Davis Advantage Chp 10 Older Adult

The U.S. Bureau of Labor Statistics projects growth of what percentage of the older population over the next 10 years?

-26%

By 2050, what percentage of the population will be over the age of 65?

-20% of the population will be older than age 65.

In the United States, older adults make up what percentage of the total population?

-12% -fastest growing population

What are the leading causes of death in America's elderly?

-Chronic diseases -Most commonly heart disease, cancer, stroke, respiratory disease, Alzheimer's, influenza, pneumonia and diabetes. -Many of these diseases are preventable or manageable with healthy lifestyle measures. But must be recognized early to minimize their impact on overall health.

What are common conditions in older adults that can impact quality of life?

-Older adults may be affected by bladder control issues, sleep disturbance, dementia, osteoporosis, falls, depression, effects of polypharmacy and loss of appetite. -If left untreated, these seemingly minor conditions can cause more serious complications, which in turn can lead to death. -For example, falls are the leading cause of injury among older adults and considered the most preventable source of mortality and morbidity in this group.

What are the three subgroups older adults are categorized into?

-Young old adults are between the ages of 65 and 74. -Middle old adults are those aged 75 to 84 -Oldest old adults are older than 85 years. -As we age, physical, cognitive and psychosocial abilities deteriorate. While this happens at a different rate for everyone, each of these subgroups has unique challenges.

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. Height and weight Pap test Breast cancer screening Gait and balance Visual acuity exam

Answer: Height and weight Gait and balance Visual acuity exam

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. Weakened immune system Decreased muscle strength Decreased cardiac output Decreased skin elasticity Decreased intercostal muscle strength

Answer: Weakened immune system Decreased muscle strength Decreased skin elasticity

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? Dehydration An enlarged prostate gland Decreased kidney filtration Medication

Answer: 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.

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. Assistance with all activities Use of grab bars in the bathroom An emergency call light that is accessible in all areas Use of a walker Not allowing her to brush her teeth

Answer: Assistance with all activities Use of grab bars in the bathroom An emergency call light that is accessible in all areas 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.

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. Use sign language. Look directly at the patient when speaking. Speak more slowly than usual. Speak loudly toward the patient's ears. Allow some extra time for the patient to respond.

Answer: Look directly at the patient when speaking. Speak more slowly than usual. Speak loudly toward the patient's ears. Allow some extra time for the patient to respond.

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. Arrange for an aide to assist with activities of daily living. Refer the client to a senior center for an adapted physical activity program. Assess the patient for symptoms of depression and memory loss. Arrange for nutritious meals to be delivered to the patient's home. Contact his children to move in with him.

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

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? Prevention of injury and falls Planning and participating in leisure activities and exercise Use of social media to stay connected with family members Resources for assisted living centers and nursing homes

Answer: Planning and participating in leisure activities and exercise

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? "Maybe you are not as aroused by your wife as you used to be." "It's probably the change of environment causing the problem." "It's a common problem of aging. I know some things we can try that will help." "You were probably exhausted from the long flight."

Answer: "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.

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? "Joint pain is common at this age, but biking is less impactful on the joints." "Take pain medicines daily when you wake up to make the run less uncomfortable." "Seek medical attention, you may have an injury." "Consider running at bedtime so the pain will be less intense."

Answer: "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.

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. Provide a foam mattress for the bed. Pad the corners of hard objects in the room. Encourage wearing long sleeves. Avoid contact with tape and adhesive bandages. Use gentle soaps and lotions.

Answer: All 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.

What is the leading cause of injury and preventable source of mortality and morbidity in older adults? Heart disease Car accidents Pneumonia Falls

Answer: Falls

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? Change her diet to include more fattening foods. Determine whether any medications she's taking would cause weight loss. Make her clean her plate with each meal. Monitor her daily calorie intake for a week.

Answer: 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.

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? Walk around the block three times a day. Participate in chair aerobics in the recreational center. Lift weights in the gym after meals. Take dancing lessons at the city dance hall.

Answer: 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.

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? Insert a Foley catheter. Use padded briefs. Change undergarments more frequently. Encourage use of the restroom more frequently.

Answer: 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.

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? His medication was outdated and therefore less potent. He was anxious when his blood pressure was taken. The blood pressure was not taken correctly. Vessels develop increased peripheral resistance with age, causing a rise in blood pressure.

Answer: 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.

What is considered the most preventable source of mortality and morbidity for older adults?

Falls

What is the prevalence of diabetes in older adults in non Hispanic blacks and Asian Americans?

Higher in non-Hispanic blacks and lower in Asian Americans