Gero Test 3

Front 1

tools for an effective psychosocial assessment

Back 1

a trusting relationship, a listening ear, an intuitive mind, a sensitive heart, and good communication skills.

Front 2

When do you perform a psychosocial assessment in acute care?

Back 2

When the patient is medically stable

Front 3

When do you perform a psychosocial assessment in long term care settings?

Back 3

It is an ongoing part of care, and you can gain a lot of information from the healthcare workers and nursing assistants that work closely with them.

Front 4

Usually when does the best communication occur

Back 4

when the nurse is verbally quiet and nonverbally responsive. Asking open ended questions and nonverbally responding indicates interest.

Front 5

Nurses assess the aspects of psychosocial function that most directly influence

Back 5

the day-to-day activities of older adults

Front 6

Confabulation

Back 6

the process of making up information. And can be difficult to assess when the nurse doesn't know the right answers. So questions like where were you born or childhood experiences are not effective for measuring cognitive function if the nurse doesn't know the answers.

Front 7

Circumstantiality

Back 7

involves the use of excessive details and roundabout answers in responding to questions

Front 8

expressive aphasia

Back 8

occurs when comprehension abilities are not affected but word retrieval or word-finding abilities are impaired.

Front 9

Receptive aphasia

Back 9

occurs when verbal and comprehension abilities are impaired but some language skills are retained.

Front 10

global aphasia

Back 10

is a combination of receptive and expressive aphasia and is manifested by inconsistent and poorly controlled language skills.

Front 11

insight

Back 11

is the ability to understand the significance of the present situation. It is an important skill for problem solving because it establishes a basis for planning care.

Front 12

The nurse begins the assessment of the affective state by focusing on what type of feelings?

Back 12

Feelings that are viewed as positive or neutral.

Front 13

delusions

Back 13

fixed false beliefs that have little or no basis in reality and cannot be corrected by appealing to no reason.

Front 14

hallucinations

Back 14

sensory experiences that have no basis in an external stimulus.

Front 15

Illusions

Back 15

misperceptions of an external stimulus. Differ from hallucinations in having some basis in reality whereas hallucinations do not.

Front 16

paranoia

Back 16

is an extreme degree of suspiciousness is one of the most common types of delusions.

Front 17

hyperactive delirium

Back 17

S/S: include restlessness, agitation, and increased psychomotor activity.

Front 18

Hypoactive delirium

Back 18

is characterized by slowed movement, paucity of speech, and unresponsiveness.

Front 19

Delirium development

Back 19

It develops over a short period of time, fluctuates over the period of the day and can persist for months.

Front 20

senile

Back 20

by definition means old age, but has a long history associate with infirmity, diseases, and feeblemindedness and for this reason it shouldn't be used.

Front 21

mild cognitive impairment

Back 21

is a transitional stage between normal cognitive aging and diagnosable dementia

Front 22

cognitive reserve

Back 22

the capacity to continue to function at an adequate cognitive level despite brain pathology.

Front 23

global deterioration scale/functional assessment staging or GDS/FAST

Back 23

is valid and reliable for staging Alzheimer's disease in diverse settings. The diagnosis of ALz is made retrospectively because it is based on a progression of manifestations.

Front 24

Risk factors associated with a higher risk of mortality associated with dementia

Back 24

increased age, male gender, decreased functional status, and medical comorbidities.

Front 25

The ultimate functional consequence of dementia

Back 25

death

Front 26

agnosognosia

Back 26

lack of awareness of cognitive deficit, and is recognized as the core diagnostic feature of frontotemporal dementia.

Front 27

retained awarness

Back 27

maintaining self-awareness of your needs and feelings despite having anosognosia

Front 28

a major focus of emotional responses in the earlier stages of dementia is

Back 28

on readjusting one's self concept, trying to maintain a sense of normalcy, and developing cognitive, social, and behavioral strategies to improve confidence.

Front 29

Two important responsibilities of caregivers during the later stages of dementia

Back 29

encourage and interpret nonverbal communication

Front 30

behavioral and psychological symptoms of dementia BPSD

Back 30

have serious implications because it is strongly associated with increased functional limitations, increased use of medications, and decreased quality of life

Front 31

catastrophic reaction

Back 31

is a wide range of behaviors that are disproportionate to the reactions that would normally be expected in a situation. They involve sudden and exaggerated response to a situation that the person with dementia percieves as a threat.

Front 32

excess disability

Back 32

is defined as limitations that are beyond what is to be expected

Front 33

progressively lowered stress threshold

Back 33

this model says that dysfunctional behaviors indicate a progressive lowering of the stress threshold, which in turn, interferes with the person's functioning and ability to interact with the environment. The goal of nursing care is then to maximize the person's functioning by limiting the stressors.

Front 34

psychosocial theories of depression

Back 34

focus on the impact of loss as well as the buffering effects of social supports and the social network in protecting against depression. Some potential risk factors include: ageism, loss of social roles, poverty, childhood trauma, stress, and poor social integration.

Front 35

Learned helplessness theory

Back 35

describes depression as a deficit in the following four areas: cognitive, motivational, self-esteem, and affective-somatic. Depression occurs when people expect bad things to happen, believe they can do nothing to prevent them, and percieve that the events result from internal, stable, and global factors. Nursing interventions include improving self-efficacy and a sense of control over one's environment.

Front 36

cognitive triad theory

Back 36

people appraise themselves by the cognitive triad of their self-image, their environment, and their future. They describe these 3 realms as lacking some features needed for happiness. Ex. Interpretations of neutral events as bad. Depression is caused by distorted perceptions according to beck. They impair one's ability to appraise oneself and the event in a constructive manner.

Front 37

Second part of beck's theory involves schema

Back 37

schemas are assumptions, or unarticulated rules that influence thoughts, feelings, and behaviors.

Front 38

Third part of beck's theory existence of certain logical errors

Back 38

such as personalization, minimization, magnification, and overgeneralization.

Front 39

vascular depression

Back 39

propose that depression can arise in late life from cerebrovascular damage caused by ischemic hemorrhagic strokes. Characteristics include: poor insight, less agitation, increased disability, more cognitive impairment, more psychomotor retardatiion, and less feelings of guilt.

Front 40

risk factors for depression in older adults

Back 40

demographic factors, psychosocial influences, medical conditions, functional impairments, and the effects of medications and alcohol.

Front 41

primary risk factor for depression

Back 41

is a combination of stressors and the absence of social supports that increase the risk for depression.

Front 42

Difference between depression in younger and older adults

Back 42

older adults are less likely to show affective symptoms and are more likely to have cognitive changes, physical compliants, and a loss of interest.

Front 43

Patient health questionaire

Back 43

is a two item screening tool used to determine depression. The 2 questions are 1. during the past 2 weeks or month have you felt down, depressed, or hopeless? and 2. during the past 2 weeks or month have you felt little interest or pleasure in doing things? A positive response to either warrants further assessment of depression.

Front 44

risk factors for hearing impairment

Back 44

age over 65, residence in a nursing facility, cognitive or visual impairments, exposure to excessive noise, use of ototoxic medications, and male gender.

Front 45

noise induced hearing loss

Back 45

is still the most preventable cause of hearing loss in the united states

Front 46

otosclerosis

Back 46

is a hereditary disease of the auditory ossicles that causes ankylosis of the footplate of the stapes to the oval window.

Front 47

Hearing impairment is most likely to occur in

Back 47

men, people of low economic status, and people exposed to prolonged noise.

Front 48

conductive hearing loss

Back 48

abnormalities of the external and middle ear impair the sound conduction mechanism

Front 49

sensorineural hearing loses

Back 49

abnormalities of the inner ear interfere with sensory and neural structures

Front 50

tinnitus

Back 50

is the persistent sensation of ringing, roaring, blowing, buzzing, or other types of noise that do not originate in the external environment.

Front 51

enopthalmos

Back 51

overall appearance of sunken eyes

Front 52

blepharochalasis

Back 52

loss of orbital fat and muscle elasticity can progress to the point of causing an eyelid fold and impairing vision.

Front 53

ectropion

Back 53

the lower eyelid falls away from the conjunctiva, blocking the flow of tears through the lower punctum and decreasing lubrication of the conjunctiva.

Front 54

entropion

Back 54

the lower eyelid becomes inverted and the eyelashes irritate the cornea, eventually leading to infection.

Front 55

Arcus senilis

Back 55

a noticeable age related change and is the development of a yellow or gray-white ring between the iris and the sclera which occurs because of the accumulation of lipids in the outer part of the cornea.

Front 56

presbyopia

Back 56

is the loss of accommodation, and is an initial and universal age related change. It affects all humans to some degree by their mid 50's. Gradually extend the near point of vision, which is the closet point at which a small object can be read.

Front 57

veiling glare

Back 57

is caused by scattering of light over the retinal surface and results in diminished contrast of the viewed object. Ex. Bright lights in grocery stores reflect on the clear plastic covering over foods.

Front 58

dazzling glare

Back 58

caused by bright visual displays, and interferes with the ability to discern details. Glass covered directories in brightly lit shopping malls.

Front 59

Scotomatic glare

Back 59

is a blinding glare caused by loss of retinal sensitivity and overstimulation of retinal pigments during exposure to bright lights. Ex. sunshine especially at sunrise or sunset.

Front 60

Glare sensitivity is influenced primarily by

Back 60

opacification of the lens

Front 61

stereopis

Back 61

is the disparity between retinal images that is caused by the separation of the two eyes, and is the primary ocular characteristic that affects depth pereption.

Front 62

opacification effects what colors most

Back 62

colors with shorter wavelengths such as blues, greens, and violets.

Front 63

critical flicker fusion

Back 63

is the point at which an intermittent light source is percieved as a continuous, rather than flashing light. Can interfere with the dicernment of emergency vehicles and road construction lights.

Front 64

The most modifiable and preventable risk factors for cataracts are

Back 64

cigarette smoking, and exposure to sunlight

Front 65

What is the most important/easiest and the least costly intervention to improve visual function

Back 65

proper nonglare lighting

Front 66

presbyphagia

Back 66

slowed swallowing that is associated with age related changes and can increase the risk for aspiration.

Front 67

What nutrients are affected by age related changes in the sm. intestines

Back 67

folate, calcium, and vitamins B12 and D.

Front 68

risk factors for inadequate nutrition in community dwelling older adults

Back 68

poverty, impaired cognition, functional impairment, medication usage, poor oral health, poor physical or mental health, and lack of social supports.

Front 69

alcohol

Back 69

has a high caloric content but low nutrient value, it provides empty calories, and interferes with the absorption of the B-complex vitamins and vitamin c.

Front 70

Smoking

Back 70

diminishes the ability to smell and taste food and interferes with absorption of vitamin c and folic acid.

Front 71

Risk factors for constipation

Back 71

functional impairments, pathologic condition, adverse medication effects, and poor dietary habits.