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31 Cards in this Set
- Front
- Back
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Feminization has four implications for nursing
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(1) The female majority is concentrated in the upper age ranges
(2) most older women do not have a spouse to care for them (3) most older women live alone. (4) most older women are in poorer health than older men. |
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Who are older adults?
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Women outlive men. 41% of older women, compared to 73% of older men, are living with a spouse. Less than 4.5% of older adults are living in instututional settings. As age advances, the statistics in crease 1.1% in the 65 to 74 age group to aproxamately 18.2% of frail adults <85 living in institutional settings. This shows that older adults live alone or in assisted living and that succesfull aging with heath promotion and health protection are the focus nursing intervention of older adults.
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What is Succesfull aging?
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Successfull aging is defined as "the ability to maintain three key behaviors or characteristics: a low risk of disease and disease related disability; high mental and physical function; and active engagment in life.
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What is the relationship between Health Promotion/Protection and Successfull aging?
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Succesfull aging is the goal of nursing intervention with older adults. Health promotion and health protection behaviors are tools used to assist. i.e. flu or pneumococcal immunizations, participation in senior citizens activity programs. It is important for all nurses to niew their approach to the care of older adults within the framework of working toward the ultimate goal of succesfull aging for all age groups.
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Standards of Practice of Gerontological Nursing.
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"Nurses must identify scietnific evidence for relationships of the care process to outcomes. Implementation and communication of such measures enhance nursing contributions to quality care."
As the gerontological specialty in nursing grows and thrives to meet the needs of an aging population, the 2001 ANA Standards of Gerontological Nursing Practice will contiue to describe and prescribe professional nursing practice. Legally, practice standards may be used as a guideline for identifying the prudent response of a nurse in a specific situation. |
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Gerontology
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The scientific study of the effects of aging and age-related disease on humans, includes the biological, physiological, psychosocial, and spiritual aspects of aging.
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Aging
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Aging is normal, with predictable physical and behavioral changes that occur in all people as the achive certain chronological milestones. It is complex and multidimensional phenomenon. It occurs at different rates, within parameters, and is unsparing.
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Wear-and-Tear Theory of Aging
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The wear and tear theory proposes that accumulation of metabolic waste products or nutrient deprivation damages DNA synthesis, leading to molecular and eventually organ malfunction.
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Personality Theory of Aging
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Neugarten et al. Found that healthy aging depended not on the amount of social activity a person has, but on how satisfied the person is with that social activity.
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Strategies for Succesfull Aging
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1. Maintaining helath but living a healthy lifestyle.
2. Continuing to be physicall and mentally active 3. Having a strong support system such as family, friends, and neighbors 4. Being able to adjust or adapt to change 5. Developing new interest 6. Participating in personally rewarding activities such as employment or volunteering. 7. Having an adequate income to meet basic needs 8. Avoiding stress-producing situations when possible 9. Being autonomous and independant 10. Doing what the person wants to do and not what family members or friends think he or she should do. 11. Planning a structured day and having something to look forward to. |
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10 Tips for Healthy Aging
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1. Eat a balance diet
2. Exercise regulary 3. Get regualr Checkups 4. Do not smoke. It is never to late to quit 5. Practice safety habits at home to prevent falls and fractures. Always wear a seat belt when traveling by car 6. Maintain contacts with fmaily and friends, and stay active through work, recreation, and community 7. Avoid exposure to sun, heat, and cold 8. Drink in moderation, if at all, and do not drive after drinking. 9. Keep personsal and financial records to simplify budgeting and investing. Plan long-term housing and financial needs. 10. KEEP A POSITIVE ATTITUDE TOWARD LIFE AND HAVE FUN. |
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Mental Activity
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Mental activity is just as important as physical activity in succesful aging. May prevent of delay development of dementia of the Alzheimer's type.
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Pet Therepy
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Pet therepy programs reduce loneliness and offer nursing home residents the chance to give and recieve love and affection.
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Ageism
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Ageism is bigotry and discrimination by one age group toward another age group. " A systematic stereotyping of and discrimination against people because they are old, just as racism and sexism acomplish this with skin color and gender. Old people are categorized as senile, rigid in thoguht and manner, oldfashioned in morality and skills... Ageism allows the younger generation to see older people as different from themselves; thus they subtly cease to identify with their elders as human beings."
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Professional Codes and Their Limits
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ANA has made a Code for Nurses. The code affirms that the recipients and providers of nursing services are viewed as individuals and groups who possess basic rights and responsibilities and whose values and circumstances command respect at all times.
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Autonomy
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Health professionals are required by this principle to disclose information about treatment options, evaluate whether patients underestand the options and the harms and benefits of each, refrain from pressuring or coercing patients, determine whether patients are competent to give or withhold consent, and clarify patients' consent to or dissent from treatment options.
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Beneficence and nonmaleficence
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The principles of beneficence and nonmaleficence require promoting others' good and avaiding actions that might harm others.
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Emergency Department for older adults
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Older adults who use the ED are likely to have an emergency diagnosis and are much more likely than the general population to be admitted to the hospital with a medical problem. A study at Yale-New Haven Hospital found that cardiopulmonary problems were the most common complaint among older adults in the ED, followed by weekness, changes in mental status, and abdominal pain.
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Primary Prevention
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Primary prevention in the acute care setting consists of preventing disease or disability that results from hopsitalization.
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Secondary Prevention
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Secondary prevention in the acute care setting involves early detection and treatment of disease and disability.
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Tertiary Prevention
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Tertiary prevention involves the early managment of problems to prevent further deterioration of complications.
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Use of Rehabilitation facilities by older adults
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Many older adults benefit from a strucutred rehabilitation program. Rehabilitation nursing in gerontology can be defined as a dynamic process of physical restoration that facilitates physical independence in all ADLs. This process includes the physical, emotional, psychological, socail, and vocational potential of the older person. In the face of chronic illness, the goals of rehabilitation are to maintain physical independence and to facilitate psychological, socail, vocational, and avocational well-being for the client.
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Rehabilitation Team Members
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Gerontological nurses trained in rehabilitation gain knowledge of each specialized area formally claimed by other therapies. The greatest advantage for the nurse is the ability to observe the client in his or her personal setting. By observing clients in their settings over many hours, the nurse can develop individualized interventions to facilitate choice and independence in activites. Gerontological nurses trained in rehabilitation can coordincate therapy and help older adults achive daily goals. This means monitoring health care, assisting with ADLs, and facilitating the psychosocial adjustment to a disability.
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Erickson's Last two stages of development
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Integrity-the acceptance of one's one and only cycle as something that had to be and that, by necessity, permitted no substitutions.
Despair- results when there is dissappointment over one's life. People who fail to accept thier lives while simultaneously realizing that there is no time to start in a new direction may feel despair. Failure to acheive ego integration may manifest itself in disgust and fear of death. Disgust may present itself as disdain, for one's self or for a particular or generalized other. |
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Special Learning: Medication
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Medication nonadherence among older adults is a national health concern. Noncompliance with a prescribed medical regimen has been identified as a major contributing factor to the therapeutic failure with older outpatients. In the United States, it has been estimated that 10% of hospital readmissions and 23% of nursing home admissions are related to patients inablility to take medications correctly.
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Impact of Noncompliance in Older Adults
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For those over age 65, the chances of having one or more medical problems increases. A variety of therepies may be used in their treatment. Patient noncompliance with any regiemn may diminish the benefits of the therapy and may lead to unnecessary diagnostic studies or prolonged treatment.
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Age-related changes in the integumentary system and physical assesment
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1. Flattening of dermoepidermal junction
2. Reduced collagen and elstin 3. Decreased epidermal cell turnover rate 4. Decreased vascular responsiveness 5. decreased subcutaneous fat 6. Decreased epidermal langerhans cells 7. Atrophy of eccrine and sebaceous glands. Thorough assessment of the skin by inspection is a major responsiblity of the nurse, regardless of the setting. Observing the skin for changes and protecting bony prominences are importnant standards of nursing care. |
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Age-related Changes in the Neurological system and physical assessment
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although the neurological system is affected by aging, the common belif that normal aging results in cognitive impairment is false.
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Osteoporosis
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Osteoporosis is a low bone mass and microarchitecural deterioration of bone, resulting in increased fragility and increased risk of fractures.
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Osteoporosis- Clinical manifestations
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It is a silent disease. There are few symptoms untill a fracture occurs. Subtle clues such as loss of height, changes in spinal curvature, and impared mobility are evident as the disease progresses. The primary fractures most often seen in clilents with osteoporossi are vertebral fractures, hip fractures, and forarm fractures. These fractures occur from either repetitive stress injuries or acute trauma, which may be superimposed on these microfractures.
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Primary Prevention- Diet
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Balanced nutrition with adequate calcium and vitamin D intake is essential to maintaining bone structure and integrity at any age.
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