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gerri Final
| Question | Answer |
|---|---|
| The kidney plays an important role in fluid and electrolyte / acid-base balance which helps to regulate what | Blood Pressure, blood volume and ph balance |
| Which muscles hold the bladder in | Sphincter |
| What is the normal specific gravity of urine | 1.010 – 1.025 |
| If urine is clear and pale normal or amber colored, is it normal or abnormal | Normal |
| Kidneys lose mass and decrease in what as we age | Size |
| Vascular changes decreases what to the kidneys | blood flow |
| Urinary Retention contributes to the risk of what disease because retaining urine is a good medium for bacteria | Urinary Tract Infection (UTI) |
| What enlarges in the man with age and can lead to benign hyperplasia or even cancer | Prostate |
| Swelling of the prostate can cause problems with | voiding |
| Plasma viscosity (thickness of blood plasma) increases with age, and this puts us at an increased risk for | Vascular Occlusion |
| Older adults have a small what of RBC’s and WBC’s | decrease |
| The small decrease in the RBC’s can put the elderly at a higher risk of | anemia |
| The elderly signs and symptoms of a disease may make it harder to diagnose them, why | they are modified |
| What may not increase in the elderly until an infection is severe | temperature |
| The elderly do not c/o or feel what the same as their younger counterparts | pain |
| The number of T-cells does not decrease as we age more of them become | immature |
| The T-cell change gives us an increased ration of helper cells to suppressor cells and this can lead to decreased | immune response |
| With a decreased immune response older adults are at a greater risk of catching which two main infections | respiratory and urinary tract infections |
| What are the inadequate amounts of RBC’s or HgB in the body called | anemia |
| What two things are commonly seen with leukemia | anemia and hemorrhage |
| The mutation (change) in DNA of a single lymphocyte is called | Chronic Lymphocytic Leukemia (CLL) |
| Which intelligence has the ability to perform tasks or make judgments based on unfamiliar stimuli, most commonly seen in the young | Fluid |
| Which intelligence is the ability to perform tasks and make judgments based on knowledge and experience acquired through a lifetime, most often seen in older adults | Crystallized |
| Many older people who seem confused actually suffer from disturbed sensory | perceptions |
| Malfunction of what results in disturbed perception and cognition | sensory organs |
| What are the three characteristics of Parkinsons disease | Tremors, Rigidity and Bradykinesis |
| What are the characteristics of Alzheimer’s | A progressive and significant loss of cognitive and behavioral function |
| Which disease is a chronic, progressive, degenerative disease in which large numbers of brain cells and tissues are affected by atrophy, beta amyloid plaques and neurofibrillary tangles | Alzheimer’s disease |
| What would your main concern be when treating a pt with Parkinsons | decreasing of symptoms |
| What two factors worsen Parkinsons | Fatigue and Stress |
| CVA's are a leading cause of disability in people over 65, more common in men and African Americans and can often be | Fatal |
| What is the priority with a pt that has just suffered a CVA | Airway |
| Blurred, Tunnel or double vision, blindness, vertigo, numbness, weakness, aphasia, slurred speech and gait problems are all symptoms of what | TIA or Transient Ischemic Attack |
| If you have damage to your left brain, what would you see | Right sided paralysis and loss of visual sense |
| If you had damage to your right brain you would see | left sided paralysis and loss of visual sense, altered sense of humor, lack of impulse control, visual, spatial and poor judgment |
| If you took damage to the right side of the cerebellum, which side would it effect | both, the cerebellum does not have crossover or decussation |
| Parkinsons is said to be a reduction or total loss of what neurotransmitter | Dopamine |
| The loss of high pitched sounds results in | Presbycusis |
| What is the major symptom of presbycusis | tinnitus |
| What is the clouding of the eyes called | Cataracts |
| What is the only treatment for cataracts | Surgery |
| What does otosclerosis cause | Loss of hearing |
| What method treats otosclerosis | Hearing Aids |
| Menieres is a disease that occurs in the | Vestibular nerve |
| Severe vertigo, tinnitus and feelings of ear fullness are all characters of | Menieres disease |
| What is tinnitus characterized by | ringing in the ear |
| Tinnitus is more common in | Men |
| What is the outer portion of the eye called | Sclera |
| Poor dark adaption refers to | nyctalopia |
| Forms of macular degeneration are | wet and dry |
| What separates the outer and middle ear | Tympanic membrane |
| Arcus Sinilis is characterized by what color circles around the cornea | White-gray |
| What is the daily recommended caloric intake for the older adult | 1200 cal/day |
| Nutritional needs of the older adult are what to the younger adult | Not the same |
| Which types of proteins have all the needed amino acids in them already | Complete Proteins |
| Which type of protein does not have all of the necessary proteins in them | Incomplete Proteins |
| The kidneys control the production of what mineral | Sodium |
| How much water should the older adult drink daily | 2 – 3 thousand mL /2-3 L |
| People who are on the low sodium diet need to be sure to do what | read labels |
| Even the intellectual. learned older adult does not do what | make good choices about nutrition |
| Nutritional status is influenced by | General Health and Emotional Status |
| What type of medication can lead to a fluid volume deficit | Diuretics |
| What kind of questions should you ask the client | open-ended questions |
| What are some problems with nutrition and aging | Alcoholism, CHF/Dementia, pain and cost of food |
| Geriatric Failure to thrive is a combo of | weight loss, depression, and decreased activity level |
| If a person refuses fluids for 24 hours they are said to be | Fluid Volume Deficit |
| Edema and fluid in the interstitial spaces, often accompanying CHF can be called | Fluid Volume Excess |
| When doing a limit on fluid intake, what would make it easiest | Breaking the amount down by hour and give that each hour |
| When a pt is swallowing, what is it important to remember | Have them close their mouths |
| Prebycusis results in what | loss of high pitched sounds |
| What is a symptom of prebycusis | tinnitus |
| What are cataracts | clouding of the lens |
| An 80 y/o person produces only ______ of tears they produced during their teenage years | 25 % |
| The decline in tear production also reduces the ________ protection provided by enzymes and can lead to decreased resistance to bacterial eye infections | antibacterial |
| What does otosclerosis cause | loss of hearing |
| Meniere’s disease is characterized by fluctuating episodes of what | Severe vertigo, tinnitus, feelings of ear fullness |
| What is tinnitus | ringing in the ear |
| The outer portion of the eye is the | sclera |
| All of these are forms of treatment for deafness | Cochlear implants, sign language, hearing aid |
| What are the three types of deafness | Conductive, sensorineural and mixed |
| What is an example of how to encourage an elderly patient to eat bland food | use food enhancers |
| What group of people is most effected by glaucoma | African American |
| What is the most preventative measure against glaucoma | annual eye exam |
| Poor dark adaption, night blindness, refers to | nyctalopia |
| Forms of macular degeneration are | Wet and Dry |
| What color is the ring around the pupil in arcus sinilis | grayish/white |
| In Alzheimer’s if the patient is pulling away from social interaction, what stage are they in | Early |
| In Alzheimer’s if the patient is easily agitated what stage are they in | Middle |
| In Alzheimer’s if the patient is losing the ability to think abstractly, what stage are they in | Middle |
| What is the study of drug actions within the body including absorption, distribution, metabolism and excretion | pharmacokinetics |
| What is the response to medicines called | pharmacodynamics |
| What is it called when you are taking more drugs than are prescribed | Polypharmacy |
| What are the two systems that are in elimination | urinary and digestion |
| What can affect our elimination | Stress, activity, fluid and food |
| What can disrupt elimination | immobility, medication, diseases and abdomen muscle control |
| What do you need to do so that any extra iron you take does not stop you up | drink water |
| With impaired swallowing, if they are paralyzed on one side of body where would you put the food in their mouth | on the unaffected side |
| What is the medical specialty that deals with the physiology of aging and with the diagnosis and treatment of diseases affecting the ages | geriatrics |
| What is the study of all aspects of the aging process, including the clinical, psychological, economic and sociologic problems of the older adult called | gerontology |
| What term is used to define the nursing care and service provided to older adults | Gerontics |
| What is the fear of aging and the refusal to accept older adults into the mainstream of society, may result in strange behavior | gerontophia |
| What is the statistical study of human populations, concerned with a populations size, distribution and vital statistics | Demographics |
| What is a term used by demographers to describe a group of people born within a specific time period | A cohort |
| Anyone born between 1946 and 1964 are considered | Baby Boomers |
| Older populations are not equally distributed throughout the U.S., they are affected by | climate, taxes and other issues |
| What is more technologically sophisticated that increased by 50% during the baby boomer years | Education |
| What are the three means by which most elder aging receive their income are | Social Security, pensions and misc. sources |
| The home is usually the older persons | largest Asset |
| Why do older people often not want to sell their home | Fear of homelessness |
| Which type of housing is simple apartments w/o any services but may assist with transport to medical services | government housing |
| Which type of housing is when one or more older adult share a home with private rooms but shared leisure and recreational areas | Group-housing |
| Which type of housing is a room and board, with ADL￢ﾀﾙs, assistance with meds, annual exams, info and referrals and programs | Community-based residential facility |
| Which type of housing provides room and board, personal care, and medical and nursing care | nursing homes or extended-care facilities |
| There are four types of Nursing Homes or Extended-Care facilities, what are they | Basic Care, Skilled care, subacute care and specialty. |
| Alzheimers units are | Specialty |
| Injury, acute illnesses go to | Subacute Care |
| Skilled Care needed on a regular basis are at | Skilled Care Facilities |
| When someone 18 y/o or older makes a decision ahead of time on how their care should be given it is called a (an) | Advanced Directive |
| Advanced Directives deal with what areas | DNR￢ﾀﾙs, Artificial Nutrition and Hydration |
| What are the two types of Advanced Directives | Durable Power of Attorney and Living Will |
| These two documents are designed to help GUIDE the family and medical professionals in planning | Care |
| Either of these documents can be | revoked |
| How many parts are there to Medicare | 4 |
| Which part of Medicare is for impatient hospital care, extended care, visiting nurse and therapies | Part A |
| Which part of Medicare pays 80% of dr. charges after deductibles are met | Part B |
| Which part of Medicare includes advantage or choice plans, private plan by HMO | part C |
| Which part of Medicare is for Prescription Drug Coverage | Part D |
| There is also a type for older adults who meet a specific financial requirement, it is | Supplemental Medicaid |
| What occurs when the older person is no longer able to care for themselves | Family Crisis |
| What is the failure to provide for the self because of lack of ability or awareness | Self Neglect |
| What is it when any person deliberately plans to mistreat or harm another person | intentional Abuse |
| What kind of abuse is it when the caregiver lacks the necessary knowledge, stamina or resources needed to care for an older loved one | Unintentional Abuse |
| What can make caregivers virtually prisoners within their own homes leaving them feeling trapped, frustrated or angry | Continuous Demands |
| Which type of abuse is any action that causes physical pain or injury | Physical |
| Which type of abuse involves one or more actions that cause harm, does not provide for the aging needs | neglect |
| What is more subtle and difficult to spot, can be verbal or nonverbal, damaging the older adults self-esteem | emotional |
| Which abuse involves stealing or misusing the resources of an older adults trust | Financial |
| Which abuse involves leaving the older adult physically, emotionally and financially defenseless | Abandonment |
| Nurses have a moral, legal and ethical responsibility to report any suspected cases of | abuse |
| What kind of care can give a primary caregiver a much needed break to decrease stress | Respite Care |
| What is done to identify older adults who are in need of further more in-depth assessments | Health Screenings |
| What is data that is used to formulate nursing Dx and to plan patient care | Health Assessments |
| What is a standardized psychological assessment tool used to determine mental state | mini-mental state examination(MMSE) |
| Older people should get 30 minutes of continuous what that is tailored to their age and ability | Exercise |
| Which vaccine should an older person get just one time | pneumonia |
| The older person should carry what list with them at all times | medications |
| What is decreased in the older adult to lead to so much bone loss | Ca++ |
| When we firmly fix rugs to the floor, maintain electrical safety, decrease clutter, provide good lighting, grip assistance and put needed items easy to reach we are doing what | preventing injuries |
| When the core body temperature is 95 degrees or below we are suffering from | hypothermia |
| What is the ability to maintain body temperature in a safe range | thermoregulation |
| Normal core body what is between 97 and 99 degrees | temperature |
| What may not be evident during hypothermia due to diminished ability | shivering |
| What is a significant increase in body temperature that places a significant strain on the heart and blood vessels that can be assisted because of medications | hyperthermia |
| The respiratory system provides what for the body | oxygen |
| What is the process of inhaling to take in Oxygen and exhaling to release carbon dioxide called which occurs at the rate of 12 ￢ﾀﾓ 20 */min | breathing |
| What is the movement of air into and out of the alveoli called | ventilation |
| When combined activities increase the size of the chest cavity until the air pressure inside the lungs is lower than the pressure outside and air is drawn into the lungs it is called | inhalation |
| The respiratory center of the body is the | medulla and pons |
| What is three commonly occurring disorders, asthma, emphysema and chronic bronchitis, together called | COPD |
| What is a highly contagious resp, infection caused by a variety of VIRUSES, with an incubation period of 1-3 days whose deaths are 90% in older people | Influenza |
| What is an acute inflammation of the lungs that can be viral, bacterial, fungal, chemical or even mechanical where the alveoli and bronchioles become clogged with thick substances to decrease gas exchange | pneumonia |
| What kind of pneumonia is due to inhalation of food or gastric contents | aspiration |
| What is an infectious disease caused by the bacillus mycobacterium tuberculosis, which spreads by airborne droplets | Tuberculosis |
| What is one of the most deadly forms of cancer in the US, that is most commonly in men and the survival rate is barely 5 years | Lung Cancer |
| What requires motivation as well as knowledge | Health Maintenance |
| All of the teaching in the world will not replace the desire to | live a healthy life |
| If we perceive that a decline in health is normal and expected as part of the aging process we will do _________ to prevent loss of function | less |
| What is another name for a pressure ulcer | Decubidus ulcer |
| What can you do with a pt to avoid decubidus ulcers | 30 degree lateral in the bed |
| The day/night cycle is referred to as | circadian or diurnal |
| What is the decreased ability to perform tasks that require high-level coordination, increased traffic accidents, home accidents, falls and irritability | fatigue |
| Sleep is under the control of what system | central nervous system |
| Current research indicates that wakefulness is regulated by what neurotransmitter | norepinephrine |
| Sleep is controlled by the release of what neurotransmitter | serotonin |
| What is produced by the pineal gland when the level of light decreases | melatonin |
| One sleep cycle consists of | 4 Non-REM and 1 REM stages |
| A drop in core temperature, decreased light exposure, or even genetic factors are suspected in the alteration of the | circadian rhythm |
| What is the difficulty falling asleep or remaining asleep or the belief that one is not getting enough sleep, also the most common type of sleep disorder | insomnia |
| What is a common breathing related sleep problem that is also called “sleep disordered breathing” | sleep apnea |
| When a person thrashes around in bed, jumps or falls out of bed or sustains an injury trying to protect themselves from a vivid or violent dream they are suffering from what type of sleep disorder | REM sleep behavior disorder |
| Daily exercise, regular routine, short or no naps, no caffeine, no late large meals, warm baths or relaxation and a restful environment are all teaching to promote adequate | sleep |
| What stage of NREM is sound sleep, easy wake, slowing body function and relaxation and lasts about 10 – 20 minutes | stage 2 |
| Which stage of NREM is the lightest level of sleep, lasts a few minutes, decreased physiological activity begins, easy wakes and person feels as though they were daydreaming if awakened | Stage 1 |
| Which stage of NREM is deep sleep, difficult to wake and barely moves, muscles relaxed, vital signs decline and lasts about 15 – 30 minutes | Stage 3 |
| What is lack of appetite called | anorexia |
| What is muscle wasting called | cachexia |
| What is common with both acute and chronic illness but is not specifically a sign of impending death | fatigue |
| The pt may begin to sleep more and may be difficult to awaken as the end of life nears due to what kind of changes | metabolic |
| As death nears our extremities can become dry, pale or cyanotic due to diminished | peripheral circulation |
| As death nears we can have shortness of breath, difficulty breathing (dyspnea) and what kind of respirations, that are known to signal the end of life is near | Cheyne-stokes |
| What two gastrointestinal changes are known to be observed with advanced terminal conditions | anorexia and cachexia |
| What type of urinary change is seen often in a terminal pt because of decreases in fluid intake, blood pressure and kidney perfusion | oliguria |
| In the nineteenth century most people died where | in the home |
| Today most people do not witness what | death |
| The most common cause of death in the elderly is what | chronic diseases |
| Discussions about death wishes in a family are often avoided or delayed because most people are | uncomfortable talking about death |
| Durable power of attorney (POA) is a document that specifies | who will carry out the pt’s health care wishes should he or she become incapacitated |
| An advance directive is a document that specifies what | What measures may or may not be taken to preserve the pt’s life |
| Hospice care may be initiated if the pt | has 6 months to live |
| Palliative care for a cancer pt includes | pain management |
| An effective way to communicate with a pt on a ventilator is | Have them write what he or she wants to say on a writing tablet |
| An effective way to assess pain in a pt with dementia is | observe for grimacing or guarding a body part |
| The average 70 y/o sleeps | @ 6 hours a night, on average |
| One way to avoid napping and promote sleep at night is | encourage activity |
| Sleep could be regulated by | norepinephrine and serotonin |
| REM sleep is needed to feel restored and refreshed. In the elderly population | there is less REM sleep |
| The most common reported sleep disorder is | insomnia |
| For purposes of maintaining adequate sleep, residents of a long-term facility should be | Allowed to go to bed at their long establisghed bed times |
| Factors that contribute to sleep disturbances in the elderly | includes depression |
| For the pt experiencing nocturia, a good intervention would be | limit fluids 2 hrs before bedtime |
| Interventions that can minimize the use of medications while promoting sleep are | teaching relaxation exercises |
| Nutritional selections that could aid sleep at bedtime include | a glass of milk or cup of yogurt |
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