Final for agining

T/FAfrican americans may consider more situations as abusive than other groups

T

T/F Latinos believe" la familia" and dont report abuse

T

T/FChinese value their elders and think that people who are abrupt, rude or demanding toward elders is considered abuse

T

T/FAmerican Indians may view substance abuse or "culture loss" not valuing their elders wisdom as abuse

T

T/F 65% of the LGBT elders report abuse due to their sexual orientation. The ones who seek help may experience retaliation for complaining

T

T/FReferral to adult protective services include any signs of violence ( bruises, welts, fractures) and any neglect, exploitation, abuse.

T

Do these require a referral to protective services FrostbiteMalnutritionDehydrationOver sedationMental changesuncontrolled medical conditions

yes

Priority referral issues

any basic human needs related to:FoodWaterand ability to obtain help in an emergency

What are age related risk factors for elder abuse

physical dependence dementiabehavioral problemssocial isolation

Obudsman

Identifies, investigates and resolves complaints of abuse

What is the most common type of neglect in WI

self neglect

Where is most abuse seen on an elder

upper part of the body

What is the nurses role when it comes to an elder being abused.

The nurse needs to be able to use their investigating skills by using clues to suspect any abuse. The nurse is the main reporter of abuse. They need to observe the caregiver and figure out if the objective findings match the explanation. They also have to consult with the team leader and PCP as soon as possible. They need to determine if they need to report to the authorities to help.

Do nurses testify in court for elder abuse

Usually it is the PCP or protective services but sometimes the nurse will be asked to explain their direct observation and to give their expert opinion.

freedom over safety

The person has a right to life in harm if they do not harm anyone else or commit a crime.

Self-determination

The person has a right to control their own life until the court says different.

participation in decision making

The person has the right to receive information to help make a decisionmake their own decisions

least restrictive alternative

Alternative services should be based on the maximum choice and the least amount of change to their life

Primacy of adult

primary adult" The patient is the practitioners only responsibility

Confidentiality

privacy

benefit of the doubt

giving the patient the benefit of the doubtin the patients favor

Do not harm

The practitioner should not put the patient in any harm

Avoidance of blame

understand the caregiver or perpetrator instead of blame. When you blame this creates a risk for the patient to continue to be abused

Maintenance of family

Deal with the abuse as a family problem and try to resolve it

post op instructions after cataract surgery

No heavy lifting or strenuous activityno rapid eye movements not a lot of screen timelay on unaffected side head elevated in bedeye shield at nightlots of eye drops! stay away from dustdont rub eyesno makeupdont swimno driving

How to assess vision in the home using things in everyday environment

have the person read lines and different font in the newspaperhave the patient find the signature line ask them to read off a phone numberlook down hallway or out the window and have the patient describe in detail ( like the words on a sign)

for a pneumatic retinopexy procedure what position does the patient need to remain in for the bubble of gas to stay in place and keep the blood vessels and retina from moving

prone position

What interventions help with safety and successfully completing ADL's

two bright dots to mark low and high temp ( 70-75)bright tape on the bottom and top of the stairscontrast colors non glare lightingbroad spectrum fluorescent lights daylight stimulating lamps pause before entering a dark room which allows your eyes time to adjust feel around with hands and feet for objectsdon't rearrange furniture without asking

How can someone tell if they have diabetic retinopathy

There may be no symptoms present and the only way to tell would be an eye examIf symptoms are present they would include constant floaters, blurred vision, impaired color vision.

How can someone prevent diabetic retinopathy

keep blood sugar levels down

Acute closed-angle glaucoma

sudden onset of COMPLETE blockage of the aqueous humor due to pressure! Ophthalmologic emergencyIrreversible vision loss within hours if left untreatedEMERGENCY!!

Chronic open angle glaucoma

slow onset of clogged canals poor visionheadachestired eyesfrequent prescription change halos most common

Is glaucoma age related

no

What happens during glaucoma

The ganglion cells in the optic nerve are damaged by the aqeuous humorEffects peripheral vision

S/S of wet macular degeneration

Weak blood vessels form in order to get rid of the drusen and in the process they hemorrhage and blood ends up in the orbit of the eye. MEDICAL EMERGENCYimmediate surgery is needed before patient goes blind The amsler grid lines will look distorted

presbyopia

loss of accommodationExample: holding a book farther away in order for the eyes to adjust

Cataracts

clouding of the lens

#1 eye surgery performed in the USA

cataract surgery

What qualifies someone for cataracts surgery

when visual acuity declines to the point where the person is not safe or they have a poor quality of life visual changes= glare, blurred, cloudy

blepharochalasis

baggy eyelid; overabundance and loss of skin elasticity on the upper eyelid causing a fold of skin to hang down over the edge of the eyelid when the eyes are open

arcus senilis

gray or white arc visible above or below outer part of cornea due to fatty deposits -no affect to vision

Enophalmos

sunken eyes due to less SUBQ around the eye

AREDS formula

vit Cvit EZINC oxideCupric oxidebeta caroteneluteinzeaxanthin

What foods are high in lutein

fruit, corn, spinach, leafy greens, egg yolks

Pinguecula

yellowish mass on the conjunctivaFat deposits in the eye

entropion

inward turning of the rim of the eyelideye lashes irritate

ectropion

lower eye lid turns outward

Age related changes to thermoregulation (COLD)

less sub Q decrease sweatingdecrease peripheral circulationinefficient vasoconstrictiondecrease CO

diurnal temp changes

fluctuation between 1-2 degrees

Age related changes to thermoregulation (HEAT) HYPERTHERMIA

threshold sweating increasedrenal and hear changesdecrease thirst=less fluidsactive adults=overexertionimmobilized adults

How to assess baseline core body temp in nursing home

3x daily for 3 days

hypothermia in elders

cool skinlethargyslurred speech slow pulselow BPslow relfexes

correct definition of fever in adults

increase of 2 degrees from baseline

How to prevent hypothermia in adults

extra clothingelectric blankets on low power modeheater (75)adequate nutrition, fluid intake and managed medical conditionshat/gloves outsidenight cap and socks insideutility assistance if needed

Potential significance of dry flaky skin

less moisture because less sebum and eccrine sweat

What common age associates abnormalities can negatively affect wound healing

flattened dermal-epidermal junction=slow transfer of nutrients and oxygenlow moisture low sweat and oilless melanocytes less langerhands dermis is thin with more elastin but less quality

What can cause hair loss

age related changes to the dermis Atrophy of hair, sweat and oil

Know differences between stages of pressure ulcers as well as different dressing types used for various stage

stage 1: non-blanchable and no breakage of the skinstage 2: partial thickness skin loss with exposed dermisstage 3: full thickness skin loss with exposed fat tunneling/undermining may occurstage 4: full thickness and tissue loss exposed bone, muscle or tendon

what type of dressings are used for pressure ulcers

occlusive (air tight)

Types of skin tears

type 1: skin covers wound bed no skin losstype 2: partial flap loss type 3: total flap loss exposing wound bed

actinic keratosis

a precancerous skin growth that occurs on sun-damaged skinrough, scaly patch on skin

Supplements good for healing skin

proteinvitamin C zinc

Around what age does bone density decline

40-50

As we age more PTH is released which leads to what

osteopenia or osteoporsis

osteopenia

abnormal reduction of bone mass

Osteoporosis

A condition in which the body's bones become weak and break easily.brittle weak bones

Risk factors for osteoporosisprimary reasons and secondary

primary: low estrogen levelslow BMIdiet lifestyle ( inadequate weight bearing exercise) low levels of calcium & vit Dsecondary: medications like glucocorticoids, anticonvulsants and thyroid hormones&disease ( osteomalacia, hyperthyroid, hyperparathyroid, hypogonadism and myeloma

What qualifies someone for a bone scan every 2 years

spinal problemshyperparathyroidismlow estrogenlong term glucocorticoid therapypeople who take FDA approved osteoporosis meds

Proprioception

Knowing where our body parts are at all timesthis declines with age which can cause a person to walk slow, slow reaction time, balance problems, body sways and fall risk!

how to help prevent osteoporosis

vit D and calciumweight bearing exercise

What medication can cause falls

anticholinergics

peak bone mass is at what age

30

recommended vit D for adults

800-2000

recommended calcium for older adults

1000-1200

Fall prevention strategies for patients in the hospital

identify patients at riskeducate keep call light nearnon slip footwearask them if they need helpencourage them to call check on frequently bed low positionwheels lockedmovement detection device

What T-score indicates osteoporosis?

T < -2.5

When a T score is between -1 and -2.5

osteopenia

Age related causes for osteoporosis

increased bone resorption ( too much bone is being broken down)less absorption of calciumincreased PTHbad regulation of osteoblast (not making new bone fast enough)decreased hormones in men and women

kyphosis

hunchback

Scoliosis

abnormal lateral curvature of the spine

lordosis

swaybacklower back

what medications can be a cause of osteoporosis

corticocsteroids

The term for an age related benign fatty deposit on the eye

pinguecula

T/F hyperthyroidism can lead to bone loss

true

T/F BMD screens are covered by T18 if patient is taking glucocorticoids

t

T/F BMD screens are covered by T18 if the patient has a primary hyperparathyroidism

t