NSG 506 Final Exam questions with answers

NSG 506 Final Exam questions with
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answers


4 M's of an Age Friendly Health System - CORRECT ANSWERS
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✔✔- matters (goals)
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-meds (using meds that don't interfere with what matters)
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-mentation (prevent, id, treat, and manage dementia, delirium,
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and depression)
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-mobility (falls/safety precautions)
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medication use in elderly considerations - CORRECT ANSWERS
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✔✔-warfarin, insulin, digoxin = 1/3 of emergency room visits for
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adverse drug reactions among older adults
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-important to educate pt and teach them about side effects
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dementia etiology - CORRECT ANSWERS ✔✔-alzheimer's;
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vascular; parkinson's; Lewy body; frontotemporal
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-very slow progressing disease
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dementia goal of care - CORRECT ANSWERS ✔✔-must always be
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directed at providing and increasing *quality of life*
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dementia baseline - CORRECT ANSWERS ✔✔ADLs and level of
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functioning

,dementia symptoms - CORRECT ANSWERS ✔✔-impaired
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perception (hallucination/illusions/delusions (false beliefs))
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-alteration in sleep/rest pattern and sundowning
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-impaired self-expression/communication |\




-physical discomfort/pain |\




-repetitiveness/loss of short term memory |\ |\ |\ |\




-caregiver role strain |\ |\




dementia nursing management - CORRECT ANSWERS ✔✔-all
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behavior is meaningful, but communication may not be clear
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-- may be indication of a UTI or trying to signal pain or discomfort
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-important to *assess for physical problems* that may be a
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trigger for behavioral symptoms
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-wandering, screaming, aggression (risk for violence/injury) =
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50% of pts --> rule out other causes (pain; UIT; fracture; med
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side effects/interactions; sensory
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-assess pts baseline with family members
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(physical aggression most common when personal care is being
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given to cognitively impaired individuals)
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Delirium - CORRECT ANSWERS ✔✔-a state of *acute* mental
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confusion
-under-recognized disorder and underdiagnosed |\ |\ |\




-reversible
-may be life threatening
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,-most *frequent* complication of hospitalized older adults
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how delirium is different than other cognitive impairment -
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CORRECT ANSWERS ✔✔-status altered from baseline (acute
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onset or fluctuating)
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-inattention
-disorganized thinking |\




-altered level of consciousness
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assess for delirium - CORRECT ANSWERS ✔✔CAM method =
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confusion assessment method tool |\ |\ |\




delirium presentations - CORRECT ANSWERS ✔✔-hyperactive
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(most recognized) = increased psychomotor activity
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-hypoactive (underrecognized) = decreased psychomotor activity
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-mixed (highest risk for morbidity/mortality) = fluctuating course
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most at risk for delirium - CORRECT ANSWERS ✔✔-older pts with
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dementia
-advanced age |\




-sleep deprivation |\




-dehydration
-pain
-sensory impairment |\




-immobility

, assess for physiologic causes and risk factors for delirium -
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CORRECT ANSWERS ✔✔-meds (BEERS criteria)
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-fecal impaction
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-urinary retention |\




-infection
-dehydration


delirium management - CORRECT ANSWERS ✔✔-id and treat
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etiology
-environmental modification |\




-control of symptoms |\ |\




-pharm treatment (haldol - treats hallucinations, paranoia,
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delusions)
-nonpharm (avoid restraints; encourage familiar faces;
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fluids/nutrition; toileting; low stimulation; provide orientation;
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correct sensory impairment devices)
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polypharmacy - CORRECT ANSWERS ✔✔- *inappropriate use* of |\ |\ |\ |\ |\ |\ |\ |\


multiple drugs |\




-- no indication
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--duplication of therapy |\ |\




--treating side effects |\ |\




--self-medicating


-important to ask pt, "why are you taking this med?"
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