Chapter 25, 33, and 40 quiz

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Social security act

1935

Medicare and medicaid and administration on aging established

1965

Older Americans Act (OAA) preserves rights and dignity of older citizens

1965

Age discrimination act passed

1967

Philosophy of hospice migrated to the US in Connecticut in the early

1970s

Medicare hospice benefit came into effect in

1983

Mandatory retirement age eliminated for most employees

1986

OBRA act

1987

Rx drug plans instituted

2004

ACA act allows for drug discount for eligible seniors in the "donut hole"

2010

In this year there will be 88.5 million people over the age of 65 living in the US

2050

Adults 75-90 need 30 calories per kilogram of body weight compared to this

40 calories for people 20-37

Young-old

65-74 years

Old-old

85-99 years

An abnormal state of motor and psychic hypoactivity

akinesia

Most common cause of dementia

alzheimer's

Observe for disorientation with older adults taking this

antibiotics

To expect, await or prepare for loss is this kind of grief

anticipatory

Observe for tremor or spasms in older adults prescribed this

antidepressants

Inability to understand words

aphasia

Language function is absent due to stroke or other neuro condition

aphasia

Problems manipulating things

apraxia

Which condition may cause the older adult to develop hypertension

arteriosclerosis

Family members should be _____ if they want to participate in care of their dying family member, never assume

asked

Upright position leaning forward, chin down does this

assists with swallowing

Impaired ability to coordinate movement

ataxia

May be used for anxiety may cause orthostatic hypotension or tachycardia

ativan

This type of nursing behavior includes appropriate eye contact, attentive body language and verbal following

attending

Make up 29% of the nation's population approaching young-old adulthood

baby boomers

Electrical condition of the heart slows or alters

can lead to dysrhymias

The death of a _____ is often viewed as one of the most devastating losses one can have

child

This may not be an accurate predictor of health or behavior

chronologic age

The _____ signs of death include; flat encephalogram, cessation of respirations, absence of apical pulse, no movement or breathing, and no reflexes

clinical

Used for emesis may cause extrapyramidal symptoms

compazine

This kind of grieving happens when an individual "gets stuck" in the grief process

complicated

This hearing loss results from interruption of sound transmission

conductive hearing loss

A person given durable power of attorney is someone who

is an agent who makes health care decisions for a patient

Which organs can be harvested for organ donation

kidney, pancreas, liver, and heart

This is sometimes referred to as a "dowager's hump"

kyphosis

Which musculoskeletal problem causes the individual to stoop forward

kyphosis

Erikson lists this task as acceptance vs anger and despair

last stage of life

Tan or brown macules known as age spots on older people

lentigo

The hospice patient and family must agree that what will not be provided

life-support measures

This document _____ will contains the patient's wishes

living

A portion of oneself becoming no longer available is

loss

Changes in vital signs for a dying patient may include; slow, weak and thread pulse, _____ BP, rapid and shallow, irregular or abnormally slow breathing

lower

Termination of tube feedings to a dying patient may be termed _____ euthanasia

passive

As nurses, we realize that when dealing with a grieving family member we must address these five aspects of human functioning

physical, emotional, intellectual, sociocultural, spiritual

Which person assists the patient with his/her fears and uncertainty

spiritual coordinator

Originates from the organs "cramping," "pressure," and "squeezing pain"

visceral pain

Which type of pain originates from internal organs

visceral pain

Difficulty writing or drawing

agraphia

An older person needs a minimum of 1500 ml daily

fluids

Arises from the musculoskeletal system

somatic pain

Leading cause of death in the US

heart disease

Standing in one place for long periods of time causes

venous stasis

Older women need this amount of calcium and vitamin D to reduce fracture

1000-1500 mg daily

Normal intraocular pressure

10-22 mm Hg

Commonly a combination of chronic bronchitis, chronic asthma, emphysema

COPD

Who coordinates the implementation of the plan of care

RN coordinator

The 7 year old child might associate death with

aggression

Inability to recognize familiar objects

agnosia

Loss is best described as

a portion of oneself becoming no longer available

A patient who is dying continually seeks out opportunities to interact with you even using her call light for things that are mundane. You recognize that she might be in fear of this

abandonment

The desertion of an elder patient that you have assumed care for

abandonment

These directives are signed and witnessed documents that provide special instructions for health care treatment

advance

The most frequent symptoms experienced by the dying older adult are pain, respiratory distress and

confusion

This theory suggests personality remains the same and behavior more predictable

continuity theory

A _____ is a public official, not necessarily a trained health care provider appointed or elected to inquire into death

corner

Aggressive care in which the goal is curing and prolonging life at all cost

curative treatment

What is the final stage of human growth and development

death

24-48 hours before death this happens as a result of fluid accumulation

death rattle

This extreme sadness is a delayed response to death

delayed

Euthanasia means

deliberately ending a patient's life

Progressive impairment of intellectual function interfering with normal life

dementia

Upon notification of a death of a relative the young girl cries out "No it's not true, I was just with her." What stage of grief might this reaction be attributed to?

denial

3 of the most crucial facets of care for the dying patient include; the need for love and affection, control of pain, and preservation of _____ and self-worth

dignity

Thanatology is the study of

dying and death

Difficult, poorly articulated speech

dysarthria

This may arise from having a stroke, neurologic dysfunction, or tumor

dysphagia

This can arise from heart failure, injection, dysrhythmias

dyspnea

This stage of Alzheimers gradual onset of memory loss and focusing

early

As death becomes_____ these responses become notable; Cheyne-Stokes respirations, fixed and dilated pupils, pulse becomes weaker and more rapid and BP continues to fall

eminent

Where did the hospice concept originate

europe

Deliberately ending a patient's life is _____

euthanasia

Moderate and severe pain may cause confusion or hypoventilation

fentanyl

This age group _____ to nine years may believe they are responsible for death

five

Cells become damaged interfering with normal body function resulting in aging

free radical theory

Occurs as a result of inability or unwillingness to get to the toilet

functional incontinence

The difference between grief and bereavement is

grief is a response to a loss, and bereavement is a depressed response to death

The process of adapting to and mourning a loss is called

grief work

Upon hearing of the death of her toddler due to drowning the mother states"I am so sorry," what is this an expression of

guilt

Set goals to prevent health risks, unnecessary disease, disability and death

healthy people 2000

Focused on improving functional independence and quality of life

healthy people 2020

Paralysis of one side of the body

hemiplegia

Studies have shown that fall risk is this soon after restraints are used

highest

After this happens a significant % of patients die within one year

hip fracture

DRGs and changes in health care reimbursements have resulted in these changes regarding terminally ill; more patients die at

home

Form the Latin word hospitium meaning "hospitality" & "lodging"

hospice

Assists with bathing, hygiene, skin care and light household duties

hospice aid

Emphasizes quality not quantity of life

hospice care

Control or alleviate patient symptoms

hospice goal

Covers all expenses for palliative care for terminal illnes

hospice medicare benefit

Who would provide respite care for the caregiver

hospice volunteer

Dementia may also occur when pt's have this disease process

huntington

Which condition may lead to weight gain

hypothyroidism

The immune system destroys body cells that it misreads as foreign

immunologic theory

Core interdisciplinary hospice team

medical director

Which person assumes responsibility for the hospice program

medical director

This stage involves difficulty with language, object

middle

Age, gender and family HX

modifiable risk factors

Acute and severe pain, can cause constipation

morphine

This term _____ means death or death rate

mortality

Second most common cause of dementia

multi-infarct dementia

Which element of the integumentary system becomes brittle and thick

nails

The refusal or failure to fulfill obligation or duties in elder care

neglect

This means urination at night and can disrupt the older person's sleep

nocturia

Smoking, high blood pressure, high-fat diet and inactivity

nonmodifiable risk factors

What is palliative care

not a cure, but relieves pain and distress

Core interdisciplinary team

nurse coordinator and social worker

Onset, Location, duration, character of pain, aggravating, alleviating, treatment, severity

oldcarts

These must be harvested prior to the patient being taken off the ventilator

organs

This is accompanied by a weak urine stream, difficulty passing urine

overflow incontinence

How does perceived loss differ from actual loss? Perceived loss may be easily

overlooked

The most dreaded and feared experience for a dying patient

pain

Has the potential to be life threatening for the older adult

pneumonia

Most common type of hearing loss in older adults

presbycusis

Farsightedness resulting from a loss of elasticity of the lens of the eye

presbyopia

The skin is at risk for _____ in the older population

pressure ulcers

Bereavement volunteer

primary hospice team

Hospice volunteer

primary hospice team

Primary nurse

primary hospice team

Makes up for 90% of all cases of primary glaucoma

primary open-angle glaucoma

Immunizations, vaccinations, pneumococcal, shingles and flu vaccines

primary prevention

Aging takes place when cells no longer have capacity to regenerate themselves

programmed aging

Noisy respirations caused by mucus collection in the throat of a dying patient is termed this death

rattle

Allows primary caregivers relief from stressors

respite care

Bereavement is a depressed _____ to death

response

Grief is the _____ to loss

response

Hazards are greater than the perceived benefits

restraints

Which would not cause nausea

salivation

Early detection and treatment of cancer, hypertension, falls, polypharmacy

secondary prevention

Removal of what helps the individual with pneumonia

secretions

This hearing loss results when the inner ear, nerve or pathways don't function

sensorineural hearing loss

This kind of loss occurs suddenly

situational

Which person evaluates the patient's psychological needs

social worker

This is an involuntary loss of a small amount of urine with coughing or sneezing

stress incontinence

The focus of palliative care is _____ alleviation

symptom

Last stage urinary and fecal incontinence, inability to

terminal

The study of dying and death is termed

thanalogy

A living will is a written document

that contains the patient's wishes

Slowly increased to a therapeutic level

titrated

Why is it important for the nurse to perform an assessment of the five aspects of human functioning

to provide adequate care to the patient and family who are experiencing death

The best way to prevent pressure ulcers

turning every 2 hours

What will help prevent pressure ulcers

turning every 2 hours

Which disease is increasing in incidence among older adults

type 2 diabetes

Ineffective pain management is usually a result of this

undermedication

A patient who states "I just keep thinking he's going to come home" after five months of the death of her spouse may be experiencing this _____ grief

unresolved

Use these instead of alcohol-based lotions

water-based or oil

What is bereavement overload

when someone has experienced multiple losses and is not processing them

Biologic theories explain

why the body ages

A nurse who hurries through patient cares and leaves with little interaction may be experiencing this

withdrawal

Passive euthanasia means

withholding resuscitative measures


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