Rnur141 Unit Iv

Front 1

what is a special ability needed by the nurse?

Back 1

patience- the elder adult takes longer to process information therefore allow for pauses in order for them to think.

Front 2

should you ask the same question muliple ways?

Back 2

yes- because they may not have fully understood it the first time.

Front 3

how should you introduce yourself?

Back 3

by name and explain your role and title

Front 4

how do you "set the stage" for an interview?

Back 4

be on the same eye level
stay in front of them so they can read your lips.
repeat as necessary
avoid unnecessary noise in the room (TV)
ask one question at a time and wait for the response

Front 5

during an assessment what is some basic information you should ask?

Back 5

name and DOB (checks cognition also)
ask them their address

Front 6

do you need to know about their house and neighbrohood?

Back 6

yes, you need to know how many floor they have in their house and where their bathrooms are situated. you need to know if they are safe in there home, also they may shut windows in the extreme heat due to unsafe conditions

Front 7

should their financial situation be discussed during the assessment?

Back 7

yes- this allows the dr to write less expensive medications if possible

Front 8

should you ask about old injurys?

Back 8

yes- may be able to see a pattern in falls.

Front 9

why would you ask about an advanced directive during the interview?

Back 9

to make sure that the wishes of the client in regards to to healthcare decisions are granted during the hospital stay.

Front 10

what other kinds of assessment should you do on the elderly?

Back 10

physcial head to toe
psychosocial assessment
depression assessment
functional assessment
fall risk assessment

Front 11

medication assessment

Back 11

should include name, amount, frequency, and route of all perscribed, OTC, and home remedies.

Front 12

medication assessment should include any medication that has been discontinued. reasons should be included

Back 12

medication assessment should include asking them if they are taking medication for someone else

Hint 12

Also ask:
do you share your medication with anyone?
how do you obtain and pay for medications?
do you manage you own medications?
is there any age-related changes that impact the pt abitlity to self-manage meds?
can non medication interventions control the problem?

Front 13

psychosocial assessment

Back 13

ask the pt if they have had recent changes in their situation or experience any losses recently

Front 14

functional assessment

Back 14

can your pt do ADLs?
can your pt to instrumental ADLs? (balance checkbook , buy appropriate food)

Front 15

fall risk

Back 15

are they at risk?
medications
hx of falls
living arrangements
medical conditions

Front 16

normal vital signs in adults >70

Back 16

temp-36
HR--60-100
BP- 120/80 can be up to 160/95

Front 17

is an elder adult always able to breath through their nose?

Back 17

no- f they cant it might be better to use a tempanic, except lower temps in elders

Front 18

can an elder be afebrile even with an infection?

Back 18

yes

Front 19

can the depths of respers decrease after age 85?

Back 19

yes

Front 20

where do you watch to obtain a resper rate on the elderly?

Back 20

abd

Front 21

can you take the elders word for their height?

Back 21

no- its common to lose up to 3inches due to osteoporosis

Front 22

when taking their weight what do you need to be aware of?

Back 22

a loss of more than 5% in last month
a gain of more than 10% in the last 6 months

Front 23

why would a weight be taken daily in an elderly patient?

Back 23

if the pt had CHF- any weight gain can mean fluid build up.
can gain significantly from one day to the next as a result of poor circulation from CHF

Front 24

what should you be aware of in their speech?

Back 24

volume
speed
tone of voice
quanity (how much are they talking)
can they carry on an appropriate conversation?

Front 25

what should you also be assessing when you assess thier speech?

Back 25

level of orientation

Front 26

what should you be looking for when you assess their cognition?

Back 26

their thinking process
attention span
"flight of ideas"
bizarre thoughts?
do they have obession

Front 27

what is flat affect?

Back 27

no emotion on the face

Front 28

when you assess their gait by walking a few steps, what are you looking for?

Back 28

shuffling
limping
do they drag a foot?
do they have coordination?
how is their balance?

Front 29

how do you check the elders integumentary system?

Back 29

get a history
inspect
palpate

Front 30

what do you ask when getting a hx of the integumentary system?

Back 30

do you have a hx of skin cancer?
any chronic skin isuss (exema, cirriosis)
any itching or dry skin
any bruising?

Front 31

what do you inspect on the skin?

Back 31

look for signs of abuse or lesions the elder cant explain

Front 32

what should you take into account when inspecting the elders skin?

Back 32

elders skin is thinner and dryer
the nails are thick and duller
may have chronic fungal infections in toenail
their hair is thinner

Front 33

what do you check for when you palpate the skin?

Back 33

check for lumps(size and location)
check for hot/cold
moisture
skin breakdowns

Front 34

are skin tags common is elderly adults

Back 34

yes

Front 35

what is cherry angioma?

Back 35

are small red freckles
usually flat and are apart of the noraml aging process

Front 36

what are lentigo senilis (liver spots)

Back 36

brown patches that are slightly darker than the skin color, found on the hands and forearms

Front 37

what is seborrheic keratosis?

Back 37

they are a dark/waxy and wart like, they can be raised and large, common in men (often in the face)

Front 38

why would a nurse be worried if the client reported moles that look different or sores that wont heal?

Back 38

could be a signs of skin cancer

Front 39

does the skin have less melanin after the age of 50?

Back 39

yes- makes the skin look uneven

Front 40

how come caucasians become very white and often have a bluish peripherally?

Back 40

poor circulation

Front 41

what makes darker complexions take on a gray apperrance in in the nail beds and mucous membranes?

Back 41

poor circulation

Front 42

where do you check for jaundice in darker complexion patients

Back 42

oral membranes, whites of eyes, and palms

Front 43

what do you assess when doing a head assessment?

Back 43

previous injury
frequent head aches
use of seatbelts
syncope
dizziness

Front 44

if pt complains of HA was else should be asked?

Back 44

what triggers the HA?
their length
describe the pain
how do they manage the HA?

Front 45

when you inspect the elderly's head what are you looking for?

Back 45

symmetry
lumps/bumps
what is the facial expression

Front 46

____for tenderness and indentations.

Back 46

palpate

Front 47

when asking a patient about their eyes what is important?

Back 47

hx of eye problems
last eye exam
suppose to wear glasses?
hx of eye trauma
dry eyes?
look for discharge of the eye

Front 48

this is a gray ring (hallow) around the iris.

Back 48

arcus senilis
this is normal

Front 49

this is when the eye lid rolls inward and the lash irritates the eye.

Back 49

entropion

Front 50

_____ is sagging of the eye lid

Back 50

ectropion

Front 51

when inspecting the eyes on assessment of the elderly what do you chart?

Back 51

can they hear
changes in hearing
hearing aids in place
long term exposure to loud noises

Front 52

is increased hair growth in the ear normal?

Back 52

yes

Front 53

______often becomes dryer, thicker, and often impacts the ear.

Back 53

cerumen (ear wax)

Front 54

what should be inspected and charted about the nose?

Back 54

constant drainage
trauma
allergies
shape and symmetry
changes in smell
patency of nostril

Front 55

what do we inspect and chart when assessing the mouth

Back 55

last dental visit
chew/smoke/drink
difficulty chewing?
missing teeth
do they have dentures
chronic dry mouth
difficulty swallowing
uvula midline

Front 56

what do we inspect and chart when assessing the neck?

Back 56

shape and symmetry
palpate the thyroid
lymph nodes

Front 57

what would you auscultate the carotid arteries?

Back 57

checking for bruitis...indicates narrowing of the arteries

Front 58

when check for ROM in the neck, what should we expect?

Back 58

some decrease in the elderly
no crepitis

Front 59

when assessing the jugular veins in a lying position and distention is noted what can that indicate?

Back 59

CHF
the further the neck distention the more progressed the CHF

Front 60

hx of elderly's back and respiration should include?

Back 60

back trauma/surgery
chemical exposure
chronic cough/sputum
hx of resp disease
hx of smoking
last pneumonia/flu shot
soa
night sweats

Front 61

how often is the pneumonia shot given?

Back 61

after 65 every 5 years

Front 62

how often is the flu shot given

Back 62

every year

Front 63

_____is when the chest is as deep is it wide

Back 63

barrel chest

Front 64

______is where the sternum sticks up

Back 64

pigeon chest

Front 65

______is where the sternum goes inward

Back 65

funnel chest

Front 66

______is the curvature of the back...seen a lot in elderly women

Back 66

kyphosis

Front 67

what is the ideal O2 sat on the elderly?

Back 67

93-95%

Front 68

what do you inspect when assesing the anterior trunk?

Back 68

last mammogram
BSE
family hx of breast CA
recent changes in the breast

Front 69

_______ is the enlargement of breast in men

Back 69

gyneocomastia-

Front 70

assessment questions for the anterior trunk that should be documented

Back 70

hx of chest pain/tighness
hx of heart burn
SOA on exertion
taking cardiac/BP meds
LE edema
pain when walking?

Front 71

what is an indication for DVT

Back 71

calves feel heavy or sore

Front 72

when auscultating the heart what are you observing for?

Back 72

irregular heart beat
breath sounds
heart sounds

Front 73

what questions should you ask when taking a hx of the elders abdomen?

Back 73

pain associated c eating
excessive belching/gas
change in appetite
change in bowel habits
rectal bleeding/hemorrhoids

Front 74

______blood in stools indicate that the blood is coming from the anus.

Back 74

red

Front 75

______blood in the stools indicates that the blood is coming from the upper GI

Back 75

black/tary

Front 76

if you are inspecting the abd of an elderly pt and you notice pulsations in the abd, what could this indicate?

Back 76

aortic aneurysm
do not push becasue you could rupture aneurysm....very serious condition

Front 77

what order do you assess the abd?

Back 77

inspect
auscultate
percuss
palpate

Front 78

what kind of hx should you get from the elderly about their musculoskelatal system?

Back 78

hx of fx/trauma
joint replacement
surgeries
hx of falls
RLS

Front 79

______ their ability to bear weight, gait and posture

Back 79

assess

Front 80

what questions do you ask to get a better understanding of their musculoskeltal system?

Back 80

hx of stroke
numbness/tingling
dizziness
change in mental status
change in mood
change in memory
decreased ability to do ADL's

Front 81

test for the musculoskelatal system...

Back 81

test their reflex
test their balance
test fine motor movement

Front 82

what is important questions to ask when assessing the GU system?

Back 82

hx of hysterectomy
number of childern

Front 83

should you ask about their continence?

Back 83

yes- this is not normal

Front 84

even if the female elderly is not sexually active, should she still get a pap smear/

Back 84

yes, still has a chance to have cervical CA

Front 85

should you encourage fluids in the elderly?

Back 85

yes-unless contradicted

Front 86

elder's should remain upright for ___hour after eating

Back 86

1-

Front 87

the chin should______if the patient is having trouble swallowing

Back 87

tuck down