Summary C475 CARE OF ADULT UNIT 3. | VERIFIED GUIDE

C475 CARE OF ADULT UNIT 3. UNIT 3 Competency 742.1.3: Health Needs of Older Adults Competency 742.1.5: Promoting Health and Independence in Older Adults Learning Objectives · Identify common risk factors that contribute to functional decline, reduced quality of life, and disabilities in older adults. · Examine techniques for assessing and treating factors that lead to functional decline in older adults. · Outline strategies to promote the older adult’s active engagement and participation in Prioritize the older adult clients’ physical, emotional, and mental needs across care settings. · Apply knowledge of the aging process and associated risk factors, skills in history-taking and assessment, and respect for the dignity of older adults in a comprehensive, individualized assessment of an older adult. · Describe how the aging process of each physiological system correlates with the functional ability of the older adult. · health promotion and prevention programs. Management of Geriatric Syndromes Review Chapter 10 “Nursing Management of Dementia” ● Review risk factors for dementia, Box 10-3 BOX 10-3 Risk Factors for Dementia • Age • Family history • Genetic factors • History of head trauma • Vascular disease • Certain types of brain infections ● Review possible warning signs for dementia, Box 10-4 BOX 10-4 Possible Warning Signs of Dementia • Frequent forgetfulness, especially of recent events • Difficulty with common tasks (e.g., cooking) • Forgetting common words • Becoming lost in familiar areas • Poor judgment, especially with finances • Misplacing objects in unusual places (e.g., puts clothes in bathtub, puts purse in oven) • Changes in mood, behavior, or personality • Lack of interest or involvement in life activities ● Diagnostic Criteria for Alzheimer’s Disease, Box 10-5 BOX 10-5 Diagnostic Criteria for Alzheimer’s Disease Criteria for dementia: The patient has cognitive or behavioral (neuropsychiatric) symptoms that: 1. Interfere with the ability to function at work or at usual activities 2. Represent a decline from previous levels of functioning and performing 3. Are not explained by delirium or major psychiatric disorder Cognitive impairment is detected through history taking and objective cognitive assessment. The cognitive or behavioral impairment involves a minimum of two of the following domains: • Impaired ability to acquire and remember new information (memory problems) • Impaired reasoning and handling of complex tasks, poor judgment • Impaired visuospatial abilities • Impaired language functions • Changes in personality, behavior, or comportment Criteria for probable AD: The patient meets the above criteria for dementia and has the following: • Insidious onset: Symptoms have developed over months to years • Clear-cut history of worsening of cognition by report or observation • The most prominent cognitive deficits are in one of the following categories: ▪ Amnestic presentation: Impairment in learning and recall of recent information ▪ Nonamnestic presentations: o Language presentations, such as word finding difficulties, aphasia o Visuospatial presentations, such as object agnosia, impaired facial recognition o Executive presentations, such as impaired reasoning, judgment, problem solving The diagnosis should not be made (1) if there is substantial concomitant cerebrovascular disease, such as recent stroke; (2) if there are key features of other dementias, such as LBD or FTLD; (3) if there is evidence for another concurrent active neurological disease or nonneurological medical comorbidity; or (4) if there is a use medication that could be affecting cognition. ● Common Medications that can cause or worsen confusion, Box 10-6 BOX 10-6 Common Medications That Can Cause or Worsen Confusion Any anticholinergic agents or those with significant anticholinergic effects Analgesics Propoxyphene (found in Darvon and Darvocet) Meperidine (Demerol) Opiates in excessive doses Antiemetics Promethazine (Phenergan)—anticholinergic Antihistamines Diphenhydramine (Benadryl)— anticholinergic Antihypertensives—Clonidine (Catapres) Antipruritics Hydroxyzine (Atarax)—anticholinergic Antiseizure medications (most, to some degree) Phenobarbital Anxiolytics Meprobamate (Equanil) Benzodiazepines (Ativan, Xanax, Valium) Bladder relaxants Oxybutynin (Ditropan)—anticholinergic Gastrointestinal antispasmodics Dicyclomine (Bentyl)— anticholinergic Hyoscyamine (Levsin)—anticholinergic Histamine-2 antagonists Cimetidine (Tagamet)—anticholinergic Muscle relaxants Cyclobenzaprine (Flexeril)—anticholinergic Tricyclic antidepressants Amitriptyline (Elavil)—anticholinergic (Alzheimer’s Association, 2016). ● Stages of Alzheimer’s Disease, Box 10-9 Mild Stage • Memory loss • Getting lost in familiar places • Having more difficulty doing normal daily tasks • Difficulty with managing finances • Making bad decisions • Not being as talkative or verbally fluent • Being more moody or anxious Moderate Stage • Increased memory loss and confusion • Short attention span • Difficulty with language, numbers • Difficulty with reasoning • Inability to learn new things or to adapt to new situations • tlessness, agitation, anxiety, tearfulness, wandering—especially in the late afternoon or at night (“sundowner syndrome”) • Repetitive statements, questions, or movements • Hallucinations, delusions, paranoia, irritability • Impulsivity (saying or doing things he or she normally would not) • Perceptual-motor problems (interfering with ADLs) Severe Stage • Weight loss • Seizures in some patients • Dysphagia (difficulty swallowing)