OA chapters 15-18

-only __________________ with sensorineural health loss perseus amplification

1 in 5

__________________ modifications are effective for improving safety and functioning for those with dementia

Environmental

______________________ of delirium include decline in functioning, increased mortality, and permanent residency in long-term care facilities.

Functional consequences

_______ ear and _____________________: fewer neurons and hair cells, diminished blood supply, degeneration of spiral ganglion and central processing systems

Inner, auditory nervous system

cerumen becomes ________________ and _________________, which increases the risk for impaction

dryer, more concentrated

____________________________________ has been shown to be effective under the following circumstances: ~geriatric major depression ~antidepressants aren't effective ~severe risk of suicide and depression with psychosis ~when patient's health is significantly compromised due to depression

electroconvulsive therapy (ECT)

______________________________________ involves the electrical induction of seizures to treat depressive episodes

electroconvulsive therapy (ECT)

Ongoing assessment of consequences also includes attention to the _____________________ experiences of the person with dementia

emotional

_____________________ is defined as limitations that are beyond what is to be expected

excess disability

walking in crowded places and driving are examples of activities that require _____________________

field of vision

____________________________ describes a complex spectrum of heterogeneous neurodegenerative disorders involving the frontal or temporal lobes, or both (can begin as early as 30 years of age)

frontotemporal dementia

diagnosis of ______________________ is difficult because manifestation vary widely and overlap with those of other types of dementia (often diagnosed misdiagnosed with psychiatric illness because of young age and they do good on usual cognitive tests)

frontotemporal dementia

Effects on overall wellness: depression, social isolation, decline in cognitive function, risks to safety and functioning, diminished quality of life

functional consequences of hearing loss

____________________________________________________________: is an evidence-based screening tool that is widely used across health care settings to detect depression in older adults which can be administered in 5-7 min, consists of 15 questions with "yes" or "no" answers to specific questions

geriatric depression scale short form (GDS-SF)

_____________ is experienced when light is reflected from shiny surfaces, when the light is excessively bright or inappropriately focused, or when bright light originates from courses at once

glare

_______________ can affect a person's ability to read signs, see objects, drive at night, and maneuver safely in bright environments

glare

__________________ is a device with an amplifier, microphone, receiver, and digital processor that is programmed to convert sounds to improve based on individualized needs

hearing aid

Delirium subtypes according to motor and behavioral subtypes are _______________________________________________

hyperactive, hypoactive, and mixed

age-related changes __________________ a person's sensitivity to glare and the time required to recover from glare

increases

____________________: vibrations are transmitted to the cochlea, where they are converted to nerve impulses and coded for intensity and frequency, nerve impulses stimulate 8th CN and send the auditory message to the brain

inner ear

Delirium occurs commonly in ___________________________

all health care settings.

______________________ the diagnostic term for poor insight or lack of awareness, ay lead to unsafe behaviors and affect the ability of the person with dementia to live independently

anosognosia

_________________________ is any device that amplifies sound for individual or group communication

assistive listening device

______________________________ refers to services that improve communication for people who are hearing impaired -they are designed to help people learn to live with hearing loss and provide the following services: ~counseling ~education ~amplification aids ~communication skills

auditory rehabilitation

_________________ functions in cleansing, protecting, and lubricating ear canal

cerumen (or earwax)

____________________ function by bypassing damaged portions of the ear and stimulate the auditory nerve, sending signals directly to the brain

cochlear implant

________________________ is a small, complex electronic device that consists of an external portion, which is magnetically held in place behind the ear, and an internal component which is surgically implants under the skin

cochlear implant

_____________________ theory hypothesizes that people appraise themselves by their self image, their environment or experiences, and their future and that depression is caused not by adverse event themselves but by distorted perceptions in these 3 realms: ~self-image: negative appraisals with feelings of worthlessness, interpretations of neutral events as bad, and unrealistic feelings of hopelessness ~environment and experiences: negative assumptions that lead to faulty conclusions (ex: "I must not be important because the nurse didn't stop to see me") ~Appraisal of their future: logical errors, such as personalization, minimization, magnification, and overgeneralization

cognitive triad

_________________ and ______________ is the ability to detect details and discern objects

color perception, acuity

It is important to adapt ___________________ techniques for people with dementia

communication

__________________ is the visual skill responsible for locating objects in 3D space, judging the differences in depth of objects, and observing relationships among objects in space

depth perception

older adults experience problems with _____________________, making it more difficult to use objects effectively and maneuver safely in the environment

depth perception

_____________________: consists of tympanic membrane which is a transparent, pearly-gray, slightly cone-shaped layer of flexible tissue that separates the outer and middle ear

middle ear

________________ include: ~reduced contrast sensitivity ~increased sensitivity to glare and difficulty driving at night ~increased lighting requirements and decreased ability to focus close up ~decreased ability to judge depth perception

mild visual impairments

___________________ are caused by normal age-related changes, but they are significantly exacerbated by environmental factors like glare and poor lighting

mild visual impairments

exposure to noise, use of ototoxic medications are all examples of ____________________________

modifiable risk factors

The initial assessment of cognitive impairment is complex and based on _________________ assessment of all aspects of health and functioning

multidisciplinary

-currently, prevention of noise exposure is the only effective strategy for reducing _____________________

presbycusis

most common sensory impairment in older adults

presbycusis

________________ is the loss of accommodation

presbyopia

____________________ is caused by degenerative changes in the lens and ciliary muscle

presbyopia

the need to hold reading materials father from the eye to focus clearly on the print. This is an indication that patient might have ________________________________

presbyopia

________________________: pacing, hand wringing, difficulty sitting still, verbal outbursts

psychomotor agitation

____________________________: slowed body movements; slowed verbal responses, sometimes to the point of muteness; monotonous or whispering tone of voice

psychomotor retardation

___________________ therapies are effective interventions for late-life depression

psychosocial

___________ are in peripheral retina and cones are in sensitive part of macula called the fovea ~__________ cells diminish with age, but vision loss is primarily in the _____________ than the fovea

rods, cone, periphery

number of ______________ also decreases with age but the existing ________________ will increase in size and maintain their ability to capture light

rods, rods

Improving psychosocial function via _________________ and ______________________

social supports, meaningful activities

_______________________________ is the self-perception of a decline in cognitive abilities beyond what would be considered normal aging but with clinically normal neuropsychological testing

subjective cognitive decline

____________________________ refers to thoughts or considerations about suicide that may result in attempts and completed suicide actions

suicidal ideation

_____________________: when BPSD or increased confusion or restlessness becomes worse or occurs primarily in the early evening

sundowning

_________________:primary function is to transmit sound energy and protect the middle and inner ear

tympanic membrane

___________________ is considered the most preventable type of dementia because primary interventions can be implemented

vascular dementia

_______________________ refers to cognitive impairment, ranging from mild to severe, that is caused by cerebral small vessel disease

vascular dementia

underlying pathological of ________________________ processes include: ~stroke ~transient ischemic attacks (aka "small strokes") ~lacunar strokes of the small arteries

vascular dementia

_________________ is an oval-shaped area encompassing the total view that people perceive while looking straight ahead

visual field

___________________ is important when people engage in tasks that require a broad perception of the environment and moving objects

visual field

____________________ is vision loss that cannot be corrected with eyeglasses or contact lenses alone, ranges from mild impairment to blindness

visual impairment

the scope of visual field narrows slightly between ___________ years of age and then steadily declines

40-50

________________ progresses through stages involving cognitive and functional decline

Dementia

Factors that decrease the risk for _____________________ include physical activity, healthy diet, higher educational level, and engagement in social and cognitive activities.

Alzheimer disease

Risk factors for ____________________ include family history, genetic factors, diagnosis of mild cognitive impairment, and traumatic brain injury.

Alzheimer disease

four main types of dementia ____________________ ____________________ ____________________ ____________________

Alzheimer disease, vascular dementia, Lewy body dementia, frontotemporal dementia

___________________________: degenerative changes in auditory nerve and central nervous system

Auditory nervous system

Examples of ____________- include agitation, personality changes, mood disturbances, repetitive movements, and changes in sleep and eating..

BPSD

______________________ Hearing Loss: results from abnormalities of the external and middle ear that interfere with sound conduction

Conductive

The ___________________________ is an evidence-based tool for confirming the diagnosis of delirium based on the following: acute onset or fluctuating course, inattention, disorganized thinking, and altered level of consciousness

Confusion Assessment Method

___________________ is a medical term that includes a group of brain disorders characterized by a gradual decline in cognitive abilities and changes in personality and behavior.

Dementia

_______________ is a serious, preventable, treatable, commonly occurring condition and is often unrecognized in older adults.

Delirium

_______________ results from an interaction between predisposing factors, such as dementia and advanced age, and precipitating factors, such as surgery and infections.

Delirium

_________________ is characterized by depressed mood and/or loss of interest, along with additional manifestations, including weight loss, appetite change, sleep disturbances, psychomotor agitation or retardation, fatigue, cognitive impairment, feeling worthless or excessively guilty, and recurrent thoughts of death or suicide.

Depression

___________ ear: thicker hair, thinner skin, increased keratin

External

______________ depression refers to the onset of depression after the age of 65 years.

Late-life

_____________ ear: less resilient tympanic membrane, calcified ossicles, stiffer muscles and ligaments

Middle

_________________ Hearing Loss: involves both conductive and sensorineural impairments

Middle

The ___________ model is an evidence-based approach to addressing dementia-related behaviors

PLST

______________________: diminished ability to hear high-pitched sounds, especially in the presence of background noise

Presbycusis

_____________________ Hearing Loss: caused by abnormalities of the sensory and neural structures of the inner ear, which usually are age related or noise induced

Sensorineural

_____________________ has been recognized since 2014 as a risk for dementia.

Subjective cognitive decline

____________________: persistent sensation of noises that do not originate in the external environment

Tinnitus

Commonly available diagnostic techniques cannot always determine the type of ________________.

dementia

___________________ is the ability to focus clearly and quickly on objects at various distances

accommodation

Many terms are used interchangeably—and not always accurately—to describe __________________.

dementia

Self-awareness and personal experiences of people with ________________ vary significantly

dementia

Two or more types of _______________ can develop at the same time or sequentially.

dementia

______________________ theory posits that depression occurs when people expect bad thing to happen, believe that can do nothing to prevent them, and perceive the events are caused by internal, stable, and global factors

learned helplessness

characteristics of __________________ (opposed to alzheimer): ~slower processing speed ~more rapid decline in cognitive functions ~pronounced fluctuations in attention and cognition ~spontaneous motor manifestations of parkinson ~visual hallucinations as an early and recurrent manifestation

lewy body dementia

____________________________ is the term used or a group of disorders that includes Parkinson's disease

lewy body dementia (aka dementia with lewy bodies)

Signs and symptoms of depression in older adults are on a continuum of severity from ________________ depression to _________________ depression.

major, subthreshold

Nurses have important roles in teaching older adults and their caregivers about ________________ for slowing the progression of dementia.

medications

Risk Factors That Affect Hearing Wellness: Exposure to _______________ Impacted ______________ ______________ medications like aminoglycosides, aspirin, loop diuretics, quinine Genetic predisposition to ________________________ __________________ like otosclerosis, Paget disease, Ménière disease

noise, cerumen, Ototoxic, otosclerosis, Disease processes

____________________________ is an important preventable type of hearing loss

noise-induced hearing loss (NIHL)

Nurses use ____________________ interventions to promote wellness and improve quality of life for people with dementia.

nonpharmacologic

Assessment is an ____________ process involving assessment of stages and all aspects of health and functioning.

ongoing

age-related calcification of ________________ can interfere with the transfer of sound vibrations from the tympanic membrane to the oval window

ossicles

__________________ is a hereditary disease of the auditory ossicles that cause ankylosis of the footplate of the stapes to the oval window

otosclerosis

___________________-it begins in youth or early adulthood, but hearing loss isn't detected until middle or later adulthood when age-related changes compound the disease-related changes

otosclerosis

____________________ primarily causes a conductive hearing loss that is beyond the expected age-related changes

otosclerosis

_____________________: made up of pinna and external auditory canal; hearing begins here

outer ear

______________________ is an evidence-based easy-to-use screening tool that involves asking 2 questions: (1) "during the past 2 weeks (or month), have you felt down, depressed, or hopeless?" and (2) "during the past 2 weeks (or month), have you felt little interest or pleasure in doing things?"

patient health questionnaire