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78 Cards in this Set

  • Front
  • Back
What is crystallized intelligence?
Use of past learning...Relating it to experience. WISDOM

-remains intact during aging
What type of time constraints should you have on activities?
Make them brief, their attention span is often decreased
What is fluid intelligence?
spatial intelligence and creativity (THINKING ON YOUR FEET)

-decreases as you age
When teaching an elderly person, what are two very important things to do?
Demonstration and Repetition

Learning ability is not seriously altered with age, but learning occurs best when the information is related to previously learned information
Why do you use repitition when teaching?
Because it takes longer for elderly to perform information processing
What is the best learning environment for elderly?
1:1

-can't switch from one auditory stimulus to another very quickly
-too much chatter is bad
-can't divide attention between two tasks
-
When lens discolors as a normal aging process, what does this affect?
discrimination of black vs blue shades of color
Why no linoleum floors?
b/c they have increased sensitivity to glare
What does the decrease in muscle tone of the eyes do to the elderly?
Can't dilate their pupils as quick
Presbyopia
Difficulty reading. Playing trombone with papers....starts at age 40
What does the decrease in eyelashes effect?
increased risk of infections

(decreased number of lashes and decreased amount of natural tears)
Blurred images at a distance
astigmatism
White/Yellow ring around cornea
arcus senilis (normal physiological aging change)
Hardening of the lens
Nuclear Sclerosis
Drusen
dots on the eye
decreases vision
detectable with otoscope
precursor to macular degeneration
Arcus senilis in an older person is normal. In a younger person, it can be a sign of....
cholesterol problem
A ripe cataract is one that you can....
see
How often should a diabetic get an eye exam?
every year
How often should an adult over 65 get an eye exam?
Every other year
Describe cataracts
blurred vision
glare
halos around objects
double vision
lack of color contrast
poor night vision
Sagging of the bottom lid of the eye
ectropion

(entropion is inward sag of eyelid where eyelashes touch eye)
Why do older people need more light to read?
Because decreased musculature of the eye causes the pupil to not dilate as quickly or largly, so they have a smaller pupil size in general
Accomodation
ability of lense ot change shape and focus correctly
Loss of ability to see close objects or small print
presbyopia
Cataracts are opacities or yellowing of the lens. What causes the decrease in vision?
decreased amount of light that goes through the lense
How do cataracts develop?

(progression)
Slow and painless
What type of vision do cataracts effect?
central and peripheral
Are cataracts unilateral or bilateral?
uni or bi
Briefly describe what the picture of the cataract example looks like.
Whole picture is fuzzy
What do patient's with cataracts feel?
nothing. painless
Describe the vision of a person with macular degeneration.
Island of blindness
What is the term for the island of blindness?
scotoma
What are the two types of macular degeneration?
wet and dry
dry is slow to progress and is from atrophy and drusen accumulations

wet is a neovascular exudate from blood and serum leaks of newly formed blood vessels under retina which lead to scar formation
What do people with ARMD need to help them see?
need more light
can't see in the center, so get to their side
What is the name of the grid used to screen for ARMD?
Amsler grid
What is the number one cause of blindness in the US?
macular degeneration
What are preventative treatments for ARMD?
zinc, vitamin E, sunglasses, lycopine, encourage eye exams
What are some risk factors for ARMD?
age, smoking, FHX, UV light, white, ble eyes, HTN, bad diet
What type of vision loss is in glaucoma?

Where do you stand?
mid peripheral vision loss

Stand in front of them
What is tx for glaucoma?
beta blockers to reduce the IOP on artery....be sure to block the PUNTA so the drug doesn't get absorbed after drops
Curtain down on eye. Medical emergency.
Retinal Detachment

separation of retina from the choroids with loss of vision
What will a patient experience with glaucoma?
no pain, just slow vision loss
What does the vision look like in the picture example of glaucoma?
Shaded around the central image. Mid peripheral vision loss
Diabetic retinopathy patients often use.....

Their vision is disturbed with chunks....caused from...
magnifying glasses

high sugar....it is a blurring, and gradual focal loss
When caring for a patient with a visual disturbance, what are some important interventions?
-let everyone know
-introduce self b/4 making personal contact
-appropriate lighting
-avoid sudden change in lighting at all times
-partially close the blinds and curtains at all times to reduce glare
-provide nightlight for bedroom and bathroom during hours of sleep
-keep frequently used items in visual field at all times
-wear glasses
-provide auditory rather than visual diversionary activities if indicated
How many people over the age of 60 have hearing problems?
1/3
Why is earwax a problem in older adults?
decreased apocrine glands make the wax drier and harder
What is decibal for hearing loss?
over 85
What are the two ways to remove cerumen?
curette (don't do if there is a perforated ear drum)

lavage/irrigation (warm water, pull auricle up and back)
Decreased number of cochlear hair cells can cause hearing loss and...
balance problems
What type of sounds do elderly have a hard time hearing?
high tones are hard for them to hear....
If you flush ears with COLD water, what will happen?
vertigo and vomit
What else can you use to clean out ears?
colace

ears and ass
What is normal aging process of:

tympanic membrane?

cerumen production?

cochlear hair cells?

health of neurons?
tympanic membrane - thins

increased cerumen production

decreased number of cochlear hair cells

degradation of neurons
Another term for HOH...
presbycusis

(normal and common)
What drugs can cause deafness?
aminoglycosides
Meniere's Disease
chronic disorder of the inner ear....vertigo
What are the two types of hearing loss?
conductive and sensorineural
Sensorineural hearing loss is a combination of these two things:::::
1. Loss of hair cells in cochlea

2. Degredation of neurons

So this is the one that is age related
Presbycusis is __________ and ____________. Can't hear high pitched sounds.
gradual and bilateral
Curtain down on eye. Medical emergency.
Retinal Detachment

separation of retina from the choroids with loss of vision
What will a patient experience with glaucoma?
no pain, just slow vision loss
What does the vision look like in the picture example of glaucoma?
Shaded around the central image. Mid peripheral vision loss
Diabetic retinopathy patients often use.....

Their vision is disturbed with chunks....caused from...
magnifying glasses

high sugar....it is a blurring, and gradual focal loss
When caring for a patient with a visual disturbance, what are some important interventions?
-let everyone know
-introduce self b/4 making personal contact
-appropriate lighting
-avoid sudden change in lighting at all times
-partially close the blinds and curtains at all times to reduce glare
-provide nightlight for bedroom and bathroom during hours of sleep
-keep frequently used items in visual field at all times
-wear glasses
-provide auditory rather than visual diversionary activities if indicated
What is the term for hard of hearing?
presbycusis

gradual and bilateral
What is the disease that is characterized by constant vertigo because of a problem with the inner ear?
Meniere's Disease
Age related hearing loss is caused from a combination of these two things:
decrease in number of cochlear hair cells (sensory)

degredation of the neurons (neural)

Sensorineural is the type of hearing loss caused from old age
Presbycusis is considered normal and common. These two hearing problems are not:
tinnitus - ringin gin ears with or without hearing loss

deafness
What drugs can cause deafness?
aminoglycosides
Cerumen production increases in older age, but it is drier due to loss of apocrine gland production. What are the two ways to remove cerumen?
scrape it (don't do if perforated ear drum)

lavage or irrigate it with WARM water. COld water will cause vertigo
Sounds levels over ____decibals can cause hearin gloss if prolonged.
85
Old people have problems hearing this type of sound:
high pitched sounds
What is the HHIE-s?
Hearing Handicap Inventory for the elderly

High score is Heavy Loss

High is Heavy
What does the Rhine test detect?
Tuning fork on mastoid bone to detect conductive hearing loss or conductive hearing. If conductive is diminished, something is blocking the outer to mid ear
What does the Weber test for hearing determine?
Tuning fork on the top of the head and it is looking more for sensorineural hearing
How do you clean a hearing aid?
with warm water/saline and a cotton pad
If a patient suffers from auditory sensory disturbance, what are some interventions to remember?
-assess for auditory alteration and ear wax
-alert all caregivers
-approach in visual path before speaking
-give enough light so they can read lips, see facial expressions and gestures
-stay within 3-6 feet of resident while speaking
-avoid chewing gum, eating and covering mouth while talking to resident
-Speak toward good ear in a lower tone of voice