g&d test 4

periodic screenings

mental health screening diabetes screening every 3 yrs

normal grief

short term (6 mo)

Kulber-Ross: 5 Stages of Grief

"DABDA" Denial Anger Bargaining - negotiating for more time Depression Acceptance

A client has died, and the nurse asks a family member about the funeral arrangements. The family member refuses to discuss the issue. Which is the appropriate nursing action?

Remain with the family member without discussing funeral arrangements.

teaching an older client about safety at home

"I will put a night light in the hallway"

When the nurse is collecting data from the older adult, which findings would be considered normal physiological changes? Select all that apply.

1) Decline in visual acuity 2) Increased susceptibility to urinary tract infections 3) Increased incidence of awakening after sleep onset

The nurse would implement which activity to promote reminiscence among older clients?

Having storytelling hours

The nurse is caring for an older client who is terminally ill. Which signs indicate to the nurse that death may be imminent?

Irregular, noisy breathing and cold, clammy skin

The nurse is caring for a client with terminal cancer who is close to death. In reviewing the plan of care, the nurse determines that which action is a priority?

Maintain the client's dignity and self-esteem, and make the client as comfortable as possible.

The nurse working in a long-term care facility is approached by the son of a resident, who wants his 78-year-old father to have a heating pad because "his feet are always cold at night." The nurse would incorporate which concept when formulating a response to the family member?

Older adults often have slower neurological response times and are therefore more at risk for burns.

The nurse is reinforcing teaching about fall prevention to family members of an older client who is at risk for falls. The nurse realizes FURTHER INSTRUCTION is necessary if the family states which concept is relevant to maintenance of balance for the older adult?

Older clients cannot think quickly enough to respond to emergencies.

The nurse is providing an education class to healthy older adults. Which exercise will best promote health maintenance?

Walking three to five times a week for 30 minutes

delirium

acute, temporary and can have a cause ( change in environment, ifection, pain)

The nurse is providing information to assistive personnel (AP) regarding caring for an older adult. The nurse determines the AP understands the information provided if the AP identifies which situation portrays ageism?

Advising older adults to forgo aggressive treatment

The nurse is caring for a client at the end of life. Which gastrointestinal findings indicate that death is approaching? Select all that apply.

Nausea Incontinence Accumulation of gas Abdominal distention

when should an older adult receive the influenza vaccine

annually in the fall

injury prevention

* Install bath rails, grab bars, and handrails on stairways * remove throw rugs * Ensure proper lighting * remove clutter from walkways/hallways * remove extension cords from hallways

nutritional recommendations

- increase intake of vitamins D, B12, E, folate, fiber and calcium. - Increase fluid intake to minimize risk of dehydration and prevent constipation. - take a low dose multivitamin along with mineral supplementation - limit sodium, fat, refined sugar, and alcohol intake

psychosocial interventions

Therapeutic communication Touch Reality orientation Validation therapy Reminiscence therapy Attending to physical appearance Assistive devices (canes, walker, hearing aid)

The nurse is working with a new nurse who is assisting an older client and family with discharge planning following hospitalization. The nurse realizes the new nurse correctly understands the needs of older adults if the new nurse helps the group plan for which situation?

To live independently, but close to their children if possible

necessary loss

a loss related to a change that is part of the cycle of life that is anticipated but still can be intensely felt. This type of loss can be replaced by something different or better

actual loss

any loss of a valued person, item, or job that OTHERS CAN RECOGNIZE

situational loss

any unanticipated loss caused by an external event (family losing house due to tornado)

perceived loss

anything clients define as loss but that is not obvious or verifiable to others

dementia

chronic and progressive

wht affects an older adult's mobility to do ADLS the most?

chronic physical disability

depression

chronic, acute or gradual onset

manifestations of approaching death

decreased level of consciousness muscle relaxation of the face labored breathing (dyspnea, apnea, cheyne-stokes respirations) "death rate" hearing not diminished touch diminished but client is able to feel pressure of touch mucus collecting in large airways incontinence of bowel and or baldder mottling (cyanosis) occurring with poor circulation pupils no longer reactive to light pulse slow and weak and blood pressure dropping cool extremities perspiration decreased urine output inability to swallow

immunizations

diphtheria flu herpes zoster pertussis tetanus varicella

maturational or developmental loss

ex. a child leaving home for college

piaget

formal operations

annual screenings

hearing fecal occult blood test digital rectal and prostate dual energy X-ray absorptiometry scanning for osteoporosis eye exam for glaucoma cholesterol screening

erikson

integrity vs despair

anticipatory loss

is experienced before the loss actually occurs

complicated grief

long term difficult progression thru expected stages of grief

inability to hear high pitched sounds

presbycusis

The nurse is preparing to care for a dying client, and several family members are at the client's bedside. Which therapeutic techniques would the nurse use when communicating with the family? Select all that apply.

1) Encourage expression of feelings, concerns, and fears. 2) Touch and hold the client's or family member's hand if appropriate 3) Be honest and let the client and family know that they will not be abandoned by the nurse.

The nurse is participating in a care plan session for a client with a terminal illness. Which nursing actions would be included? Select all that apply.

1) Provide information about what to expect during the dying process to the client and family. 2) Support the client's decision-making in order to promote client control. 3) Respond to requests from the client and family promptly.

The nurse is working with an older client who has a diagnosis of depression. To work most effectively with this client, the nurse recalls that which information is accurate regarding depression and the older client? Select all that apply.

1) Suicide is a frequent cause of death among the older population. 2) Some indications of dementia may actually originate as depression. 3) Depression in an older person is likely to have physical manifestations

The nurse is caring for a client who has just died. Which end-of-life information needs to be documented in the client's medical record? Select all that apply.

1) Time and date of death 2) Time of body transfer and destination 3) Medical tubes, devices, or lines left in the body 4) Name of primary health care provider certifying death

The nurse is caring for an older adult and knows that an ethical dilemma is most likely to occur in this population because of which issues? Select all that apply.

1) limited vision 2) chronic illness 3) lack of assertiveness