NUR 257 Exam 2 Study Guide
This study guide covers the key concepts: age-related changes, nutrition, safe
medication use, assessment & documentation, promoting safety, hydration
& oral care, and elimination.
1. Age-Related Changes
Key Physiological Changes
Cardiovascular: ↓ Cardiac output, ↑ BP, arteriosclerosis risk.
Respiratory: ↓ Lung elasticity, weaker cough reflex, increased risk for
pneumonia.
Musculoskeletal: ↓ Bone density (osteoporosis), muscle mass loss, joint
stiffness.
Neurological: Slower reflexes, memory changes (distinguish normal vs.
dementia signs).
GI System: ↓ Peristalsis (constipation), reduced appetite, weaker
swallowing reflex.
Renal/Urinary: ↓ Kidney filtration, increased urinary urgency, nocturia,
incontinence.
Skin: Thinner, drier skin, decreased wound healing, ↑ risk of pressure
ulcers.
Sensory: ↓ Vision (presbyopia, cataracts), ↓ Hearing (presbycusis), ↓
Taste/Smell.
Nursing Considerations
Promote independence while considering safety (assistive devices).
Encourage regular physical activity and proper nutrition.
Monitor for dehydration due to diminished thirst sensation.
Fall prevention strategies (non-slip socks, grab bars, adequate lighting).
2. Nutrition in Older Adults
Common Nutritional Concerns
Malnutrition: Caused by poor appetite, dental problems, dysphagia, or
financial limitations.
Protein Deficiency: Leads to muscle loss, poor wound healing.
, Vitamin Deficiencies:
o Vitamin D & Calcium → Osteoporosis prevention.
o Vitamin B12 → Prevents anemia and cognitive decline.
o Iron Deficiency → Common in chronic diseases, leads to fatigue.
Dehydration: ↓ Thirst sensation, diuretic use, mobility issues.
Unintentional Weight Loss: May indicate malnutrition or an underlying
disease.
Nursing Interventions
Encourage high-protein, high-calorie foods for those at risk of malnutrition.
Ensure adequate hydration (offer fluids frequently).
Modify food textures if dysphagia is present (pureed diet, thickened liquids).
Monitor weight and BMI regularly.
3. Safe Medication Use in Older Adults
Common Issues
Polypharmacy (taking multiple medications) → Increased risk of drug
interactions.
Altered Pharmacokinetics:
o Slower metabolism → Drugs stay in the system longer.
o Decreased renal function → Risk of medication accumulation/toxicity.
Side Effects Risk: Older adults are more sensitive to sedatives, opioids,
anticoagulants.
Beers Criteria: List of potentially inappropriate medications for the elderly.
Nursing Interventions
Medication Reconciliation: Review all medications regularly.
Educate Patients & Caregivers: Use pill organizers, simplify regimens.
Monitor for Adverse Effects: Watch for confusion, dizziness, GI upset.
Encourage Non-Pharmacologic Alternatives: Pain management (heat
therapy, PT), sleep hygiene for insomnia.
4. Assessment & Documentation
This study guide covers the key concepts: age-related changes, nutrition, safe
medication use, assessment & documentation, promoting safety, hydration
& oral care, and elimination.
1. Age-Related Changes
Key Physiological Changes
Cardiovascular: ↓ Cardiac output, ↑ BP, arteriosclerosis risk.
Respiratory: ↓ Lung elasticity, weaker cough reflex, increased risk for
pneumonia.
Musculoskeletal: ↓ Bone density (osteoporosis), muscle mass loss, joint
stiffness.
Neurological: Slower reflexes, memory changes (distinguish normal vs.
dementia signs).
GI System: ↓ Peristalsis (constipation), reduced appetite, weaker
swallowing reflex.
Renal/Urinary: ↓ Kidney filtration, increased urinary urgency, nocturia,
incontinence.
Skin: Thinner, drier skin, decreased wound healing, ↑ risk of pressure
ulcers.
Sensory: ↓ Vision (presbyopia, cataracts), ↓ Hearing (presbycusis), ↓
Taste/Smell.
Nursing Considerations
Promote independence while considering safety (assistive devices).
Encourage regular physical activity and proper nutrition.
Monitor for dehydration due to diminished thirst sensation.
Fall prevention strategies (non-slip socks, grab bars, adequate lighting).
2. Nutrition in Older Adults
Common Nutritional Concerns
Malnutrition: Caused by poor appetite, dental problems, dysphagia, or
financial limitations.
Protein Deficiency: Leads to muscle loss, poor wound healing.
, Vitamin Deficiencies:
o Vitamin D & Calcium → Osteoporosis prevention.
o Vitamin B12 → Prevents anemia and cognitive decline.
o Iron Deficiency → Common in chronic diseases, leads to fatigue.
Dehydration: ↓ Thirst sensation, diuretic use, mobility issues.
Unintentional Weight Loss: May indicate malnutrition or an underlying
disease.
Nursing Interventions
Encourage high-protein, high-calorie foods for those at risk of malnutrition.
Ensure adequate hydration (offer fluids frequently).
Modify food textures if dysphagia is present (pureed diet, thickened liquids).
Monitor weight and BMI regularly.
3. Safe Medication Use in Older Adults
Common Issues
Polypharmacy (taking multiple medications) → Increased risk of drug
interactions.
Altered Pharmacokinetics:
o Slower metabolism → Drugs stay in the system longer.
o Decreased renal function → Risk of medication accumulation/toxicity.
Side Effects Risk: Older adults are more sensitive to sedatives, opioids,
anticoagulants.
Beers Criteria: List of potentially inappropriate medications for the elderly.
Nursing Interventions
Medication Reconciliation: Review all medications regularly.
Educate Patients & Caregivers: Use pill organizers, simplify regimens.
Monitor for Adverse Effects: Watch for confusion, dizziness, GI upset.
Encourage Non-Pharmacologic Alternatives: Pain management (heat
therapy, PT), sleep hygiene for insomnia.
4. Assessment & Documentation
