Fundamentals- chapter 33: health promotion and care of the older adult
what may be given for older adults who have difficulty picking up a cup or bending the neck
an adaptive cup with a double handle or a cutout for the nose
rapid weight loss may indicate what?
an illness
after bathing, what usually increases most individuals comfort
application of water-based lotion to dry areas
When discussing aging, the nurse clarifies that the term older adulthood applies to those who are older than: a. 55. b. 65. c. 70. d. 75.
b. 65
People born between 1946 and 1964 are generally referred to as
baby boomers
most moles are
benign
regarding the nails... what indicated possible pulmonary or cardiac disease
bilateral clubbing of fingers
What nursing interventions will minimize the effects of venous stasis?a. Pillows under the knee in a position of comfort b. Sitting with the feet flat on the floor c. Early ambulation d. Gentle leg massage
c. Early ambulation Early ambulation has been a significant factor in hastening postoperative recovery and preventing postoperative complications.
The nurse recognizes that an older adult patient with COPD has a higher incidence of developing which age-related skeletal change that will alter the ability to exchange air effectively? a. Osteoporosis b. Arthritis c. Kyphosis d. Osteomyelitis
c. Kyphosis usually caused by osteoporosis, is a curvature of the spine that alters respiration and air exchange.
The nurse recognizes that a term referring to mechanical difficulty of swallowing is ___________.
dysphagia
a decrease in pacemaker cells occur, and the electrical conduction is slowed or altered, which can lead to
dysrhythmias
what is something that seems only natural for a nurse to encourage but many frequently fail to do so?
encourage people to make decisions that affect their own lives
Sandwich generation
the generation of adults who simultaneously try to meet the competing needs of their parents and their children
wellness is
the individual operating at the optimal level of function, even during chronic illness and dying, some level of well being is attainable.
why might and older adult sometimes decrease their fluid intake
to control incontinence or bc of an illness such as heart failure
When fluid deficit is caused by the older adult trying to control incontinence, the most appropriate interventions are
to make fluids readily available and toilet facilities more easily accessible. arranging the room so the access to the bathroom is unobstructed often helps.
what would be an exception for addressing an older individual as "Gramps", "Grandma", "Honey", or any other similar term or familiarity
unless the person is the caregivers grandparent
associated with cystitis, urethritis, tumors, stones, and central nervous system (CNS) disorders such as a stroke, dementia, and Parkinson's disease
urge incontinence
elite- old
100+
a total cholesterol level of ____mg/ dL raises the risk for carina disease
130
an older person needs a minimum of _________ of fluids a day
1500 mL
successful coping strategies to deal with grief may include
- avoiding isolation and self pity - helping others - joining groups - adopting a pet - setting goals - maintaining independence - retaining a sense of humor
patient protection and affordable care act (ACA)
- free medicare preventive services - medicare drug discount for eligible seniors who are in the "donut hole" - the health care law cracks down on waste, fraud, and abuse while providing new protections for seniors
secondary prevention
-focuses on early identification of individuals or communities experiencing illness, providing treatment, and conducting activities that are geared to prevent worsening health status -examples: communicable disease screening and case finding; early detection and treatment of diabetes; exercise programs for older adult clients who are frail
the AHA recommends ____ minutes of moderate intensity exercise three to five times a week
20 to 30 minutes
the ACA was signed into law in what year?
2010
sometimes the older adult needs assistance to the bathroom on a schedule, usually every 2 hours during the waking hours and every __ hours at night.
4
bladder capacity decreases approximately _____ with age
50%
older adulthood is considered between what age range?
65 and continues until death
young-old
65-74 years
Middle old age
75-84 years
by what age does almost everybody have some degree of COPD
90
primary prevention
Actions that change overall background conditions to prevent some unwanted event or circumstance, such as injury, disease, or abuse.
chronological age
Age as measured in years from date of birth
aging skin is defined as
dry and thin and loses tone and elasticity
combination of chronic bronchitis, chronic asthma and emphysema
COPD
who would a nurse ask to examine any suspicious- looking lesions?
Dermatologist
Frequent symptoms of depression in older adults
Fatigue, sadness, insomnia, anorexia, helplessness, crying, agitation, and hypochondria.
the "donut hole"
Medicare part D coverage gap
Provides a means of addressing the growing needs of caregivers
National Family Caregiver Support Program
to see clear results, should the client use more than one alternative therapies at once?
No; use only one therapy at a time to allow sufficient time to identify reactions
Objectives were to preserve the rights and dignity of our nation's older citizens
Older Americans Act 1965
Yellowed nails indicates
Possible fungal infection
older people who receive what type of therapy for depression show an improvement?
Psychotherapy
on non shower days, what may be provided for the patient
a partial bath
possible causes of dysphagia
a stroke or other neurologic dysfunction, local trauma, and obstruction w a tumor
The nurse suggests that to relieve the pain of claudication the patient should: a. rest. b. exercise. c. cross his legs. d. walk.
a. rest. A nursing intervention to relieve pain is to recommend the patient rest periodically until the pain subsides. The nurse could also suggest improving circulation progress by walking.
which psychosocial theory goes with the idea that older adults develop a positive concept concept of self as a result of maintaining ongoing social interaction. well-being in later life is enhanced by the substituting new roles in relation to family, recreation, and volunteer services for previous occupational roles
activity theory
a term that describe prejudice against older adults
ageism
In the past 50 years, life expectancy for Americans has increased by
almost 10 years
When assessing the skin of an older adult patient who is complaining of pruritus, the nurse advises the patient that to reduce further drying of her skin, she should avoid using: a. perfumed soap. b. hard-milled soap. c. antibacterial soap. d. antiseptic soap.
c. antibacterial
When the nurse attempts to assist an older adult who is having difficulty swallowing, the nurse suggests a position in which the chin is held: a. parallel. b. upward. c. down. d. to the side
c. down
A change of aging related to the circulatory system includes decreased blood vessel elasticity, which leads the nurse to assess for: a. confusion. b. tachycardia. c. hypertension. d. retained secretions.
c. hypertension
The nurse explains that the major difference between rheumatoid arthritis and osteoarthritis is that rheumatoid arthritis: a. is degenerative. b. affects patients over 40 years of age. c. is inflammatory. d. is curable.
c. is inflammatory is an inflammatory disease; osteoarthritis is degenerative.
The nurse recognizes that arthritis affects an individual's functional ability. Interventions are aimed at relieving: a. pain and discomfort. b. formation of contractures. c. stress on affected joints. d. inflammation and scarring.
c. stress on affected joints. Interventions for older individuals with arthritis are aimed at relieving stress on affected joints.
malignant melanoma
cancerous growth composed of melanocytes
those who are older than 100 years of age may be referred to as
centenarians
knowledge about a persons culture and religious beliefs help the team provide what type of care?
compassionate care
Because thin skin and lack of subcutaneous fat predisposes the older adult to pressure ulcers, the nurse alters the care plan to include turning the bedfast patient every: a. shift. b. 4 hours. c. evening. d. 2 hours.
d. 2 hours
The nurse prepares the older adult patient with diabetes for which symptom of the disease that distorts tactile sensation? a. Proprioception b. Loss of visual acuity c. Progressive paresis d. Peripheral neuropathy
d. Peripheral neuropathy is the presence of abnormal sensation.
When an older female patient complains of painful sexual intercourse, the nurse recognizes that the probable cause is: a. urinary incontinence. b. arthritic joints. c. kyphosis. d. mucosal drying.
d. mucosal drying. Sexual intercourse may be uncomfortable because of drying of the mucosa of the vagina.
medications may alter the taste of foods or adults in a
decrease in saliva production
what is more common in the older adult than any other age-related group
depression
dysphagia
difficulty swallowing
what can nocturia (urination at night) be a risk for?
fall risk
what other terms may be used to refer to individuals who are older than 75 years of age with health conditions?
frail elderly
occurs as a result of inability or unwillingness to get to the toilet because of physical limitations, depression, or confinement to bed or use of restraints
functional urinary incontinence
people inherit a genetic program that determines their specific life expectancy falls under what biologic theory?
genetic factors
the leading cause of death in the U.S. is
heart disease
What is known as the silent killer?
hypertension
the immune system becomes less effective and less able to distinguish between foreign and host cells, and aging is a result of the consequentially diminished protection from infection or disease, and the immune system destroying body cells that it misreads as defective or foreign... is what biologic theory of aging?
immunologic
what is the most important contributing factor to declining physical mobility and function
inactivity
age spots called ____ are tan and brown muscles brought on by sun exposure
lentigo
When bathing an 80-year-old woman who lives on a farm, the nurse assesses brown macules on the patient's hands and forearms. The nurse recognizes these as _________.
lentigo is a term that refers to brown-pigmented lesions on the skin of the older person who has spent a great deal of time in the sun. These macules are also called "age spots."
when should a lesion be examined by a dermatologist?
lesions that are irregularly shaped, raised, crusted or pitting, or bleeding easily
what tends to make chewing difficult and often allow food to collect under which results in lesions
loose-fitting dentures
what makes the skin wrinkles more apparent
loss of fat under the skin
forcing changes that exceed the individual's ability to cope sometimes results in
mental deterioration physical illness, and even death
is loss of teeth normal for an aging adult or a misconception?
misconception. it is NOT part of the normal aging process.
for detection of colorectal cancer, an annual fecal occult blood test is recommended for adults of what age
more than 50 years of age
two classifications are used for risk factors:
nonmodifiable and modifiable
to best meet the challenge of delivering age-appropriate care, what should the nurse know the differences between?
normal aging vs illness or disease-related changes
Defined as weighing 20% above a healthy body weight
obesity
why might an older adult have a higher chance of choking and aspiration?
older adults have decreased secretion of saliva and a diminished gag response
a chronically full bladder increases bladder pressure to a higher level than urethral resistance is able to counter, resulting in loss of a small volume of urine
overflow incontinence
decreased production or lack of production of the intrinsic factor causing the body to become unable to use ingested vitamin B12, leads to what
pernicious anemia
what should you assess the oral cavity for
presence of lesions; dental caries; loose, broken, or missing teeth; dentures that do not fit well; edematous gums, and halitosis (bad breathe)
cells in the body can reproduce only 40 to 60 times. aging takes place when more and more cells no longer have the capacity to generate themselves falls under what biologic theory of aging?
programmed aging
older people may report dryness and itching of the skin also known as
pruritus
Psychosocial theories try to give?
reasons for the responses and interactions older adults have w society during late adulthood
the provision of care by non family members with a goal of allowing the primary caregivers the opportunity for relief from the stressors and strains imposed by caring for an ill or debilitating family member refers to as
respite care
The nurse initiates the application of a drawsheet on every bedfast patient on her unit to facilitate lifting and to prevent _________ forces.
shearing
what increases the risk of debilitating COPD
smoking
First major legislation that attempted to provide financial security for older adults
social security act of 1935
the first major legislation that attempted to provide financial security for older adults was the?
social security act of 1935
recommended mouth care for older adults consisted of a thorough cleaning of the entire mouth with a soft or hard bristled tooth brush?can a foam-stick applicator also be used?
soft; yes
how should older adults use soap?
sparingly and rinse the residue completely away. avoiding antibacterial soap
what may be completed for detection of colorectal cancer
stool DNA test
involuntary loss of small amount of urine with increased abdominal pressure, such as coughing or sneezing
stress incontinence
what are caregivers at high risk for
stress related problems, including depression, anxiety, and increased vulnerability to physical health problems
enhance the quality of life for older adults, what should the nurse support?
support the patients hope, pride, confidence, security, and integrity
regarding GI system older adults may experience a reduction in the
taste and smell
which biologic theory believes cells in the body wear our from internal and external stress, including chemical damage, trauma, or dysfunction of body systems, and a buildup of waste products
wear and tear
biologic theories attempt to explain what
why the body ages