WGU C475 (Care of the Older Adult) Objective Assessment 2022/2023

BOOST (The Better Outcomes for Older Adults through Safe Transitions) - ANSWER-Intervention that includes pre-discharge and post-discharge interventions (5 goals) BOOST (The Better Outcomes for Older Adults through Safe Transitions) - ANSWER-Model that aims to reduce 30 day hospital readmission rates for older adults BOOST (The Better Outcomes for Older Adults through Safe Transitions) - ANSWER-Model that aims improves patient satisfaction BOOST (The Better Outcomes for Older Adults through Safe Transitions) - ANSWER-Model that aims to identify high-risk patients to prevent adverse events BOOST (The Better Outcomes for Older Adults through Safe Transitions) - ANSWER-Model that aims to improve communication between providers and patients (4/5) BOOST (The Better Outcomes for Older Adults through Safe Transitions) - ANSWER-Model that aims to better prepare the patient and family for discharge CTI (Care Transitions Intervention) - ANSWER-Model developed by Eric Coleman CTI (Care Transitions Intervention) - ANSWER-Patient-centered 4 week intervention program CTI (Care Transitions Intervention) - ANSWER-Program designed to improve quality of care and contain costs for patient with complex care needs as they transition across care settings TCM (Transitional Care Model) - ANSWER-Model where the nurse acts as the main care manager who consults with the patient in the hospital, at home within 24 hrs of discharge, follow up visits, weekly home visits, telephone support for 2 months TCM (Transitional Care Model) - ANSWER-Emphasis of this model is care coordination and continuity of care Better care Better health outcomes Lower costs - ANSWER-3 Triple Aim goals functional incontinence - ANSWER-Type of incontinence where the pt is unable to get to the restroom b/c of physical or mental conditions Functional decline - ANSWER-New loss of independence typically associated with decreased mobility and performance of ADLs Frailty - ANSWER-Dependency because of 3 or more ADL deficiencies Aerobic exercise 10-15 minutes a day Moderate strength training - ANSWER-Exercise recommendations for an older adult Autonomy - ANSWER-Each person has a right to make independent choices and decisions Non-malfeasance - ANSWER-Means to "do no harm" Hispanic Americans - ANSWER-Group of people who emphasize family interdependence over independence Falls - ANSWER-leading cause of unintentional injury death in older adults in this country Wear and Tear Theory - ANSWER-Idea that cells wear out and cannot function with aging Medicare - ANSWER-Provides insurance for people over 65 and some patients with disabilities Medicaid - ANSWER-Provides insurance for low income persons Isometric exercise (example of...) - ANSWER-Pushing on a wall Isotonic exercise (example of...) - ANSWER-Using resistance bands Prevent external hip rotation - ANSWER-While caring for a client with immobility the RN applies a trochanter roll after placing the client in supine position. What is the rationale behind this nursing intervention? 3 item recall Clock drawing test - ANSWER-What is on the mini-cog test? Sleep Problems with eating Incontinence Confusion Evidence of fall Skin breakdown - ANSWER-What are the components of the SPICES tool? People over 65 People with ESRD Diabetics People retired from the rail road industry - ANSWER-Who qualifies for Medicare? Patient Protection and Affordable Care Act - ANSWER-Eliminates lifetime insurance gaps, provides free preventive care, provides insurance plans for patients with pre-existing conditions, and allows children to stay on parents' plan until age 26 To reduce avoidable re-admissions - ANSWER-What is the major goal of Care Transition Systems? nociceptive pain - ANSWER-Pain that usually responds well to opioid treatment (also NSAIDS) - reduced hepatic and renal blood flow - lower total body water - higher % of body fat - ANSWER-Physiologic changes in the elderly that affects medication dosing MMSE (Mini Mental Status Exam) - ANSWER-The most extensively used cognitive assessment tool Katz Index Barthel Index - ANSWER-Two tools commonly used to assess ADLs Functional Assessment - ANSWER-Type of assessment that focuses on the patient's abilities Custodial care - ANSWER-Non-medical assistance with ADLs Medicaid - ANSWER-Assistance program that is jointly financed by states and federal government for low income individuals Medicare Part B and D - ANSWER-Participation in these programs are not mandatory and premiums must be paid and covered by the individual Social Security - ANSWER-75% of the poor are elderly women who rely on this as their major source of income The "Donut Hole" - ANSWER-Medicare coverage gap for prescription drugs that is scheduled to close by 2020 HRQOL (Health Related Quality of Life) - ANSWER-The tool from the CDC that measures the number of healthy days an individual has in a given month Morphine 2.5-5mg PO q4 - ANSWER-Commonly used to relieve dyspnea at the end of life (medication and dose) Fluid/electrolyte imbalance Infection CHF Medications (ex. opioids) Pain Sleep deprivation Hypoxia Organ failure - ANSWER-Potential causes (8) of delirium in the elderly With tricyclic antidepressants and anticonvulsants - ANSWER-How is neuropathic pain best treated? Morphine O2 Raise HOB Fan Anti-anxiety meds (Ativan) Meds that dry up excretions (scopolamine) - ANSWER-What interventions help relieve dyspnea in a dying patient? (6) Beers Criteria - ANSWER-A list of medications, which are considered inappropriate when given to an older patient Visual comprehension Praxis - ANSWER-In a mental status exam, copying a simple geometric shape tests which mental functions? (2) Acetylcholine - ANSWER-Chemical needed for memory and problem solving Meds that inhibit acetylcholinesterase - ANSWER-Often prescribed for patients with dementia Amnesia Agnosia Aphasia - ANSWER-3 assessment findings in dementia Pain Dyspnea Delirium - ANSWER-Common symptoms in end of life care (3) Using opioids for dyspnea - ANSWER-Has the highest level of evidence to support interventions at the end of life A patient with neuropathic pain - ANSWER-Has the highest level of evidence for the use of adjuvant analgesics Osteoporosis Muscle weakness Degenerative Disc Deterioration - ANSWER-Causes of senile kyphosis (3) 2006 - ANSWER-Year that the TCM appeared 2008 - ANSWER-Year that the Guide Model appeared Goal of the Guide Model - ANSWER-To improve healthcare of the older adult with comorbidities Invite Follow through Maximize communication Arrange environment Maximize understanding - ANSWER-Basic principles of communication as described by V. Satir (5) Medicare - ANSWER-Program covers certain disabled Americans who have not reached age eligibility Medicare - ANSWER-Recipients of this program range from those simply needing wellness services to those who are profoundly ill Upright - ANSWER-What is the orthopneic position that prevents SOB? Gustatory Deficit - ANSWER-Lack of appetite and sense of smell Short Gut Syndrome - ANSWER-Malabsorption disorder caused by lack of functional small intestine. (Diarrhea-- dehydration, malnutrition, and wt loss) Cachexia - ANSWER-When a pt looses a lot of body weight and muscle mass in a short period of time due to chronic illness Nociceptive - ANSWER-Bone pain Nociceptive - ANSWER-Soft tissue pain Nociceptive - ANSWER-Internal organ pain Nociceptive - ANSWER-Peripheral pain Nociceptive - ANSWER-Somatic or visceral injury Neuropathic - ANSWER-Shooting pain Neuropathic - ANSWER-Stabbing pain Neuropathic - ANSWER-Burning pain Neuropathic - ANSWER-Constant or intermittent pain NSAIDS Steroids Tylenol - ANSWER-Best meds for nociceptive pain Opioid analgesics Antidepressants Anticonvulsants - ANSWER-Best meds for neuropathic pain MMSE (Mini Mental State Examination); below 20 - ANSWER-What aids in detecting dementia, and what is the score that indicates dementia? Cut down on drinking Annoyance with friends and family asking you to stop Guilt about drinking Eye opener - ANSWER-C.A.G.E. HTN Smoking Obesity - ANSWER-Risk factors associated with CHD (3) Diabetes Sedentary lifestyle Abnormal lipid levels - ANSWER-Family hx that increases the risk of premature CHF (3) CAM (Confusion Assessment Method) - ANSWER-Method to diagnose delirium Sarcopenia - ANSWER-Loss of muscle mass Primary - ANSWER-What kind of prevention is... - prevention of disease - flu or pneumonia shot Secondary - ANSWER-What kind of prevention is... - early detection/management of disease