Examples of Quality and Safety Education for Nurses (QSEN)

-Putting patients on ventilators in a prone position can improve their lung function and get rid of the stuff in the lungs -Taking the mattresses and putting them on the floor (decreased falls by 42%)

Mandates for Long Term Care Facilities

-The presence of an RN at all times to provide oversight, assessment, staff supervision, and delegation of care -The Director of Nursing (DON) be either prepared at the baccalaureate level or certified in geriatric nursing -The hours of direct nursing care for each resident should be at least 4.1 hours/resident day with a minimum of 30% of care provided by licensed nurses -Skilled-nursing-facility residents may have higher clinical acuity, thus requiring more than 4.1 hours per resident as the minimum standard of care -Administrative nursing positions should not be counted as contributing to the ratio calculation of direct nursing hours per resident.

Mini-Cog Test

-Use for cases in concern with forgetfulness or mental status -consists of three item recalls and a clock drawing test (CDT) -takes about 3 minutes to administer and is not affected by language, education, or culture -can differentiate older persons with dementia from those without dementia

Components of End of Life care

-Varying acceptability of discussion of death or disability -Variation by ethnic group and subgroup in knowledge of advance directives -Cultural rituals and traditions at the time of death -Biomedical model of autonomy in decision making that does not recognize cultural expectations that others (e.g. family, son, clan leader) would make healthcare decisions for elder

Things to do prior to Cultural and Heritage Assessment

-What language the person speaks -The degree of fluency in the English language -The older person's communication patterns, space, and privacy preferences

Differences amongst Gender in the Older Population

-Women comprise the majority of the older population. This is thought to be because they have historically acted more so as caretakers/more passive roles compared to physical, industrious work men usually did -In the U.S., the ratio of men to women over the age of 65 is 49 men to every 100 women. -Older women face different socio-economic circumstances than men as they age.

Health Status

-a description of the health of the total population, using information representative of most people living in this country -The leading causes of death are used frequently to describe the health status of the nation.

culture and education

-assess educational level, language barriers, reading levels, and cultural background before using standardized instruments -It is important to understand and elicit the beliefs, attitudes, values, and goals of older people relating to their lives, illness, and health states in order to provide culturally appropriate care

Duties of the Gerontological Nurse

-assessing a patient's cognitive abilities -evaluating a patient's acute or chronic condition -educating patients on ways to prevent falls or injuries -organizing medications -linking patients with community resources -watching for signs of elder abuse -helping patients with daily grooming needs -giving advice on disability-related problems

Katz Index of Independence in Activities of Daily Living

-assessment of level of independent functioning and type of assistance required in six areas of ADL -evaluator observes activity performance or interviews the individual about performance -Bathing, dressing, toileting, feeding, transferring Population: Adults and elders with chronic illness (not in assisted living facility)

Role of Gerontological Nurse: researcher

-collaborates with established researchers in the development of clinically based studies, assists with data collection and the identification of appropriate research sites, communicates relevant research findings to others, and participates in the presentation of findings at gerontological conferences and publications

Role of Gerontological Nurse: consultant

-consults with and advises others who are providing nursing care to older patients with complex healthcare problems -participates in the development of clinical pathways and quality-assurance standards and the implementation of evidence-based practices

Evaluation

-final component of the nursing process -It considers information from the physical, social, and psychological assessment of the patient. -a nurse systematically gathers and records actual patient outcomes and compares these outcomes to the patient outcomes set as goals in the nursing care plan.

Role of Gerontological Nurse: educator

-organizes and provides instructions regarding healthy aging, disease detection, treatment of disease, and rehabilitation to older patients and their families -participates in in-service education, continuing education, and training of ancillary personnel as appropriate

Rehabilitation hospitals or facilities

-provide subacute care to patients with complex health needs -these patients may have head injuries or be on ventilators, require aggressive rehabilitation after injury or surgery, or require services and intensive treatments from specialists such as physical therapists, occupational therapists, dietitians, and physiatrists -Usually the patient's private insurance or Medicare cover rehabilitation in these facilities

retirement communities

-range in size and scope of services -Residents can move from one level of care to another as their situation demands -Nurses help maintain their health and check in to assist with anything -offer a diverse range of services from the narrowest offering of independent apartments to others with a clubhouse with activities -Some have indoor or outdoor pools, dining rooms with optional meal services, healthcare facilities, and a range of housekeeping services -Usually the resident pays an admission fee and then a monthly fee for rent and services Some communities have 24-hour supervision and concierge services

goal of care planning

-should be individualized to reflect the older adult's values -The overall goals of nursing care are to influence health outcomes, to improve or maintain the older person's health status, or to provide comfort care at the end of life

research agenda

-used to provide evidence-based nursing interventions to their patients. -work in research teams and collaborate with nursing colleagues with advanced education and research training. -always be learning and always changing

Populations within Spector's Cultural Care Nursing

1) Nurse 2) Older person 3) Direct caregiver

types of programmed theories

1) Programmed Longevity 2) Endocrine Theory 3) Immunological

end-of-life issues

-variety of legal and ethical issues ​​-An older patient who is approaching death may not be able to make ongoing treatment decisions. -Confusion as to how to provide appropriate care -If the person has named a healthcare proxy to make a decision or has an advance directive such as a living will, then healthcare professionals will have guidance through the decision-making process at the end of life -Do not resuscitate (DNR) and Allow natural death (AND)

Community Nursing Care (Visiting Nurse Service)

-visits on a regular basis to monitor vital signs, provide education or counseling, administer intramuscular injections, change a dressing and deliver wound care, and provide supervision to home health aides or homemakers. -Usually Medicare covers it during the period when there is a need for skilled nursing services, under the direction of a physician

Transitional-care units

-within acute-care hospitals -provide subacute care, rehabilitation, and palliative-care health services to patients who no longer require acute care -Most of these patients are recuperating from major illness or surgery, have complex health-monitoring needs, or require palliative care with pain and symptom control -Diagnostic and support services of the acute-care facility support the care given on transitional-care units as needed -Keeping patients safe and comfortable

components of cultural competence

1) Knowing the prevalence, incidence, and risk factors (epidemiology) for diseases in different ethnic groups 2) Understanding how the response to medications and other treatments varies with ethnicity 3) Focusing on relational ethics and identifying the culturally held beliefs and attitudes toward illness, treatment, and the healthcare system 4) Keeping an open mind and approaching each older person as a unique individual.

Components of Comprehensive Geriatric Assessment

1) Physical, psychological, and socioeconomic factors interact in complex ways to influence the health and functional status of the older person 2) Comprehensive evaluation of an older person's health status requires an assessment in each of these domains 3) Functional abilities should be a central focus of the comprehensive evaluation to determine overall health, well-being, and the need for social services

Types of Biological Aging Theories

1) Programmed Theories - Aging follows a biological timetable 2) Error Theories- Emphasizes environmental assaults to the human system

the 3 elements of the scope of practice

1) Quality of care 2) Evidence based actions and interventions 3) Safety

goals of delivering culturally competent care

1) To develop cultural and linguistic competence by nurses and other healthcare providers. 2) For healthcare organizations to understand and respond effectively to cultural and linguistic needs.

Types of Psychological Aging Theories

1. Jung's theory of individualism 2. Erikson's developmental theory

Spector's Cultural Care Nursing

A holistic model delivered with empathic awareness of the older person's (individual, family, and/or community) beliefs about health, illness, and healing

immunological theory

A programmed decline in immune-system functions leads to an increased vulnerability to infectious disease, aging, and eventual death

Jung's Theory of Individualism

A psychological theory that states that as a person ages, the shift of focus goes from extroversion to introversion. -At this stage of life, the older person will search for answers to many of life's riddles and try to find the essence of the "true self."

Healthy People 2020

A set of disease prevention and health promotion objectives for Americans to meet during the second decade of the new millennium

Role of Gerontological Nurse: advocate

Advances the rights of older persons and educates others regarding negative stereotypes of aging

Programmed Longevity Theory

Aging is the result of the sequential switching on and off of certain genes, with senescence defined as the point in time when age-associated functional deficits are manifested

Functional Health Pattern Assessment

An interrelated group of behavioral areas that provides a view of the whole person and his/her relationship with the environment

ADPIE (Nursing Process)

Assessment Diagnosis Planning Implementation Evaluation

aspects of ethical decision making

Assessment Relevant contextual factors Capability of the patient to make decisions Patient preferences Needs of the patient as a person

Accuracy of Health History

Clear instructions should be provided to the patient and family beforehand regarding the parking arrangements and registration process -The dates of hospitalizations, operations, serious injuries or accidents, procedures, and so on can be ascertained beforehand to save time during the assessment appointment -The form would also include history of adverse drug effects or allergies. Instructions to bring in all prescription, over-the-counter, and herbal medications for review by the gerontological nurse. Instructions to bring any medical records, laboratory or X-ray reports, electrocardiograms, reports of vaccination, and other pertinent health records that the patient or family may possess -Instructions to write down and bring the names of all healthcare providers involved with the patient's health care, including primary-care providers, specialists, and alternative-medicine practitioners (e.g., acupuncturists, massage therapists, chiropractors)

secondary prevention

Efforts to limit the effects of an injury or illness that you cannot completely prevent - focuses on early identification of individuals or communities experiencing illness, providing prompt treatment, and conducting activities that are geared to prevent worsening health status

primary prevention

Efforts to prevent an injury or illness from ever occurring.

Modifiable risk factors

Factors contributing to the development of a noncommunicable disease that can be altered by modifying one's behavior or environment

Non-modificable factors

Factors contributing to the development of a noncommunicable disease that cannot be altered by modifying one's behavior or environment; these are innate

What diseases were responsible for 2/3 of all deaths in 2013?

Heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD), and diabetes

example of secondary prevention

Hepatitis B & C screening, Screening questions and health assessment (use of standardized assessment instruments appropriate for older adults, including function, cognition, mood, mobility, pain, skin integrity, quality of life, nutrition, neglect, and abuse), Referral for examination and testing, Disease cure and aggressive treatment to limit disability and stop disease progression

examples of primary prevention

Immunizations, Yearly Blood Pressure screening, education of harmful effects of tobacco use, Education about a healthy lifestyle, Injury prevention, Nutritional assessment and guidance, Exercise prescriptions as appropriate, Avoidance of tobacco, Moderation of alcohol, Education regarding importance of health screenings and vaccinations

Professional Liability Insurance

Insurance that covers persons engaged in various occupations against liability resulting from their rendering or failing to render professional services -pays financial damages should they be the target of a lawsuit

Common Cultural Conflicts

Language Dietary blunders Missed cues Misunderstandings Religious holidays Family dynamics Violation of manners End of life

signs and symptoms of B-12 deficiency

Numbness or tingling in the fingers and toes Poor balance and coordination Forgetfulness Depression Confusion Difficulty thinking and concentrating Impaied judgement Poor control of impulses Decreased ability to sense vibrations Tinnitus dementia

Areas of Assesment in PULSES Profile

Physical condition, Upper limb function, Lower limb function, Sensory components, Excretory functions, Support factors

Reasons for Increased Hemoglobin/ Hematocrit Values in the Elderly

Polycythemia (increase in Hemoglobin) Dehydration (increase in Hematocrit)

skilled nursing facilities

Residents receive skilled care from nurses and others. Care may be sub acute (Medicare reimbursed, short stay) or chronic (private pay or Medicaid) for older adults requiring custodial care and assistance with activities of daily living

things to check for in home environment of a client

Stairs Bathing and toileting Medications Advance directives Nutrition and cooking Falls smoke/carbon monoxide detectors Emergency numbers Temperature of home and water Safety of the neighborhood financial

Transcultural Nursing Society's Standards for Cultural Competence

Standard 1: Promotes social justice for all people Standard 2: Engages in ongoing personal reflection to recognize that personally held values, beliefs, and cultural heritage affect the delivery of nursing care Standard 3: Recognizes cultural diversity and its impact upon traditions, values and beliefs regarding healthcare in older persons and families receiving care Standard 4: Engages in competent cultural nursing practice based on cross-cultural knowledge and highly sensitive nursing skills Standard 5: Meets the language, translation and cultural needs of older persons by devising and implementing the necessary structure and supports in healthcare systems and organizations Standard 6: Provides patient advocacy and empowerment in support of cultural beliefs, applied to all facets of health care Standard 7: Supports the education and development of a multicultural workforce Standard 8: Develops education and training in culturally competent care Standard 9: Supports both verbal and non-verbal cross cultural communication skills Standard 10: Provides cross-cultural leadership to influence others and serve as a role model in the provision of culturally competent nursing care Standard 11: Establishes comprehensive policies for cultural care at the local, regional and national levels Standard 12: Implements evidence-based practices that are effective in diverse cultural populations

activity theory of aging

The psychosocial theory that life satisfaction in late adulthood is highest when people maintain the level of activity they displayed earlier in life -By staying active and extending the activities enjoyed in middle age, the older person has a better chance of enjoying old age -Happiness and satisfaction with life are assumed to result from a high level of involvement with the world and continued social involvement

continuity theory of aging

The view that in aging people are inclined to maintain, as much as they can, the same habits, personalities, and styles of life they developed in earlier years -Everything stays in place -Older age is not viewed as a time that should trigger major life readjustment, but rather just a time to continue being the same person

Do Not Resuscitate (DNR)

a designation placed on a patient's medical record indicating that in the case of cessation of circulation and breathing, artificial resuscitation (CPR) is not to be done.

Resident Assessment Instrument (RAI)

a federally mandated standard assessment used to collect demographic and clinical data on residents in a Medicare- or Medicaid-certified long-term care facility -determines placement of client within a facility

Geriatric Assessment

a key part of the geriatric evaluation is the systematic evaluation of the older person's level of function and self-care.

scope of practice

a range of nursing function that are differentiated according to the level of practice, the role of the nurse, and the work setting

Minimum Data Set (MDS)

a report that focuses on the degree of assistance or skilled care that each resident of a long-term care facility needs -All residents of facilities that collect funds from Medicare or Medicaid must be assessed using the RAI with this

Clock Drawing Test (CDT)

a technique used in clinical neuropsychological examinations whereby the testtaker draws the face of a clock, usually indicating a particular time, that us then evaluated for distortions that may be symptomatic of dementia or other neurological or psychiatric conditions

error theory of aging

a theory that aging occurs because of environmental forces such as disease that affect the function of cells, causing deterioration

tertiary prevention

actions taken to contain damage once a disease or disability has progressed beyond its early stages

examples of environmental modifications

adequate lighting, decreased background noise, comfortable seating for the older patient and family, easily accessible restrooms, examination tables that can be raised or lowered to assist patients with disabilities, and availability of water or juice for patient use

Communication

an ongoing, continuous dynamic process including verbal and nonverbal signals -Key in establishing a relationship with the patient, give them the best care possible

Allow Natural Death (AND)

an order that no attempts are to be made to resuscitate a patient who stops breathing or whose heart stops beating

Elder Abuse and Neglect

any knowing, intentional, or negligent act by a caregiver or other person that causes harm to people age 65 and older -signs and symptoms may vary according to cultural values

Why do nurses in long-term facilities earn less than their acute care hospital counterparts?

because the care given in these facilities is less valued than the care given in acute care settings -Attracts more LPNs and LVNs than RNs

Endocrine theory of aging

biological clocks act through hormones to control the pace of aging

example of tertiary prevention

cardiac rehabilitation program, Multidisciplinary rehabilitation (physical, occupational, speech, and recreational therapy), Short-term placement in rehabilitation facilities or aggressive in-home rehabilitation, Appropriate services and aids to increase independence (walkers, canes, homemaker/home-health aid, visiting nurse)

Characteristics of Normal Aging

changes in the heart, arteries, lungs, brain, kidneys, bladder, body fat, muscles, bones, sight, hearing, and personality.

home environment

check the adequacy of the home environment and the available resources to maintain adequate levels of function

Standards of Clinical Gerontological Nursing Care

describe the necessary competencies of care for each step of the nursing process

Culturally Competent Nursing Care

effective, individualized care that demonstrates respect for the dignity, personal rights, preferences, beliefs, and practices of the person receiving care while acknowledging the biases of the caregiver and preventing these biases from interfering with the care provided -both parties feel validated and respected

Social History

evaluate social support system; many frail older persons receive support and supervision from family members and significant others to compensate for functional disabilities.

Psychological history

evaluation of psychological and cognitive function

Healthy People 2030

focuses on reducing health problems and improving quality of life for older adults for the year 2030

Non-modificable factors examples

gender, age

Rights of all Geriatric Patients

have a DNRs, bill of rights, HIPAA, Receive individualized care, Be free from abuse, neglect, and discrimination, Be free from chemical and physical restraints, Have privacy, Control their funds, Be involved in decision making., Raise grievances and make complaints, Vote, File lawsuits, Practice religion, Marry, Participate in facility and family activities, Have freedom to leave the facility, Make a will and dispose of property, Enter into contracts *The healthcare facility is required to post the bill of rights in a conspicuous place and list the name and telephone number of the ombudsman so patients know who to contact if they feel their rights have been violated*

central concepts of culture

heritage, diversity, health panoramas, and health/illness

Cause of Folic acid deficiency

inadequate intake/malabsorption of folic acid due to diet and or medications

Nonverbal communication

includes body language such as position, eye contact, touch, tone of voice, and facial expression

Anemia

insufficient hemoglobin content to meet body's needs; decrease in the # of circulating RBCs -Not normal yet many older adults experience due to multiple and chronic comorbidities

continuous-care retirement facilities

life-care communities and offer coordinated independent living in apartments, assisted-living apartments, and nursing-home care

Role of Gerontological Nurse: manager

maintains current relevant information regarding federal and state regulations, and provides nursing leadership in a variety of healthcare settings

Goals of Quality and Safety Education for Nurses (QSEN)

meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work.

Health Insurance Portability and Accountability Act (HIPPA)

national legislation that protects every patient's health information through the establishment of standards and requirements for the electronic transmission of certain health information (eligibility, referrals, and claims)

examples of modifiable risk factors

nutrition, exercise, weight

Adult Day Care Centers

option for older adults with multiple comorbidities or people who require daytime supervision and activities -Sometimes an older person lives with an adult child who may have to work during the day or otherwise be absent from the home -Some offer transportation -Usually the older person and family are offered options for attendance ranging from once a week to daily -usually paid for privately and not covered by insurance -Meals are served, planned activities are provided, and some health services (e.g: Podiatry, immunizations, monitoring of blood pressure, blood glucose testing) may be offered on a private-pay basis -Nurses take vital signs, ensure taking meds

Gordon's Functional Health Patterns

organizes info and makes assessments identifying functional and dysfunctional patterns

Nursing Diagnosis

provides the basis for selection of interventions for which the nurse is accountable

Patient Self-Determination Act (PSDA) of 1990

requires providers to seek informed consent from all patients before they receive health care or engage in a research protocol

Cause of B-12 deficiency

secondary to absorption challenges with GI tract

Areas of Assesment in SPICES Assesment Tool

sleep disorders, problems with eating and feeding, incontinence, confusion, evidence of falls, skin breakdown

Nurse Practice Act

statute in each state and territory that regulates the practice of nursing

Certification

the formal process by which clinical competence is validated in a specialty area of practice, demonstrated through a written exam developed and reviewed by nursing experts

Ethnogeriatrics

the healthcare for elders from diverse ethnic populations -Patients come from all different walks of lives and cultures -Study of the causes, processes, and consequences of race, national origin, culture, minority group status, and ethnic group status on individual and population aging in 3 broad areas of biological, psychological, and social aging

medical pluralism

the intersection of multiple cultural approaches to healing

Prioritization

the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions

Ageism

the prejudice, stereotyping, and scapegoating of people based solely on age

health promotion

the process of enabling people to increase control over, and to improve, their health -Risk for diseases vary by cultural background (i.e. older african americans at higher risk for HTN, prostate cancer)

Goal of Quality Nursing Care for Aging Persons

the provision of high-quality care to older adults -ongoing revision and refinement of standards reflect rapid growth of the practice of gerontological nursing and the challenges that result from the evolving healthcare needs of older adults

Patient Confidentiality

the right to expect that healthcare information will not be disclosed without a patient's authorization -Healthcare providers should not discuss patients in elevators, cafeterias, or other public areas where they can be overheard

disengagement theory of aging

the theory that suggests that successful aging is characterized by a gradual withdrawal from the world on physical, psychological, and social levels -The older person and society engage in a mutual and reciprocal withdrawal -Thus, when death occurs, neither the older individual nor society is disadvantaged, and social equilibrium is maintained.

Possible Problems with General Assesment of Geriatric Patients

to identify and use the strengths of older adults and help them maximize their independence, minimize disability, and where appropriate, achieve a peaceful death.

SPICES assessment tool

used to plan and promote optimal function in older adult (most likely in skilled facility)