NR 601 Final Exam Study Guide: Elder Abuse, Diabetes, UTI, Menopause, ED, Exams of Nursing

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NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ Types of Elder Abuse - correct answers > emotional abuse > sexual abuse > neglect > exploitation > abandonment > self-neglect Risk Factors for Elder Abuse - correct answers > age > gender > ethnicity > cultural beliefs > living arrangements > social isolation > loneliness Provider Responsibility in Cases of Suspected Abuse - correct answers > always keep abuse as a differential > any patient who present with unexplained STDs > listen to your patients' responses to your social history questions or any reports of not having access to their funds > perform a physical exam and order any necessary tests > include a cognitive screen > You may need to interview your patient and caregiver separately to see if the stories are the same If your patient is living independently but not able to provide for his or her needs, this is an example of what type of abuse? - correct answers self-neglect Exploitation definition - correct answers > refers to taking the assets of the elder, either their funds or their property, when this is without the consent of the elder and not for the benefit of the elder NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ > E.g. when a family member moves into grandma's house and uses her home and social security check or their income to provide for themselves, and they don't provide for grandma's needs. Neglect definition - correct answers > failing to provide food, shelter, healthcare or protection to a vulnerable elder Abandonment definition - correct answers > leaving the elder after assuming responsibility for the care of the elder Emotional abuse definition - correct answers > includes verbal and nonverbal actions, can cause anguish distress or pain to the elder Sexual abuse definition - correct answers any form of sexual contact without the consent of the elder Who is most likely to be abusers? - correct answers > People between 60 and 70 y.o. > living with spouses or children Additional Risk Factors for abuse - correct answers > Studies report that women are more at risk for physical and sexual abuse > There is a concern that abuse towards men may be under-reported > Culture and ethnicity also play a factor in abuse and abuse reporting > Consider the cultural beliefs about abuse which may include tolerance for abuse Signs of neglect - correct answers > A lack of hygiene > Failure to meet the patient's needs (ex: missed medical appointments) > Does the patient have needed assistance like a cane or eyeglasses? > Is the patient losing weight? NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ Exercise goal for diabetics - correct answers 150 mins/ week *Individualize Type 1 Diabetes Medication - correct answers glargine (Lantus) *Typically the 1st insulin used in DM because it is peakless, pts do not have nearly as many hypoglycemic episodes Type 2 Diabetes Medication - correct answers glucophage (Metformin) - dosage (start low & go slow) - SE (GI) - education - If HbA1c >9.0 needs adjunct therapy If diabetic is >40 y.o. which agent should be added to their daily medications for protective mechanisms? - correct answers ASA 81 mg Who is at risk for diabetes? - correct answers - Family Hx - BMI >25 - Impaired FBG or A1c >5.7% - Hx of gestational diabetes - HTN - Hyperlipidemia - Women w/ PCOS - African American, Latino, Native American, Asian, Pacific Islander Which race is most at-risk for diabetes? - correct answers Native Americans NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ Diabetic complications - correct answers - Neuropathy (may need Rx for tricyclic antidepressants to Tx pain) - Kidney failure - Eye (think small blood vessels that might be affected) - DKA (most serious) Who do you need to refer the diabetic patient to? - correct answers Ophthalmology for retinal exam UTI pathophysiology - correct answers Normal sterile environment invaded by pathogenic bacteria UTI causes in men - correct answers > most bacteria from prostate > cystitis not common due to increased length in urethra > from fecal matter (poor perineal hygiene) > from unprotected sex; particularly anal intercourse What bacteria most commonly causes UTI? - correct answers > E. Coli (80-90%) > Staph What is the gold standard for diagnosis of a UTI? - correct answers Urine culture Most offices only perform a U/A d/t cost & needed to treat UTI treatment in geriatric patient - correct answers sulfamethoxazole/ Trimethoprim (Bactrim DS) When to treat a UTI treatment in geriatric patient - correct answers > Pregnancy NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ > Removal of catheter > Urologic procedure When not to treat a UTI treatment in geriatric patient - correct answers > Asymptomatic in men > Non-pregnant women > Diabetic > Spinal cord pts w/ indwelling urinary catheters > 12 consecutive months of amenorrhea - correct answers > hematuria > dysuria > pyuria (pus in urine) > flank pain > pelvic pain Who's at risk for UTI? - correct answers > people having anal intercourse > indwelling foley catheter > urological procedure > incontinence Complications of UTI - correct answers > Pyelonephritis > Sepsis > Shock > Death Do you need to refer a patient w/ a UTI to a specialist? - correct answers No; only if they are not responding to abx tx Education related to UTI - correct answers > Cotton underwear NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ Osteoporosis is a complication of menopause, therefore what do you want to assess? - correct answers > bone density What population to test bone density? - correct answers All women over 65 years old Erectile Dysfunction Pathophysiology - correct answers Anything that impairs the resistance to efflux of blood from the penis (AKA "failure to store") Erectile Dysfunction Labs - correct answers > Blood glucose > Lipid Panel > TSH > Testosterone > CBC > CMP > PSA Erectile Dysfunction Diagnosis - correct answers nocturnal penile tumescence and rigidity (NPTR) Erectile Dysfunction Pharmacologic Treatment - correct answers - sildenafil (Viagra) - tadalafil (Cialis) - vardenafil (Levitra) ........................................................ *Know SE, 1/2 L, pros/cons, contraindications Erectile Dysfunction Procedural Treatment - correct answers > Penile prosthesis > Penile revascularization > Low intensity shock wave therapy Who is at risk for Erectile Dysfunction? - correct answers > Diabetics > Atherosclerosis NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ > Vascular disease > Psychological D/Os (anxiety, depression bipolar) > Anatomic defects Erectile Dysfunction complications - correct answers Priapism from meds ED referral - correct answers Clinician experienced in eval & monitoring male pts on HT Alzheimer's Disease Pathophysiology - correct answers Depletes cerebral cortex of neurons resulting in cerebral atrophy & neuritic plaques & tangles What is the most common form of dementia? - correct answers Alzheimer's disease Pt typically denies symptoms since it's a slow onset & lack of insight in which disease? - correct answers Alzheimer's disease Alzheimer's disease assessment - correct answers > Focused Hx > Cognitive Assessment > Functional Assessment > MRI Alzheimer's disease labs - correct answers > CMP > CBC > TSH > Vitamin B12 > Lipid panel Stages of Alzheimer's disease - correct answers Mild, moderate, and severe NR 601 Final Exam Study Guide question and answers Latest update 2023/2024 ranked A+ Mild Alzheimer's disease - correct answers > starts in medial temporal lobe & progresses to lateral temporal lobe & parietal lobe Moderate Alzheimer's disease - correct answers > disease spreads to lateral lobe Severe Alzheimer's disease - correct answers > disease spreads to occipital lobe Alzheimer's disease Diagnostics - correct answers > MRI > Cognitive & functional assessment Alzheimer's disease Pharmacologic Treatment - correct answers Mild to moderate: donepezil (Aricept), galantamine (Reminyl or Razadyne), rivastigmine (Exelon) [oral as well as patch] Severe: memantine (Namenda or Namzaric) Who's at risk for Alzheimer's disease? - correct answers > Age > Genetics/ family Hx Alzheimer's disease complications - correct answers > Confusion > Falls > UTIs > Fractures Alzheimer's disease referral - correct answers memory center Dementia Pathophysiology - correct answers > Pre-clinical can last 2-4 years > Slow, insidious onset Dementia assessment - correct answers > Assess for persecutory delusions (unable to recognize reality)