GERIATRIC NURSING MIDTERM EXAM CORRECT ANSWERS 2023/2024

GERIATRIC NURSING MIDTERM EXAM CORRECT ANSWERS 2023/2024 patient's bill of rights - CORRECT ANSWER-make their own decisions receive fair and equal treatment (considerate) have their information and identity protected (confidentiality) be provided with all information can accept or refuse TX privacy receive responses to request (within reason) education categories of aging - CORRECT ANSWER-young-old: 65-74 middle-old: 75-84 old-old: 85+ biological theories of aging - CORRECT ANSWER-attempt to explain changes in the individual that ultimately lead to death cells become disorganized/chaotic, no longer replicate, die oxidative stress theories - CORRECT ANSWER-rise in reactive oxygen species (ROS) damages cells and results in impaired cell function ROS increased by external factors (smoke, pollution) and internal factors (inflammation) damage is random and unpredictable immunological theory of aging - CORRECT ANSWER-aging is a result of an accumulation of damage to immune system chronic state of inflammation and increasing ROS assessment of falls - CORRECT ANSWER-assessment of the older adult at risk nursing assessment of the client after a fall assessment of the environment and other situational circumstances upon admission and during institutional stays. after a patient falls, we should - CORRECT ANSWER-Make sure they are stable (take some vital signs) Check for injuries Do not force movement, but ask if they can move voluntarily Alert and oriented What were they doing when they fell Document as accurately as possible what happened Did they fracture something Get help before you move them interventions for fall preventions - CORRECT ANSWER-One-size-fits-all approach does not work Interventions depend on the person's changing condition Type, timing, and frequency of the interventions are determined for the specific older individual. assessment of the older adult - CORRECT ANSWER-Signs and symptoms tend to be subtle Don't stereotype Sensory and physical limitations may affect ability to respond quickly Be patient Allow pauses Observe for signs of fatigue: sighing, grimacing, irritability, leaning against objects for support, drooping head and shoulders frequent problems to address in an assessment - CORRECT ANSWER-sexual function depression incontinence alcoholism hearing loss oral health environmental safety assessment of the frail and medically complex - FANCAPES - CORRECT ANSWERfluids aeration nutrition communication activity pain elimination socialization documentation - CORRECT ANSWER-patient confidentiality detailed! clear and vivid and objective - should be able to be understood if it is in a court of law 10 years later communicates qualities of care cognition - CORRECT ANSWER-a process of acquiring, storing, sharing, and using information can change or remain stable age-associated memory loss - CORRECT ANSWER-normal in the older adult key element of nutrition - CORRECT ANSWER-preserving the health of the older adult quality and quantity of a diet will - CORRECT ANSWER-help prevent, delay the onset of, and manage chronic disease processes calorie needs in older adult - CORRECT ANSWER-fewer calories, low saturated fats, trans fatty acids, protein, and need more fiber obesity - CORRECT ANSWER-increasing in older adults maintaining weight is a clinical recommendation malnutrition - CORRECT ANSWER-a deficiency, excess, or imbalance of energy, protein, and other nutrients causes adverse effects on body form, function, and clinical outcomes. (b/w 16-30% older adults are malnourished) appetites - CORRECT ANSWER-influenced by physical activity, functional limitations, smell, taste, mood, socialization, and comfort. interventions to increase food intake - CORRECT ANSWER-Nutrition education Medication that stimulates appetite (orexigenic drugs) Hydration management Continued oral health care aspiration - CORRECT ANSWER-the most dangerous complication with someone who suffers with dysphagia factors that affect meds in older adults - CORRECT ANSWER-increased gastric pH (bad for acid-dependent drugs) stomach emptying is delayed intestinal mobility is slowed decreased response to beta-adrenergic receptor stimulators and blockers decreased baroreceptor sensitivity increased sensitivity to anticholinergics, benzodiazepines, opioid analgesics, warfarin, and the cardiac drugs diltiazem and verapamil decreased response to beta-adrenergic receptor stimulators - CORRECT ANSWER- [vasoconstriction, vasodilation] (heart, smooth muscle in bronchioles, arterioles, visceral organs) decreased response to beta-adrenergic blockers - CORRECT ANSWERcardioselective, smooth muscle contraction in bronchioles decreased baroreceptor sensitivity - CORRECT ANSWER-nerve terminal stimulated by pressure; pressure receptors increased sensitivity to anticholinergics - CORRECT ANSWER-parasympatholytics; block acetylcholine; atropine increased sensitivity to benzodiazepines - CORRECT ANSWER-sedative-hypnotic, anxiolytic; diazepam, zolpidem; potentiates GABA receptors-depressant actions on CNS, inhibit stimulation increased sensitivity to opioid analgesics, warfarin, and the cardiac drugs diltiazem - CORRECT ANSWER-rx. rapid ventricular response increased sensitivity to verapamil - CORRECT ANSWER-calcium channel blocker antidepressants - citalopram (celexa) - CORRECT ANSWER-Selective Serotonin Reuptake Inhibitor (SSRI) Restores the balance of serotonin the the brain Monitor patient for suicidal feelings/thoughts sleep-zolpidem (ambien) - CORRECT ANSWER-creates a calming effect in the brain treats insomnia aid patient with non pharmacological interventions not too late of a dinner lights off elimination-sennosides (Senoiot) - CORRECT ANSWER-laxative treats constipation ensures adequate hydration pain-acetaminophen/hydrocodone (norco) - CORRECT ANSWER-hydrocodone = opioid narcotic (pain) acetaminophen = non-opioid analgesic (fever and pain) used on severe pain scale be aware of addiction prevent constipation evidence-based assessment tools - "try this" - CORRECT ANSWER-spirituality alcohol use and screening Morse fall scale kats index of independent living (ADLs) pittsburgh sleep quantity index (PSQI) fall risk assessment (Hendricks II) health - CORRECT ANSWER-influenced by culture and age wellness - CORRECT ANSWER-one's whole being: physical, emotional, mental, and spiritual functional abilities - CORRECT ANSWER-the person's ability to live independently to enjoy family and life maslow's hierarchy of human needs - CORRECT ANSWER-Basic needs -Air, food, water, sleep, homeostasis, sleep Safe and secure -Family, health, morality, employment Needs of belonging -Friendships, family, sexual intimacy Develop self-esteem and self-efficacy -Confidence, achievement, respect of others Self actualization -Morality, creativity, acceptance, lack of prejudice Role of the Gerontological Nurse - CORRECT ANSWER-assists the older person to achieve the highest level of functioning will empower, enhance, and support the client for achievement of wellness uses available resources gerontological nurses as generalists: - CORRECT ANSWER-work in hospitals, homes, or subacute and long-term facilities, or in the community providing care to the individuals and their families gerontological nurses as specialists - CORRECT ANSWER-work in acute care settings, nursing homes, retirement homes, assisted living facilities, adult day care centers, and senior citizen housing culture - CORRECT ANSWER-The shared and learned values, beliefs, expectations, and behaviors of a group of people Guides thinking, decision making, and beliefs about aging, health and health seeking, illness, treatment, and prevention Cultural values extend into the delivery health care any time the "seeker" and "giver" meet nursing care considerations in regards to diversity - CORRECT ANSWER-verbal exchange facial and body expressions postures gestures touching reduction of disparities - CORRECT ANSWER-increase cultural competence increase cultural awareness obtain cultural knowledge cultural skills - CORRECT ANSWER-based on mutual respect explain the nurse's perception clearly without judgement develop a plan that considers both perspectives and is mutually acceptable biological theories of aging - CORRECT ANSWER-cells in the body become disorganized or chaotic cells no longer replicate cellular death occurs oxidative stress theories - CORRECT ANSWER-stressors in the environment that influence the way our bodies biologically function. ex: second hand smoke, pollution, BPA (plastic water bottles) immunological theory - CORRECT ANSWER-aging is a result of an accumulation of damage to the immune system, or immunoescence (don't respond to infection because immune system is slow in response) skin changes of aging - epidermis - CORRECT ANSWER-thins, making blood vessels and bruises more visible, fewer melanocytes result in a lighter appearance of the skin, age spots or liver spots appear on the backs of hands and wrists and on the face, seborrheic keratoses and thick, brown, and raised lesions appear. skin changes of aging - dermis - CORRECT ANSWER-loses about 20% of its thickness, dermal blood vessels are reduced, which accounts for resultant skin pallor and cooler skin temperature, collagen synthesis decreases, elastin fibers thicken and fragment, leading to loss of stretch and resilience and a "sagging" appearance. skin changes of aging - hypodermis - CORRECT ANSWER-areas atrophy, causing increased sensitivity to cold, sebaceous (oil) glands atrophy hair changes - CORRECT ANSWER-thins on the head increased hair in the ears, nose, and eyebrows loses pigmentation (graying occurs) women develop chin hair, and leg, axillary, and pubic hair decrease nail changes - CORRECT ANSWER-become harder, thicker, dull, and more brittle vertical ridges appear growth slows