Chapter 25, 33, and 40 quiz
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
