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TL Gero 2 and 3
Principles of Gerontology
| Question | Answer |
|---|---|
| Goals for care plan should have eight qualities. What are they? | linked to nursing diagnosis; formulated with patient, family and team; culturally appropriate; attainable –resources available; time frame included; reflect benefits and costs; continuity of care; measurable |
| If an assessment of an older adult provides a number of nursing diagnosis, how do we assign priority to the nursing diagnoses? | focus first on problems that have potential for immediate negative effect on health status, the problem that is forefront on the mind of the patient/family, and those that affect function and quality of life |
| A nurse finds that a patient is losing weight and then places them on liquid nutrition. What step is missing? | The nurse did not assess the patient to find out why they are losing weight so the intervention may be coming at the problem from the wrong direction. |
| When establishing goals of care, why are verbs like performs, identifies, increases/decreases preferred to verbs like accepts, knows, appreciates? | because they are measurable |
| The gerontological nurse is a key member of an interdisciplinary team. Why? | The complexity of problems and concerns common to the older person often require a team approach to practice |
| Why is it unreasonable to think that problems linked to lifestyle choices of the older patient could be resolved quickly? | Many of the health problems older people face are the result of lifestyle choices that have taken years to develop. Modifications to lifestyle will require a journey of little steps. |
| The nurse collects patient health data is which standard of clinical gerontological nursing care? | Standard I Assessment |
| The nurse analyzes the assessment data in determining diagnoses is which standard of clinical gerontological nursing care? | Standard II. Diagnosis |
| The nurse identifies expected outcomes individualized to the patient diagnoses is which standard of clinical gerontological nursing care? | Standard III. Outcome Identification |
| The nurse develops a plan of care that prescribes interventions to attain expected outcomes is which standard of clinical gerontological nursing care? | Standard IV. Planning |
| The nurse implements the interventions identified in the plan of care is which standard of clinical gerontological nursing care? | Standard V. Implementation |
| The nurse evaluates the patient’s progress toward attainment of outcomes is which standard of clinical gerontological nursing care? | Standard VI. Evaluation |
| The nurse systematically evaluates the quality and effectiveness of nursing practice is which standard of professional practice? | Standard I. Quality of Care |
| The nurse evaluates one’s own nursing practice in relation to professional practice standards and relevant statutes and regulations is which of the standards of professional practice? | Standard II. Performance Appraisal |
| The nurse acquires and maintains current knowledge in nursing practice is which of the standards of professional practice? | Standard III Education |
| The nurse interacts with and contributes to the professional development of peers and other health care providers as colleagues is which of the standards of professional practice? | Standard IV Collegiality |
| The nurse’s decisions and actions on behalf of patients are determined in an ethical manner is which of the standards of professional practice? | Standard V. Ethics |
| The nurse collaborates with the patient, family and other health care providers in providing patient care is which standard of professional practice? | Standard VI. Collaboration |
| The nurse uses research findings in practice is which standard of professional practice? | Standard VII. Research |
| The nurse considers factors related to safety, effectiveness, and cost in planning and delivering patient care is which standard of professional practice? | Standard VIII. Resource Utilization |
| What does a nurse need to seek certification as a gerontologic nurse (RN-BC)? | associate, diploma, or baccalaureate degree and 2 years experience working as a full time RN with a minimum of 2000 hours in the past 3yrs. |
| What is the role of a RN-BC? | direct care provider, case manager, nurse leader, and administrator – coordinate services and manage care for older people |
| What kind of degree do Clinical nurse specialists and nurse practitioners have? | Masters |
| What is the role of advanced practice nurse (CNS, NP, GNP-BC, CNS-BC)? | primary care providers that focus on health promotion, disease prevention and long-term management of chronic conditions and their exacerbation that require prompt and intensive nursing interventions |
| In 2015 what will a DNP and CNL be? | a doctorate of nursing will be required for NP and the masters level will become clinical nurse leader. |
| What are the responsibilities of the gerontological nurse? | direct care, management and development of the professional and other nursing personnel, evaluation of care and services for the older adult. |
| What is an APRN? | an RN who holds a master’s, doctorate, or higher degree, and demonstrates advanced knowledge and clinical expertise in the care of the older adult |
| Currently which nurses are APRNs? | CNSs and NPs |
| What is the function of GNP (Gerontological Nurse Practitioner)? | primary care to older clients and have considerable autonomy addressing healthcare problems, often with prescriptive authority |
| Which type of nurse provides direct and indirect care to patients and their families and serves as a consultant to staff on complex issues of patient care? | CNS |
| In some ways CNS and GNP are interchangeable. What is the usual difference in the focus of the two types of nurses? | GNP focuses more on the direct provision and evaluation of care. CNS focuses more on education and consultative roles. |
| Can CNS and GNP write prescriptions? | probably, depending on the state’s scope of nurse practice acts |
| What is required to fully understand the health needs of an older adult? | Comprehensive Geriatric Evaluation |
| A key part of the comprehensive geriatric evaluation that focuses on the older adults level of function and capacity for self-care | Functional assessment |
| Which domains of function will be explored in a comprehensive geriatric evaluation? | physical, social, and psychological |
| Who are the key players on the clinical interdisciplinary team that works on behalf of the older adult? | Geriatric nurse, geriatric physician, and social worker |
| 5 times when a comprehensive geriatric evaluation is recommend for the older adult | after hospitalization - acute illness; when nursing home or change in living arrangements is being considered; abrupt change in physical, social, or psychological function; yearly with primary HCP; for second opinion |
| Research was done to evaluate the outcomes of the use of a comprehensive geriatric evaluation. What did the research show? | reduced hospital use, reduced mortality rates, improved mental status, lower health costs, improved functional ability, and lower hospital readmission |
| Name three instruments used to assess the functional abilities of the older adult. | Katz, Pulses profile, SPICES |
| Which assessment tool is for assessing independence in ADLs? | Katz |
| Which assessment tool is for assessing general functional performance in mobility and self-care, medical status and psychosocial factors? | Pulses Profile |
| Which assessment tool is for planning, promoting, and maintaining optimal function in older adults? | SPICES |
| What does SPICES stand for? | Sleep disorders, Problems eating, Incontinence, Confusion, Evidence of falls, Skin breakdown |
| What does PULSES stand for? | Physical condition, Upper limb function, Lower limb function, Sensory components, Excretory functions, Support factors |
| What are some essential skills to team dynamics? | Awareness of the roles and contributions of other disciplines, excellent communication skills for sharing ideas, and lack of professional arrogance |
| Collaboration involves shared planning, decision making, and accountability in the care of the older client. What are some advantages of collaboration? | complex problems of older adults may require several disciplines; more knowledgeable professionals enhance problem solving and health care delivery |
| If the patient brings in a large bag of medications bottles to show what drugs they are taking what might a potential problem be? | Risk for adverse drug reaction related to polypharmacy |
| What is the reported range of adults over age 65 with mental disorders? | 20 to 30% |
| What is the Geriatric Depression Scale? What score indicates the possibility of depression and indicates need for further testing? | 15 questions designed to measure depression in the older adult a sore of 5 suggest depression |
| What is the purpose of the Mini-Cog test? | to differentiate older persons with dementia from those without dementia |
| You have administered the Minimental Status Examination to a client who scored poorly on the reading portion. Before we interpret the results of this test it is important to know what about this client? | Their level of education or if they have any language barriers, because low scores could be contributed to cognitive impairment when in reality they reflect low reading literacy. |
| Give 4 components of cultural competence in health care | Know prevalence, incidence, and risk factors for different ethnic groups, understand differences in response to medication and therapies by different ethnicities, find out cultural beliefs toward illness, treatment and health care system, open-mindedness |
| Define heterogeneity | non-uniformity or diversity |
| What tool is used for assessing an older person for placement in a nursing home or long-term care system? | Minimum Data Set |
| What does the Omnibus Budget Reconciliation Act of 1987 say about MDS? | that all residents of facilities that collect funds from Medicare and Medicaid be assessed using MDS |
| What was the belief that led to the enactment of the use of MDS? | better more holistic patient assessment would facilitate better patient care |
| What are the purposes for which the MDS is used? | validates need for long – term care, reimbursement, ongoing assessment of clinical problems, and need to alter current plan of care |
| Who would be at greater risk for vitamin D deficiency a person taking Ionazid or someone who does not drink milk? | The guy who does not drink milk |
| What is the person called who makes medical decisions for a resident if they become unable to do it themselves? | Designated surrogate |
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Perseverandovercome
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