Medication Management for Older Adults, Exams of Nursing

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what is the most effective form to prevent STI's besides abstinence? ---------- Correct Answer ---- -------- Condoms If an older female is experiencing vaginal dryness, what can we recommend? ---------- Correct Answer ------------ Water Based lube and pain medication 30 minutes before If someone has liver problems, what types of vitamins should they NOT take? ---------- Correct Answer ------------ ADEK Risk factors for malnutrition ---------- Correct Answer ------------ Unable to cook for themselves, poor fitting dentures, unable to read food labels how to walk with a walker? ---------- Correct Answer ------------ Advance strong leg first Then advance the weak side with the cane Repeat How to walk with crutches? ---------- Correct Answer ------------ Must have upper body strength coordination balance should not rest in armpits If a patient has Hemiparesis (side paralysis), how should we approach them? ---------- Correct Answer ------------ Approach the patient from the strong side Delirium versus dementia ---------- Correct Answer ------------ Delirium is reversible, rapid onset, altered cons Expressive asphasia ---------- Correct Answer ------------ This damage affects the speaking ability and causes specific problems with articulation and fluency receptive aphasia (Wernicke's aphasia) ---------- Correct Answer ------------ difficulty understanding language global aphasia ---------- Correct Answer ------------ Difficulty expressing or sending out thoughts and difficulty understanding language; mixed aphasia How does pain affect a persons nutritional status? ---------- Correct Answer ------------ b/c pain can unmotivated the patient to eat, drink or move around If someone is having a sleep disturbance, what do we want them to avoid? ---------- Correct Answer ------------ Sleeping throughout the day

What is one of the biggest potential problems if someone has a sleeping disorder? ---------- Correct Answer ------------ Has the potential to die or get potential disease, and the immune system is decreased due to not sleeping well, If someone is fatigued because of depression, and are not taking meds, what do we do? ---------- Correct Answer ------------ Reorient them and motivate them to take their medications, figure out the underlying cause (if any) What kinds of medications can interrupt sleep? ---------- Correct Answer ------------ Lasix, Beta blockes Why don't older people want to go to the doctor? ---------- Correct Answer ------------ No motivation, transportation and financial issues What would you question if a patient is being non-adherent with medication? ---------- Correct Answer ------------ As k them why, and how it makes them feel and if there are other contributing factors Why cant you use medial terminology with anyone who is familiar with it? ---------- Correct Answer ------------ It can become a communication barrier Is it normal for other cultures to not make eye contact? ---------- Correct Answer ------------ Yes A patient is waiting to get a chest X-ray, they have been waiting for 3-4 hours and they are becoming agitated, what do we do? ---------- Correct Answer ------------ Advocate for your patient by calling down to the x-ray department to see what is going on Evidence of a positive self image ---------- Correct Answer ------------ Self grooming, proper hygiene what is the concept of agism? ---------- Correct Answer ------------ Useless, helpless, and they are "all the same", physical impaired examples of ineffective coping: ---------- Correct Answer ------------ Maladaptive behaviors, such as substance abuse, isolating themselves If someone is doing a sudden revision of will and they are giving away priced possessions, what are they at risk for? ---------- Correct Answer ------------ Sucide What types of exercises would keep calcium and potassium in the bones? ---------- Correct Answer ------------ Weight bearing exercises (low impact) Benefits of exercise ---------- Correct Answer ------------ bone strength, weight loss, muscles, cardiac, resp, decrease blood glucose

How do you speak to someone who is hard of hearing? ---------- Correct Answer ------------ low tone, eye level, face the patient What do we ask for when asking for a health history? ---------- Correct Answer ------------ medications (previous and current) Family history Chief complaint advance directives (if any) Hypervolemia and hypovolemic shock ---------- Correct Answer ------------ increased blood volume When you lose more than 20% of your bodies fluid supply > cant pump enough blood > measure fluid status daily by weight Normal pH levels ---------- Correct Answer ------------ 7.35-7. If someone is in menopause for awhile and they have vaginal bleeding, should it be reported? ---- ------ Correct Answer ------------ Yes What is a uterine prolapse and when does it happen? ---------- Correct Answer ------------ Usually happens after multiple vaginal births, A hysterectomy is a treatment for ---------- Correct Answer ------------ Multiple Vaginal Births Signs and symptoms of an enlarged prostate: ---------- Correct Answer ------------ Decreased urine output Weak stream of urine Nocturia Frequent UTI'S What happens if you see scattered bruising areas on patients fore arms ---------- Correct Answer - ----------- Normal Age related change for bruising, this is due to capillaries becoming fragile FVD ---------- Correct Answer ------------ causes- not enough in, too much out (Lasix), alcohol, hypernatremia, D/V, sweating/hemorrhaging S/S- Decrease in BP, increase ing HR, headache, dry mucous membranes, confusion/altered mental status, concentrated urine, decreased UO, weak thready pulse Interventions- IV fluids (cautious of elderly, can cause pulmonary edema if done too quickly), oral fluids, hold diuretic, treat underlying cause, monitor i/o, monitor vitals, decrease sodium intake stress ---------- Correct Answer ------------ s/s- decreased in immune resonse, lose/gain weight, decrease output, increased frequency, constipation/diarrhea, teeth grinding, mood swings

vitals- increased HR, BP, RR fatiguues/insomnia, gastic ulcer, blood glucose increased elderly and stress ---------- Correct Answer ------------ #1 cause - loss of loved one- child unexpected financial loss, loss of independence, lack of support. Elderly do not tend to fear/stress about death themselves at risk ineffective coping ---------- Correct Answer ------------ substance abuse, tobacco, alcohol, prescriptions, cognitive impairment, poor coping in younger years, poor support systems, chronic illness Can normal age changes contribute to sexual dysfunction? ---------- Correct Answer ------------ Yes Hyperkalemia: Causes: Signs/Symptoms: Treatment/interventions: ---------- Correct Answer ------------ Potassium overloadC: Burns, too much K intake (IV, foods), kidney failure S/s: N/V/D, skeletal muscle WEAKNESS, arrhythmia/dysrythmias, T: Diuretics, sodium bicarb, low potassium diet Hypokalemia Causes S/s: Treatment/interventions: ---------- Correct Answer ------------ Not enough potassium C: Low potassium diet, diarrhea, alcohol, lassie, sweating, diuretics S/S: ABD dissection, muscle cramps, skeletal muscle weakness, constipation/vomiting prostate exams ---------- Correct Answer ------------ At 40 years yearly Mini-Cog Test ---------- Correct Answer ------------ Determines alertness, tests for cognitive impairment Nursing Interventions for non adherence: ---------- Correct Answer ------------ ▪ Motivate them ▪ Teach them ▪ Ask questions; "why are you not taking your medication" ▪ Find resources- medicare/Medicaid, HHA ▪ Unpaid Caregivers: educate them, be mindful of their stress, give praise ▪ Offer Respite care HDL cholesterol ---------- Correct Answer ------------ good cholesterol, helps protects blood vessels "happy cholesterol"

LDL cholesterol ---------- Correct Answer ------------ bad. low density lipoprotein. low protein, high fatbad for blood vessels NAPNES ---------- Correct Answer ------------ delegation too much isn't good Pt education on assistive devices ---------- Correct Answer ------------ stop if pain occurs, hydration/diet, comfortable clothing, non slip shoes, if temps are hot exercise early or later in the evening Swimming, walking, weight bearing exercise (no strenuous exercise What does a persons experience as stress increases: ---------- Correct Answer ------------ Decreased problem solving ability Indecisiveness Irrational behavior Delirium vs dementia ---------- Correct Answer ------------ Delirium: rapid onset, decreased level of consciousness, memory impairment Dementia : slow onset, loss of judgment, apashia motor skills, agnostic, non reversible Expressive aphasia ---------- Correct Answer ------------ Can't express words Hyperthermia ---------- Correct Answer ------------ Risks: endocrine problems S/s: confusion, sweating then stopping, increased heart rate/cramps Interventions: ice packs in auxiliary/groin region, encourage fluids SPICES ---------- Correct Answer ------------ Sleep Problems eating Incontinenece Confusion Evidence of falls Skin break down FANCAPES ---------- Correct Answer ------------ Fluids Aeration Nutrition Communication Activity Pain Elimination Socialization Hypothermia ---------- Correct Answer ------------ Risks: elderly, living in cold temps, decreased sub q tissue S/S: shivering, temp drop, confusion, swollen/puffy face

What kind if catheters are used for patients with Benign prostatic hyperplasia (enlarged prostate) ---------- Correct Answer ------------ Coude (curved to go around prostate fluid volume excess means Causes? S/s Treatment: ---------- Correct Answer ------------ Fluid overload, hypervolemia Causes: Urine retention liver disease, HF, COPD S/s: edema, high hr, HF high BP, crackles Treatment: diuretic, monitor I&O, fluid restriction Normal Bicarb (HCO3) levels ---------- Correct Answer ------------ 22 - 26 fluid volume deficit Causes: S/s? ---------- Correct Answer ------------ Dehydration in which the fluid intake of the body is not sufficient to meet the fluid needs of the body Causes: Vomiting, diarrhea, sweating, not drinking enough fluids S/s: Low BP, high HR, Skin tenting (poor skin turgor) Decreased urine output Normal PaCO2 levels ---------- Correct Answer ------------ 35 - 45 Define a disruptive living situation: ---------- Correct Answer ------------ When resident moves from one living place to another Family/familiar If a pt is able to walk, what are you looking for? ---------- Correct Answer ------------ Gait, posture, balance, pain If you have a patient that doesn't speak English, when should we be using the interpreter to communicate? ---------- Correct Answer ------------ To communicate necessary information only Why does the elderly tend to complain about room temperature? ---------- Correct Answer -------- ---- Because they have a slower metabolism, so they cant regulate their temperature If someone has cancer but they want to be with family and attend public functions, how can we teach them to conserve energy? ---------- Correct Answer ------------ Pace themselves in between activities, conserve energy

If someone was standing outside in the rain, and they are hypothermic, what is the first thing we would do? ---------- Correct Answer ------------ Remove their wet clothes If a health care org is trying to present cultural safety, what do they need to make it effective? --- ------- Correct Answer ------------ Effective communication! Why don't pharmaceutical companies test older adults for new medications? ---------- Correct Answer ------------ Because younger people are usually healthier and don't have many comorbitites (more than one disease) How can medication errors happen when older adults self medicate? ---------- Correct Answer --- --------- They can misread medication labels, forget they took it (which can lead to overmedicating or not taking it at all) What is a reliable method of patient identification? ---------- Correct Answer ------------ Their Wristband If a patient is having difficulty swallowing medications what do we offer? ---------- Correct Answer ------------ More water When a elderly patient is in the hospital, Why are older adults hesitant to taking medications that may not look or be shaped like the ones they have at home? ---------- Correct Answer ------------ Because they think it may be the wrong medication Intervention: Educate them that it has the same effects and is the same medication, just a different brand Would you give a sedative to a patient that is diagnosed with sleep apnea? ---------- Correct Answer ------------ NO What types of assessments are mental health assessments? what is not? ---------- Correct Answer ------------ Mini-cog Montreal KATZ What benefits can exercise do for the older adult? ---------- Correct Answer ------------ increase circulation, maintain weight and lower glucose levels, promote sleep and can help with depression. If someone has cancer but they want to be with family and attend public functions, how can we teach them to conserve energy? ---------- Correct Answer ------------ Pace themselves in between activities, conserve energy If someone has cancer but they want to be with family and attend public functions, how can we teach them to conserve energy? ---------- Correct Answer ------------

subjective vs objective data ---------- Correct Answer ------------ Subjective- What the patient tells you Objective- what you observe during exam Mini-cog and moteral is used for? ---------- Correct Answer ------------ Orientation, cognitive function Why can older adults get STI's more easily than someone who is younger ---------- Correct Answer ------------ Yes b/c their immune system is decreased If a patient is having decreased circulation, what disease can put men at risk for erectile dysfunction? ---------- Correct Answer ------------ Diabetes If you walk in on an elderly couple having sex what do we do? ---------- Correct Answer ---------- -- Leave the room and put up a Do Not Disturb sign on the door What is senile purpura? ---------- Correct Answer ------------ Benign, easy bruising that affects older adults: skin and blood vessels become more fragile If someone is having trouble sleeping, what intervention could we use? ----------- Correct Answer ------------ Encourage pt to go outside, because sunlight helps with melatonin levels What is a intervention for a older adult who is having trouble sleeping because of a constant need to go to the bathroom ----------- Correct Answer ------------ Wear depends (adult diapers) A newley admitted patient is having multiple problems. What symptom do you report first? ------ ----- Correct Answer ------------ Breathing What is a primary sexual right? ----------- Correct Answer ------------ 2 consenting adults To be effective communicators, nurses must.. ----------- Correct Answer ------------ Develop awareness of their own values and beliefs and the way they influence their perception of patients experiences Cultural Competence ----------- Correct Answer ------------ A set of behaviors that includes understanding the impact of cultural values and beliefs on human experiences, while maintaining awareness of own cultural values and their effect on the perception of self and others. Circadian ----------- Correct Answer ------------ From Latin word "about a day" What is the average amount of sleep needed for people ages 20 to 60 years? ----------- Correct Answer ------------ 7.5 hours What body system controls sleep? ----------- Correct Answer ------------ Central Nervous System What causes older adults to feel sleepy earlier in the evening and to wake earlier in the morning?

Know as "phase advance" ----------- Correct Answer ------------ Decreases in melatonin (which regulates the sleep-wake cycle) and growth hormone (which promotes sleep) lead to a shift in circadian rhythm Does sleep efficiency increase with age? ----------- Correct Answer ------------ No, sleep efficiency decreases, older adults may complain that they do not feel refreshed after sleep. Does the risk for sleep disorders increase with age? ----------- Correct Answer ------------ yes Nocturnal Movement Disorders ----------- Correct Answer ------------ Restless leg syndrome, which is an irresistible urge to move the lower extremities, or nocturnal myoclonus, which causes sudden repetitive jerking or kicking movements of the lower extremities. What is the most effective nonpharmacological therepy for insomnia? ----------- Correct Answer ------------ Cognitive Behavioral Therapy What do you teach a UAP who is feeding a patient with trouble swalowing? ----------- Correct Answer ------------ Feed them slow, with frequent rest breaks. Lak of tendon reflexes/ deep muscle reflexes is a sign of what? ----------- Correct Answer --------- --- Hypercalcemia What are the normal calcium levels? ----------- Correct Answer ------------ 8.5-10 mg/dL Water Soluble Vitamins ----------- Correct Answer ------------ Vitamins B & C (Birth Control) Fat Soluble Vitamins ----------- Correct Answer ------------ All- A Dogs-D Eat-E Kibble- K If you overdose on Vitamins A,D,E & K what will happen? ----------- Correct Answer ------------ Liver Damage What is the primary prevention for the flu? ----------- Correct Answer ------------ Flu Shot If someone is complaining of fatigue, what are some interventions we can tell our patient? -------- --- Correct Answer ------------ To rest and exercise. What is the Valsalva Maneuever? ----------- Correct Answer ------------ Breathing through the mouth during exercise. What is the main cause of stress? ----------- Correct Answer ------------ change What are external physical threats? ----------- Correct Answer ------------ Extreme heat or cold,

noise, physical trauma What are internal or psychological threats? ----------- Correct Answer ------------ Thoughts and feelings What are external social threats? ----------- Correct Answer ------------ Job pressure or changeable social relationships Can stress be benificual? ----------- Correct Answer ------------ Yes, some stress is normal and necessary. Individuals are able to pay attention to detail, to learn and to solve problems Signs someone is experiencing high stress. ----------- Correct Answer ------------ Individuals are more likely to complain of fatigue, tension and anxiety. They may appear distracted, irritable, short-tempered, even angry. People living with high stress may have feelings of. ----------- Correct Answer ------------ Poor self-worth or low self-esteem Why are signs of alcohol and drug abuse sometimes missed in the elderly? ----------- Correct Answer ------------ They mimic age-related changes such as bone density changes, urinary incontinence, altered sleep patterns, unsteadiness, hypertension, stomach complaints and falls What can prevent illness or improve a person's ability to cope with existing illness ----------- Correct Answer ------------ Decreasing the number of stressors or the level of stress. Problem-focused coping ----------- Correct Answer ------------ Attempt to change or eliminate the stressful event or threat. If someone is overcoming any kind of surgery, what is important? ----------- Correct Answer ----- ------- A diet high in protein Is strenuous exercise good for the elderly? ----------- Correct Answer ------------ No What does a physical therapist assess for? ----------- Correct Answer ------------ Gait, pain and ROM If you have a patient who is bed bound what should you do? ----------- Correct Answer ------------ ROM, isometric exercises What is a good exercise for a patient who have osteoporosis? ----------- Correct Answer -----------

• Wight bearing exercise If someone is in pain and you are trying to do something to improve the pain, what can you do? - ---------- Correct Answer ------------ Find something that improves the pain by ASKING them Orthostatic Hypotension ----------- Correct Answer ------------ When a person stands up, blood

pressure drops, person could faint What are interventions for orthostatic hypotension? ----------- Correct Answer ------------ Have patient stand up slowly, let patient sit on the side of the bed and dangle feet. Intervention for someone experiancing shortness of breath? ----------- Correct Answer ------------ Encourage patient to take frequent breaks What is polypharmacy? ----------- Correct Answer ------------ Multiple medications, multiple providers What does polypharmacy increase the risk of? ----------- Correct Answer ------------ Falls What is hypothermia? ----------- Correct Answer ------------ A core body temperature of 95 or lower Why is the older adult at a increased risk for developing hypothermia? ----------- Correct Answer ------------ Normal changes in aging affect the body's ability to regulate temperature. Changes in the skin reduce the older person's ability to perceive dangerously hot or cold environments. Decreased muscle tissue, decreased fat and decreased metabolic rate affect the amount of heat produced and retained in the body What disease processes decrease heat production? ----------- Correct Answer ------------ Hypothyroidism Hypoglycemia Malnutrition What medications that decrease enviromental awareness to extreme temperatures. ----------- Correct Answer ------------ Barbiturates, tranquilizers, and antidepressants can increase risk of hypothermia. Can alchohol increase the risk of hypothermia? If so, how? ----------- Correct Answer ------------ It decreases environmental awareness and, at the same time, increases vasodilation with resulting in heat loss What is one of the first signs of hypothermia? ----------- Correct Answer ------------ Mental confusion Does pulse and respiratory rate increase or decrease with hypothermia? ----------- Correct Answer ------------ Decrease, slow down How may the face appear in hypothermia? ----------- Correct Answer ------------ Swollen Are heating pads, blankets a good intervention for a patent who has hypothermia? ----------- Correct Answer ------------ No, because they can cause cardiovascular problems

What are early indicators of hyperthermia? ----------- Correct Answer ------------ Cramps in the legs, arms and abdomen. What is one the first signs of a UTI in the elderly? ----------- Correct Answer ------------ Confusion What 2 regions of the brain play key roles in language and speech? ----------- Correct Answer ---- -------- Broca's area, which is located in the posterior frontal lobe and Wernicke's area, which is located in the posterior temporal lobe. What is the most common language problem seen in adults? ----------- Correct Answer ------------ Aphasia (or dysphasia) What is a excellent resource for information about speech and swallowing disorders? ----------- Correct Answer ------------ Speech pathologists Dysphagia ----------- Correct Answer ------------ Difficulty swallowing Receptive Aphasia ----------- Correct Answer ------------ A person has difficulty understanding language Exspressive Aphasia ----------- Correct Answer ------------ A person is unable to express himself or herself using language Global Aphasia ----------- Correct Answer ------------ A person loses the ability both to understand language and to express himself or herself. Broca Aphasia ----------- Correct Answer ------------ A person is able to understand verbal and written language but is unable to speak words fluently. The area of the brain that coordinates muscles of speech is damaged. Wernicke Aphasia ----------- Correct Answer ------------ the person is able to speak, but the words produced may be nonsensical or have little connection to reality. Foods high in potassium OTHER than bananas? ----------- Correct Answer ------------ Spinach and Apple Juice Canned foods are high in which electrolyte? ----------- Correct Answer ------------ Sodium What is a sign that a person is having trouble coping? ----------- Correct Answer ------------ They are not grooming themselves What are some interventiosn for relocation syndrome? ----------- Correct Answer ------------

IDENTIFY problem and take steps to improve that problem Arthritis ----------- Correct Answer ------------ Inflammation of the joints Rheumatoid Arthritis ----------- Correct Answer ------------ Chronic inflammation of the synovial membrane of the diarthrodial joints (also called the synovial joints: the freely moveable joints in which continuous bony surfaces are covered by cartilage and connected by ligaments lined with synovial membrane. Osteoarthritis ----------- Correct Answer ------------ A nonsystemic, noninflammatory disorder that progressively causes bones and joints to degenerate. Osteoporosis ----------- Correct Answer ------------ Disorder that results in a loss of bone density What disorder can cause a person to "shrink" or lose height? ----------- Correct Answer ------------ Osteoporosis What do we always monitor for in a patient who has been on anesthesia? ----------- Correct Answer ------------ Pneumonia What organization establishes safety goals? ----------- Correct Answer ------------ The Joint Commission What are signs that a person is getting good sleep? ----------- Correct Answer ------------ Mental clarity A person who has good self-esttem is ----------- Correct Answer ------------ They have strong personal values and believe they have the ability to control their lives Our sense of self-control starts wtih. ----------- Correct Answer ------------ Our bodies When fatigue is persistant and impairs normal life functioning it is considered ----------- Correct Answer ------------ A health problem. Some fatigue is normal Chrronic Fatigue ----------- Correct Answer ------------ Persisting greater than 6 months What is secondary fatigue caused by? ----------- Correct Answer ------------ Underlying medical condition or treatment and will eventually be resolved or decreased when the underlying problem is addressed What is the etiology of chronic fatigue? ----------- Correct Answer ------------ unknown What are some causes of fatigue? ----------- Correct Answer ------------ Waste product accumulation, insufficient supply of substances and inflammatory processes.

What can fatigue cause? ----------- Correct Answer ------------ Depression What population is at the greatest risk of fatigue? Excluding college students ----------- Correct Answer ------------ Middle aged adults between 40 and 50 years. Individuals with nutritional deficiencies, particularly protien-calorie malnutrition are at increased risk for ----------- Correct Answer ------------ Fatigue What should the assessment for fatigue focus on? ----------- Correct Answer ------------ The patient's report about his or her fatigue experience, use OPEN-ENDED questions Brief Fatifue Inventory (BFI) ----------- Correct Answer ------------ Measures amount, activities affected by fatigue. Target population- Cancer patients Multidimensional Fatigue Inventory (MFI) ----------- Correct Answer ------------ Measures general, physical, mental, reduced motivation, and reduced activity. Target population- various patient population, including those with cancer, CFS, and COPD Multidimensional Assessmet of Fatigue ----------- Correct Answer ------------ Measures severity, distress, degree of interference in ADLs, timing (frequency of occurrence and changeability) Fatigue Severity Scale (FSS) ----------- Correct Answer ------------ Measures severity, how fatigue interferes with certain activities. Developed for patients with MS an lupus Coping mechanism for elderly ----------- Correct Answer ------------ Reminiscing helps them reflect on good times Fear ----------- Correct Answer ------------ elderly generally do not fear death Intrinsic motivation ----------- Correct Answer ------------ motivation from within homogenous ----------- Correct Answer ------------ share a common historical and cultural experience heterogenous ----------- Correct Answer ------------ many diverse subcultures with diff historical and cultural experiences must interact phases of greiving ----------- Correct Answer ------------ - shock and numbness: denial, anger, guilt searching and yearning: despair, depression, anger, guilt

• disorientation: depression, guilt, disorganization
• Reorganization: sence of release, decrease obsession with loss, renewed hope optimism Reorganization ----------- Correct Answer ------------ sence of release, decrease obsession with

loss, renewed hope optimism teaching a pt and they become overwhelmed ----------- Correct Answer ------------ break it down measuring fatigue ----------- Correct Answer ------------ subjective chronic fatigue syndrome ----------- Correct Answer ------------ pt is tired all the time regardless of sleep, significantly interferes with daily activities and work chronic fatigue syndrome interventions ----------- Correct Answer ------------ alternate rest and activity, when planning day balance work and rest sunlight ----------- Correct Answer ------------ needed for improved sleep and proper sleep patterns and the melatonin hormone intervention for poor sleep pattern ----------- Correct Answer ------------ encourage outside sunlight intervention for incontinent pt up to use bathroom at night ----------- Correct Answer ------------ briefs do not restrict fluids do not use catheter bedside commode can be used but more of fall risk new admit with multiple comorbidities, what do you report to physician ----------- Correct Answer ------------ breathing problems genital discharge sign of ----------- Correct Answer ------------ STD/STI intervention for dysphagia (difficult swallowing) while feeding ----------- Correct Answer -------- ---- feed slowly, small bites, allow rest peroids hypercalcemia ----------- Correct Answer ------------ demenished deep tendon reflexes and muscle weekness primary prevention for flu ----------- Correct Answer ------------ get flu shot Cause stress in elderly ----------- Correct Answer ------------ change in routine, crime and victimization, loss of loved one, disease, injury, pain/suffering, loss of independence, financial destitution, loneliness intervention to avoid stress in elderly ----------- Correct Answer ------------ continuity of care food encouraged for wound healing ----------- Correct Answer ------------ protein

physical therapist assesment ----------- Correct Answer ------------ includes: gait, pain, ROM, NOT bone density bed bound patient exercises ----------- Correct Answer ------------ passive min 2x/d pt bedbound/ or active ROM (for joint flexibility and muscle toning) cataracts ----------- Correct Answer ------------ clouding of the lens of the eye, progresses over period of time and is painless no bright light they get glares glaucoma ----------- Correct Answer ------------ increased intraocular pressure damages the retina and optic nerve initially peripheral vision is affected non obvious sx so can progress before know they have it age related macular degeneration(AMD) ----------- Correct Answer ------------ two kinds: dry and & wet and dry more common wet painful and severe if pt has poor vision ----------- Correct Answer ------------ speak at eye level never approach from behind speak from doorway or loud voice intervention to prevent orthostatic hypotension ----------- Correct Answer ------------ get pt up slowly, sit up on side of bed, dangle feet interventions for skin breakdown ----------- Correct Answer ------------ turn q2hr barrier cream bladder training float heals use bed pad to pull up pt in bed diet high protein frequent incontinence care what is not always a sign/sx of DVT ----------- Correct Answer ------------ swelling legs prevention of osteoporosis ----------- Correct Answer ------------ adequate exercise,-strengthening exercise, adequate intake calcium, diet prevention of falls ----------- Correct Answer ------------ no throw rugs, don't turn off lights polypharmacy ----------- Correct Answer ------------ the prescription, administration, or use of more medications than are clinically indicated in a given patient first indicator of UTI ----------- Correct Answer ------------ confusion foods high in potassium ----------- Correct Answer ------------ spinach, applejuice, bananas, potatoes, tomatos

alcoholism and elderly ----------- Correct Answer ------------ hard to dx alcoholism in the elderly bc the sighs mimic aging signs pt is having trouble coping ----------- Correct Answer ------------ not grooming self well interventions for pt high risk of dehydration ----------- Correct Answer ------------ daily wts I&O's long term osteoporosis ----------- Correct Answer ------------ can cause a pt to shrink last resort for poor sleep patterns ----------- Correct Answer ------------ medication pt has roommate intervention to help with good sleep patterns ----------- Correct Answer ---------- -- similar schedules vision screening ----------- Correct Answer ------------ yearly joint commission ----------- Correct Answer ------------ Establishes national patient safety goals. intervention for good oral care ----------- Correct Answer ------------ fluoride toothpaste caffeine ----------- Correct Answer ------------ interrupts sleep sleep patterns ----------- Correct Answer ------------ sleep same time every night, consistency, read, no tv Suicide rates are higher among men than among women ----------- Correct Answer ------------ likely to abuse other things alcohol, drugs etc if pt has good self esteem ----------- Correct Answer ------------ in control of life and more motivated poor self esteem ----------- Correct Answer ------------ less motivated, less control over life stress sx ----------- Correct Answer ------------ above abd goes up below abd goes down may get dizzy interferences with good nutrition ----------- Correct Answer ------------ money inability to read labels lack of access transportation physical stressors ----------- Correct Answer ------------ heat, hunger, cold, noise, and trauma emotional stressors ----------- Correct Answer ------------ feelings, thoughts, memories

hypothermia sx ----------- Correct Answer ------------ 95deg or lower temp mental confusion decreased pulse and respitory rate decreased body temp cool cold skin pallor or cyanosis swollen puffy face muscle stiffness fine tremors altered coordination changes in gait balance lethargy apathy irritability, hostility aggression delegate to UAP ----------- Correct Answer ------------ ted hose non medicated barrier cream record I&O's causes of sex dysfunction in women ----------- Correct Answer ------------ joint pain cardiac issues or fear of chronic depression discomfort during intercourse (dryness of vaginal walls increased risk for yeast infection stress medications uterine prolapse, rectoceles,cystocele hydrocelei ----------- Correct Answer ------------ scrotal swelling caused by a collection of fluid interventions to maintain sex health in elderly ----------- Correct Answer ------------ sex does not decrease with age offer interventions for pain discomfort discuss sex give info STD/STI example of complimentary alternative massage ----------- Correct Answer ------------ geriatric massage cane use ----------- Correct Answer ------------ left side weakness: hold cane on right side (strong side) cane and strong leg (right leg) will work together cane 6 in out from side of foot ( strong side) emotion focused strategies for coping ----------- Correct Answer ------------ attempt to change the pt response to a special event or threat repression ----------- Correct Answer ------------ remove anxious thoughts from conscience

awareness denial ----------- Correct Answer ------------ refuse to aknowlege when its obvious to others rationalization ----------- Correct Answer ------------ create acceptable reason for unacceptable thoughts or actions intellectualization ----------- Correct Answer ------------ make generalizations to avoid disturbing thoughts or feelings displacement-transfer emotions about one situation or person to another suppression ----------- Correct Answer ------------ avoid thinking about projection ----------- Correct Answer ------------ attributing ones own feelings to another sublimation ----------- Correct Answer ------------ channeling negative energy into socially acceptable behaviors substitution ----------- Correct Answer ------------ keeping so busy with activities that there is no time to think about stressors physical illness causes stress in older adult how ----------- Correct Answer ------------ takes away energy to deal with new stressors pt with dementia how to help with effective coping ----------- Correct Answer ------------ assess pts sleep patterns mild stress ----------- Correct Answer ------------ good bc it raises mental alertness effective outcome for pt with impaired mobility ----------- Correct Answer ------------ pt remains safe and free from joint contractures assess pt coping abilility ----------- Correct Answer ------------ ask what coping they have used in the past insert iv in pt get dizzy and breath rapidly ----------- Correct Answer ------------ tell me your fav memory with your family, slow breathing intervention for concern about pts caregiver having caregiver strain ----------- Correct Answer --- --------- speak with caregiver discuss and gather info from the caregiver supplements for osteoporosis ----------- Correct Answer ------------ Calcium and Vit D pt showing severe stress what sx display ----------- Correct Answer ------------ agitated agressive

relocation syndrome ----------- Correct Answer ------------ pt moved from one home to another the physiologic or phychological stress that occurs problem focused coping ----------- Correct Answer ------------ focusing on the problem, not denying or suppressing it, used to eliminate the problem pt transfer from bed to wheelchair ----------- Correct Answer ------------ have pt help as much as possible purpose of incentive spirometer ----------- Correct Answer ------------ make respirations easier insensible fluid loss ----------- Correct Answer ------------ Occurs daily through lungs and skin-- cannot be measured for accurate output hypervolemia ----------- Correct Answer ------------ excess fluid volume high bp, high hr, edema hypovolemia ----------- Correct Answer ------------ decrease fluid volume low bp, high hr, sunken eyes, dehydration, dry skin Vit A ----------- Correct Answer ------------ - milk butter cheese, liver green and yellow veggies, fruits because of chronic conditions that interfere with fat absorbtion ie. gallbladder disease and cholitis

• Vit a deficiency is found in many pts with cholitis stroke pt watching them eat signs ----------- Correct Answer ------------ drooling and coughing hypernatremia ----------- Correct Answer ------------ dry mucous membranes, rubbery skin, decrease urine output pt has low sodium value-precautions seizure precautions when stress increases the results are ----------- Correct Answer ------------ decreased problem solving indecisive irratonal pt bedridden- what interventions ----------- Correct Answer ------------ draw sheet to pullup in bed turn pt q2h pad bony prominences vit b12 ----------- Correct Answer ------------ found in organ meats, eggs, shellfish, and dairy requires intrinsic factor from stomach for absorbtion- if inadequate absorbtion results in pernicious anemia needed for maturation on rbc's deficiency commonly seen in folacin deficiency DOES NOT AID ABSORBTION OF CALCIUM THAT IS VIT D electrolytes are excreted through ----------- Correct Answer ------------ urine

stool sweat emesis hypercalcemia above 45 ----------- Correct Answer ------------ muscle weakness depressed reflexes which organ effected by drug toxicity ----------- Correct Answer ------------ liver fatigue prevention ----------- Correct Answer ------------ alternate rest and activity if pt worried about osteoporosis ----------- Correct Answer ------------ increase Ca+ wt bearing exercises bone density pt unable to urinate fully ----------- Correct Answer ------------ enlarged prostate skin breakdown what position bad for pt ----------- Correct Answer ------------ high fowlers