Davis- Chapter 10: Life Span: Older Adults

What is ageism? 1. Slowness of gait 2. Age discrimination 3. Greying of the hair 4. Depressed mood

2. Age discrimination (treating someone in a negative way based on their age is ageism)

John retired from work last month after 38 years with the same corporation. He's been looking forward to retirement at the age of 65, but is concerned that the days are beginning to wear on him. Physically he does "okay." His hypertension is under control with medications and he runs 2 miles three mornings a week. He is planning a trip overseas this summer with Martha, his wife of 43 years. John has noticed that his knees feel stiff and painful in the mornings as he gets out of bed, so he decides to give up his morning run. What suggestion would be best for John? 1. "Joint pain is common at this age, but biking is less impactful on the joints." 2. "Take pain medicines daily when you wake up to make the run less uncomfortable." 3. "Seek medical attention; you may have an injury." 4. "Consider running at bedtime so the pain will be less intense."

1. "Joint pain is common at this age, but biking is less impactful on the joints." Physical activity is healthy at all ages, but may require modification as the body changes. Joint pain, limited range of motion, and activity intolerance are anticipated age-related changes. With biking, John can remain active without further damage to joints.

As Marjorie is trying to brush her teeth at the bathroom sink, she loses his balance and falls. What actions by the nursing care facility could have prevented this injury? Select all that apply. 1. Assistance with all activities 2. Use of grab bars in the bathroom 3. An emergency call light that is accessible in all areas 4. Use of a walker 5. Not allowing her to brush her teeth

1. Assistance with all activities 2. Use of grab bars in the bathroom 3. An emergency call light that is accessible in all areas 4. Use of a walker Older adults are at high risk for falls. Falls often lead to greater health problems and even death. Integration of fall precautions such as closer observation and assistance, grab bars, and call lights can help prevent injury.

What is the leading cause of death in older adults? 1. Chronic illnesses 2. Car accidents 3. Pneumonia 4. Heart disease

1. Chronic illnesses

Which of the following nursing care may be necessary for older adults as they age? Select all that apply. 1. Community resources 2. Multidrug prescriptions 3. Support for change 4. Long-term care 5. Family therapy

1. Community resources 3. Support for change 4. Long-term care

Adapted Physical Activity (APA) is a program developed for older adults. What is the benefit for older adults when they participate in this type of program? 1. Corrects sedentary lifestyle 2. Helps older adults make friends 3. Prevents chronic illness 4. Increases cognition

1. Corrects sedentary lifestyle (aimed at correcting sedentary lifestyle and prevent disability secondary to the chronic condition)

While helping Marjorie with her morning care, the nurse notices several skin tears and bruises on her arms. Marjorie notices the nurse looking at them and says, "My skin used to look smooth and pretty, but now it gets damaged so easily." What steps should the nurse make? Select all that apply. 1. Provide a foam mattress for the bed. 2. Pad the corners of hard objects in the room. 3. Encourage wearing long sleeves. 4. Avoid contact with tape and adhesive bandages. 5. Use gentle soaps and lotions.

1. Provide a foam mattress for the bed. 2. Pad the corners of hard objects in the room. 3. Encourage wearing long sleeves. 4. Avoid contact with tape and adhesive bandages. 5. Use gentle soaps and lotions. Because of loss of elasticity and thinning of the skin, the older adult's skin is more prone to tears and bruises. Limiting trauma by providing padding and avoiding tape is helpful. Use of gentle soaps and lotions can improve skin's dryness, a factor that can lead to tissue breakdown.

Which of the following vaccines would be important for an older client? Select all that apply. 1. Tetanus 2. Herpes zoster 3. MMR 4. Influenza 5. Pneumococcal

1. Tetanus 2. Herpes zoster (shingles) 4. Influenza 5. Pneumococcal Immunizations. Health-promotion activities include teaching and facilitating immunizations for varicella, influenza, pneumonia, herpes zoster (shingles), and tetanus/diphtheria/pertussis. To see the Recommended Adult Immunization Schedule,

Which of the following techniques would the nurse use when communicating with someone who has cognitive deficits? Select all that apply. 1. Use simple short sentences. 2. Say yes, yes, that's okay. 3. Repeat your words exactly. 4. Avoid using specific language. 5. Provide many choices.

1. Use simple short sentences. (conveying 1 idea at a time makes understanding easier) 3. Repeat your words exactly. (keeping communication consistent will assist the pt to understand) [WRONG] 2. Say yes, yes, that's okay. (pt with cognitive deficits struggle to understand vague comments) 4. Avoid using specific language. (struggle with understanding comments that are vague) 5. Provide many choices. (get overwhelmed by too many choices)

Marjorie becomes bedridden after a fall that resulted in a hairline fracture of her pelvis. She begins to develop a cough of yellow sputum and requires higher amounts of oxygen at night to maintain adequate oxygen levels. Which physiological changes of aging contribute to her current condition? Select all that apply. 1. Weakened immune system 2. Decreased muscle strength 3. Decreased cardiac output 4. Decreased skin elasticity 5. Decreased intercostal muscle strength

1. Weakened immune system 2. Decreased muscle strength 4. Decreased skin elasticity Marjorie is exhibiting signs of pneumonia that developed after she became immobile following her fall. Her weakened immune system is contributing to her inability to fight the infection, and muscle weakness is impacting her ability to cough.

Throughout the day, John has to urinate every 2 to 3 hours. Although it's only a small amount each time, there is a feeling of urgency. He has limited the amount of liquid he drinks, but it doesn't seem to help. What could be causing this issue? 1. Dehydration 2. An enlarged prostate gland 3. Decreased kidney filtration 4. Medication

2. An enlarged prostate gland As men age, the prostate often enlarges, making it difficult to fully empty the bladder. The urgent feeling results from the full bladder, but the enlarged prostate blocks the urethra, allowing only small amounts of urine to pass.

Which of the following known prevention measures can help older adults avoid many illnesses and disabilities associated with chronic diseases? 1. Cancer research and medications 2. Healthy lifestyle and immunizations 3. Cognitive exercise 4. Social media and the Internet

2. Healthy lifestyle and immunizations (staying active and taking advantage of health promotion activities, like immunization, will assist in preventing illness and disability)

Which of the following are the most common and costly chronic disease processes? 1. Osteoporosis, Dementia, Cancer 2. Heart Disease, Stroke, Diabetes 3. Pneumonia, Depression, Stroke 4. Skin tears, Infection, Diabetes

2. Heart Disease, Stroke, Diabetes (these are long term illnesses that are rarely cured but can be prevented or modified with therapeutic lifestyle changes)

The nurse suspects that an older adult patient may have difficulty hearing. Which strategies will the nurse use to improve communication? Select all that apply. 1. Use sign language. 2. Look directly at the patient when speaking. 3. Speak more slowly than usual. 4. Speak loudly toward the patient's ears. 5. Allow some extra time for the patient to respond.

2. Look directly at the patient when speaking. (allow lip reading) 3. Speak more slowly than usual. (increase understanding) 4. Speak loudly toward the patient's ears. (direct sound to the ear, improving hearing) 5. Allow some extra time for the patient to respond. (may need more time to process information)

Marjorie is an 80-year-old female. After a car accident 3 years ago, she lost her driver's license because of her poor vision. Her husband died shortly afterward and she could no longer care for herself. Her daughter placed her in an assisted living facility that provides meals and 24-hour supervision and care. Marjorie tells the nurse that she feels "worthless" and wants to become more active. What would be the nurse's best suggestion? 1. Walk around the block three times a day. 2. Participate in chair aerobics in the recreational center. 3. Lift weights in the gym after meals. 4. Take dancing lessons at the city dance hall.

2. Participate in chair aerobics in the recreational center. With Marjorie's advanced age, she is at risk for fall and injury. Chair aerobics is a safe option that still allows her to be active and social.

The nurse is planning a teaching workshop about maintaining an active lifestyle at the local community center for a group of older adults. What information is most important to discuss at the workshop? 1. Prevention of injury and falls 2. Planning and participating in leisure activities and exercise 3. Use of social media to stay connected with family members 4. Resources for assisted living centers and nursing homes

2. Planning and participating in leisure activities and exercise (having a plan and being involved will assist in maintaining an active lifestyle)

How can the nurse be supportive to the caregiver of a client suffering from dementia? 1. Call another family member and make them feel guilty. 2. Provide rapid support during times of crisis. 3. Send the caregiver to a medical doctor. 4. Reassure the caregiver that the patient will improve.

2. Provide rapid support during times of crisis. (this can contribute to the physical and psychological well-being of the caregiver)

Which of the following would be the best definition of the "spiral of vulnerability"? 1. The client gives out their Social Security number, which leads to being scammed. 2. The client has a decrease in mobility, which leads to a fall, which leads to hospitalization 3. The client becomes confused, wanders away, and the police must be called. 4. The client lacks understanding and begins yelling at his caregiver.

2. The client has a decrease in mobility, which leads to a fall, which leads to hospitalization (this demonstrates how a client becomes weaker and more susceptible to chronic illness or disability)

Marjorie notices that she is less able to control her urine. She speaks with the nurse about it, saying, "It used to be an issue only when I coughed or laughed and now it's all the time." Which step should the nurse make? 1. Insert a Foley catheter. 2. Use padded briefs. 3. Change undergarments more frequently. 4. Encourage use of the restroom more frequently.

2. Use padded briefs. Urinary incontinence can be embarrassing to older adults. Encouraging more frequent use of the restroom can lessen the problem but may not be realistic for those with decreased mobility. Use of padded briefs is helpful provided they are changed frequently to prevent skin breakdown.

The nurse practitioner is performing an annual physical examination on an 88-year-old female. Which assessments are most important to include? Select all that apply. 1. Breast cancer screening 2. Visual acuity exam 3. Gait and balance 4. Pap test 5. Height and weight

2. Visual acuity exam 3. Gait and balance 5. Height and weight

The nurse is speaking with a 69-year-old female patient. What should the nurse explain about osteoporosis? 1. Osteoporosis affects mostly men, so you needn't worry about it. 2. Women are at high risk because of the lack of calcium intake and changes caused by menopause. 3. Osteoporosis is uncommon, but you should be aware that it exists. 4. As long as you drink a glass of milk every day, you won't get osteoporosis.

2. Women are at high risk because of the lack of calcium intake and changes caused by menopause. (treating someone in a negative way based on their age is ageism)

John and Martha are on vacation and John is unable to perform sexually as he normally does. He's quite concerned and sees his healthcare provider when the problem continues at home. What statement from his healthcare provider is most accurate? 1. "Maybe you are not as aroused by your wife as you used to be." 2. "It's probably the change of environment causing the problem." 3. "It's a common problem of aging. I know some things we can try that will help." 4. "You were probably exhausted from the long flight."

3. "It's a common problem of aging. I know some things we can try that will help." Changes in libido, energy level, and sexual patterns are common in the older adult, and can be caused by a decrease in estrogen and testosterone levels. Treatments may include the use of hormone therapy, phosphodiesterase type 5 inhibitors, or nonmedication alternatives.

A frail elderly man lives at a senior independent living apartment complex. He is weak, stays in bed most of the time, and becomes fatigued after taking only two or three steps with a walker. His personal hygiene is poor. He moves very slowly when doing even small tasks such as eating a meal. Which interventions are most appropriate for this person? Select all that apply. 1. Contact his children to move in with him. 2. Refer the client to a senior center for an adapted physical activity program. 3. Arrange for nutritious meals to be delivered to the patient's home. 4. Assess the patient for symptoms of depression and memory loss. 5. Arrange for an aide to assist with activities of daily living.

3. Arrange for nutritious meals to be delivered to the patient's home. 4. Assess the patient for symptoms of depression and memory loss. 5. Arrange for an aide to assist with activities of daily living.

As Marjorie ages and becomes more frail, her family decides to move her to a nursing care facility. She has been hospitalized twice in the past 6 months for pneumonia and does not wear her oxygen device at night. As the nurse is helping Marjorie into her wheelchair to go to the dining hall for breakfast, she notices how loose her pants are. She decides to weigh her and finds she has lost 8 pounds in the past month. What should be the nurse's next action? 1. Change her diet to include more fattening foods. 2. Determine whether any medications she's taking would cause weight loss. 3. Make her clean her plate with each meal. 4. Monitor her daily calorie intake for a week.

4. Monitor her daily calorie intake for a week. Weight loss is common in older adults as they experience decreased appetite and difficulty with chewing and digestion. Weight loss can also be a sign of further problems, so monitoring calorie intake and weight can determine the next course of action.

John has taken the same blood pressure medication at the same dosage for 10 years. At his last routine physical, his blood pressure was higher than normal. Which statement best describes the reason for this change? 1. His medication was outdated and therefore less potent. 2. He was anxious when his blood pressure was taken. 3. The blood pressure was not taken correctly. 4. Vessels develop increased peripheral resistance with age, causing a rise in blood pressure.

4. Vessels develop increased peripheral resistance with age, causing a rise in blood pressure. The increase of peripheral resistance and rise in systolic blood pressure are expected parts of aging. Additionally, cardiac output tends to decrease. As a result of these physiological changes, John should continue a healthy lifestyle, but may also need to increase medications for better outcomes.