NR - 226 NURSE FUNDAMENTALS EXAM 2 : ELDERLY, SLEEP,
ELECTROLYES QUESTIONS WITH COMPLETE SOLUTION
What is contributing to the increase in the older adult population?
increase in average life span, the baby boomers,the growth of the population segment
older than 85 years.
True or false, most older adults are inactive and can not care for themselves.
false: Most older adults are active and involved members of their communities. A
smaller number have lost the ability to care for themselves, are confused or withdrawn,
and/or are unable to make decisions concerning their needs. Most older adults live in
noninstitutional settings. However, a smaller number have lost the ability to care for
themselves.
True or false: Aging is directly correlated to disability and dependence of older
adults.
Most older adults are active and involved members of their communities. A smaller
number have lost the ability to care for themselves, are confused or withdrawn, and/or
are unable to make decisions concerning their needs. Most older adults live in
noninstitutional settings. However, a smaller number have lost the ability to care for
themselves.
What do you encourage the older population during your plan of care?
Do not assume that all older adults have signs, symptoms, or behaviors representing
disease and decline or that these are the only factors you need to assess. You also
need to identify an older adult's strengths and abilities during the assessment and
encourage independence as an integral part of your plan of care
What is ageism?
discrimination against people because of increasing age.
what are some myths about older people?
they are disabled, unattractive, forgetful, confused, rigid, boring, unfriendly, poor, unable
to learn and understand new information, not interested in sex, etc
What are some developmental tasks for older adults?
Change and loss of : Health, significant others, a sense of being useful, socialization,
income, and independent living
Coping with: Retirement, Residence change, Death
Having: Adult children
You are doing an assessment of an elderly patient and he is having trouble
understanding you. Would you conclude he is confused?
If an older adult is unable to understand your visual or auditory cues, your assessment
data will likely be inaccurate or misleading, leading you to incorrectly conclude that the
older adult is confused.
How would you speak with a person with hearing impairment?
When a person has a hearing impairment, speak directly to the patient in clear, low-
pitched tones and move to a quiet area to reduce background noise.
how would you care for a patient with vision impairment?
,When caring for people with visual impairments, sit or stand at eye level and face them.
Always encourage the use of assistive devices such as glasses and hearing aids.
Your patient is having trouble remembering things during his history. What can
you do to complete a through assessment?
Memory deficits, if present, affect the accuracy and completeness of your assessment;
may need to enlist help of family member or caregiver. The additional person
supplements information with the consent of the older adult, but the older adult remains
the primary source of the interview.
What should you look for in the elderly as early indicators of acute illness?
Note changes in mental status, occurrence and reason for falls, dehydration, decrease
in appetite, loss of function, dizziness, and incontinence because these symptoms are
not frequently present in younger adults.
What are some physiological changes of skin in older adults?
With aging the skin loses resilience and moisture. The epithelial layer thins, and elastic
collagen fibers shrink and become rigid. Wrinkles of the face and neck reflect lifelong
patterns of muscle activity and facial expressions, the pull of gravity on tissue, and
diminished elasticity. Spots and lesions are often present on the skin.
What are some changes in elderly vision?
Visual acuity declines with age. This is often the result of retinal damage, reduced pupil
size, development of opacities in the lens, or loss of lens elasticity.
Presbyopia, is common.
Glare effects increase.
Pupils are smaller and react slower.
Difficulty with going from bright to dark environments.
Changes in color vision makes it difficult to distinguish between blue and green.
Diseases include cataract, macular degeneration, diabetic retinopathy, and retinal
detachment.
What are some changes in elderly hearing?
Auditory changes are often subtle. Common change is presbycusis, which affects the
ability to hear high-pitched sounds and conversational speech and is typically bilateral,
affecting more men than women. Inspect the external auditory canal for the presence of
cerumen.
What are some changes in elderly tasting?
Salivary secretion is reduced, and taste buds atrophy and lose sensitivity. Health
conditions, treatments, and/or medications often alter taste. It is often a challenge to
promote optimal nutrition in an older patient because of the loss of smell and changes in
taste.
What are some changes in elderly thorax and lungs?
Because of changes in the musculoskeletal system, the configuration of the thorax
sometimes changes. Vertebral changes caused by osteoporosis lead to dorsal
kyphosis, the curvature of the thoracic spine. Calcification of the costal cartilage causes
decreased mobility of the ribs. The chest wall gradually becomes stiffer. Lung expansion
decreases, and the person is less able to cough deeply. If kyphosis or chronic
, obstructive lung disease is present, breath sounds become distant. Older adult is more
susceptible to pneumonia and other bacterial or viral infections.
Respiratory muscle strength decreases
anteroposterior diameter of thorax increases
What are some changes in elderly heart and vascular system?
The body tries to compensate for decreased cardiac output by increasing the heart rate
during exercise; takes longer for an older adult's rate to return to baseline. Systolic
and/or diastolic blood pressures are sometimes abnormally high. Although a common
chronic condition, hypertension is not a normal aging change and predisposes older
adults to heart failure, stroke, renal failure, coronary heart disease, and peripheral
vascular disease.
decreased contractile strength of the myocardium which leads to decrease in cardiac
output.
Peripheral pulses frequently are still palpable but weaker in lower extremities.
What are some physiological changes in elderly breast?
As estrogen production diminishes, the milk ducts of the breasts are replaced by fat,
making breast tissue less firm. Decreased muscle mass, tone, and elasticity result in
smaller breasts in older women. In addition, the breasts sag. Gynecomastia, enlarged
breasts in men, is often the result of medication side effects, hormonal changes, or
obesity. Both older men and women are at risk of breast cancer.
What are some physiological changes in elderly GI and abdomen?
Abdomen increases in size due to an increase in the amount of fatty tissue in the trunk.
Because muscle tone and elasticity decrease, it also becomes more protuberant.
Gastrointestinal function changes include a slowing of peristalsis and alterations in
secretions. Alterations in the lower gastrointestinal tract lead to constipation, flatulence,
or diarrhea.
What are some physiological changes in elderly reproductive system?
Hormonal changes include reduced estrogen and progesterone levels in women,
causing vaginal mucosa dryness, irritation and pain with intercourse, and decreased
libido for women; ,men typically experience less firm and shorter acting erection, and
less forceful ejaculation. Sexual desires, thoughts, and actions continue throughout all
decades of life. Less frequent sexual activity often results from illness, death of a sexual
partner, or decreased socialization.
What are some physiological changes in elderly urinary system?
Hypertrophy of the prostate gland is frequently seen in older men; urinary retention,
frequency, incontinence, and UTIs occur. Prostatic hypertrophy results in difficulty
initiating voiding and maintaining a urinary stream. Benign prostatic hypertrophy is
different from cancer of the prostate. Cancer of the prostate is the second leading cause
of cancer death in American men.
Urinary incontinence is an abnormal and typically embarrassing condition. Stress
incontinence is involuntary release of urine that occurs when they cough, laugh, sneeze,
ELECTROLYES QUESTIONS WITH COMPLETE SOLUTION
What is contributing to the increase in the older adult population?
increase in average life span, the baby boomers,the growth of the population segment
older than 85 years.
True or false, most older adults are inactive and can not care for themselves.
false: Most older adults are active and involved members of their communities. A
smaller number have lost the ability to care for themselves, are confused or withdrawn,
and/or are unable to make decisions concerning their needs. Most older adults live in
noninstitutional settings. However, a smaller number have lost the ability to care for
themselves.
True or false: Aging is directly correlated to disability and dependence of older
adults.
Most older adults are active and involved members of their communities. A smaller
number have lost the ability to care for themselves, are confused or withdrawn, and/or
are unable to make decisions concerning their needs. Most older adults live in
noninstitutional settings. However, a smaller number have lost the ability to care for
themselves.
What do you encourage the older population during your plan of care?
Do not assume that all older adults have signs, symptoms, or behaviors representing
disease and decline or that these are the only factors you need to assess. You also
need to identify an older adult's strengths and abilities during the assessment and
encourage independence as an integral part of your plan of care
What is ageism?
discrimination against people because of increasing age.
what are some myths about older people?
they are disabled, unattractive, forgetful, confused, rigid, boring, unfriendly, poor, unable
to learn and understand new information, not interested in sex, etc
What are some developmental tasks for older adults?
Change and loss of : Health, significant others, a sense of being useful, socialization,
income, and independent living
Coping with: Retirement, Residence change, Death
Having: Adult children
You are doing an assessment of an elderly patient and he is having trouble
understanding you. Would you conclude he is confused?
If an older adult is unable to understand your visual or auditory cues, your assessment
data will likely be inaccurate or misleading, leading you to incorrectly conclude that the
older adult is confused.
How would you speak with a person with hearing impairment?
When a person has a hearing impairment, speak directly to the patient in clear, low-
pitched tones and move to a quiet area to reduce background noise.
how would you care for a patient with vision impairment?
,When caring for people with visual impairments, sit or stand at eye level and face them.
Always encourage the use of assistive devices such as glasses and hearing aids.
Your patient is having trouble remembering things during his history. What can
you do to complete a through assessment?
Memory deficits, if present, affect the accuracy and completeness of your assessment;
may need to enlist help of family member or caregiver. The additional person
supplements information with the consent of the older adult, but the older adult remains
the primary source of the interview.
What should you look for in the elderly as early indicators of acute illness?
Note changes in mental status, occurrence and reason for falls, dehydration, decrease
in appetite, loss of function, dizziness, and incontinence because these symptoms are
not frequently present in younger adults.
What are some physiological changes of skin in older adults?
With aging the skin loses resilience and moisture. The epithelial layer thins, and elastic
collagen fibers shrink and become rigid. Wrinkles of the face and neck reflect lifelong
patterns of muscle activity and facial expressions, the pull of gravity on tissue, and
diminished elasticity. Spots and lesions are often present on the skin.
What are some changes in elderly vision?
Visual acuity declines with age. This is often the result of retinal damage, reduced pupil
size, development of opacities in the lens, or loss of lens elasticity.
Presbyopia, is common.
Glare effects increase.
Pupils are smaller and react slower.
Difficulty with going from bright to dark environments.
Changes in color vision makes it difficult to distinguish between blue and green.
Diseases include cataract, macular degeneration, diabetic retinopathy, and retinal
detachment.
What are some changes in elderly hearing?
Auditory changes are often subtle. Common change is presbycusis, which affects the
ability to hear high-pitched sounds and conversational speech and is typically bilateral,
affecting more men than women. Inspect the external auditory canal for the presence of
cerumen.
What are some changes in elderly tasting?
Salivary secretion is reduced, and taste buds atrophy and lose sensitivity. Health
conditions, treatments, and/or medications often alter taste. It is often a challenge to
promote optimal nutrition in an older patient because of the loss of smell and changes in
taste.
What are some changes in elderly thorax and lungs?
Because of changes in the musculoskeletal system, the configuration of the thorax
sometimes changes. Vertebral changes caused by osteoporosis lead to dorsal
kyphosis, the curvature of the thoracic spine. Calcification of the costal cartilage causes
decreased mobility of the ribs. The chest wall gradually becomes stiffer. Lung expansion
decreases, and the person is less able to cough deeply. If kyphosis or chronic
, obstructive lung disease is present, breath sounds become distant. Older adult is more
susceptible to pneumonia and other bacterial or viral infections.
Respiratory muscle strength decreases
anteroposterior diameter of thorax increases
What are some changes in elderly heart and vascular system?
The body tries to compensate for decreased cardiac output by increasing the heart rate
during exercise; takes longer for an older adult's rate to return to baseline. Systolic
and/or diastolic blood pressures are sometimes abnormally high. Although a common
chronic condition, hypertension is not a normal aging change and predisposes older
adults to heart failure, stroke, renal failure, coronary heart disease, and peripheral
vascular disease.
decreased contractile strength of the myocardium which leads to decrease in cardiac
output.
Peripheral pulses frequently are still palpable but weaker in lower extremities.
What are some physiological changes in elderly breast?
As estrogen production diminishes, the milk ducts of the breasts are replaced by fat,
making breast tissue less firm. Decreased muscle mass, tone, and elasticity result in
smaller breasts in older women. In addition, the breasts sag. Gynecomastia, enlarged
breasts in men, is often the result of medication side effects, hormonal changes, or
obesity. Both older men and women are at risk of breast cancer.
What are some physiological changes in elderly GI and abdomen?
Abdomen increases in size due to an increase in the amount of fatty tissue in the trunk.
Because muscle tone and elasticity decrease, it also becomes more protuberant.
Gastrointestinal function changes include a slowing of peristalsis and alterations in
secretions. Alterations in the lower gastrointestinal tract lead to constipation, flatulence,
or diarrhea.
What are some physiological changes in elderly reproductive system?
Hormonal changes include reduced estrogen and progesterone levels in women,
causing vaginal mucosa dryness, irritation and pain with intercourse, and decreased
libido for women; ,men typically experience less firm and shorter acting erection, and
less forceful ejaculation. Sexual desires, thoughts, and actions continue throughout all
decades of life. Less frequent sexual activity often results from illness, death of a sexual
partner, or decreased socialization.
What are some physiological changes in elderly urinary system?
Hypertrophy of the prostate gland is frequently seen in older men; urinary retention,
frequency, incontinence, and UTIs occur. Prostatic hypertrophy results in difficulty
initiating voiding and maintaining a urinary stream. Benign prostatic hypertrophy is
different from cancer of the prostate. Cancer of the prostate is the second leading cause
of cancer death in American men.
Urinary incontinence is an abnormal and typically embarrassing condition. Stress
incontinence is involuntary release of urine that occurs when they cough, laugh, sneeze,
