HESI Hints Only- Gerontology 2021/2022

What is a more accurate measure of age than chronological age? Correct answer- The ability to perform activities of daily living (ADL's). The majority of this aged 65 and older regard their health as good or excellent Chronological age may or may not correspond to: Correct answer- Physical, mental, social, and cultural actions and feelings Changes in the heart and lungs result in less efficient utilization of what? Correct answer- Of oxygen, which reduces the individual's capacity to maintain physical activity for long periods of time. Physical training for older people can significantly reduce blood pressure, and increase aerobic activity. Teaching and designing rehabilitation programs for older adults should contain which 2 things: Correct answer- Exercise and nutrition Old people often complain that they cannot get to sleep at night and do not sleep soundly even after they fall asleep. Why is this? Correct answer- This is because they have shorter stage sod sleep, particularly shorter cycles between 1 and 4 and REM sleep. Stage 4 is deep sleep. They are easily awakened by environmental stimuli. They often compensate by napping during the day which leads to further disruption of night sleep. A common response is the us elf prescription sleeping pills, which can create further problems of disorientation. Peripheral circulation increases or decreases with age? Correct answer- Decreases. Why is regular assessment of the feet important in the elderly? Correct answer- It increase the opportunity to discoed and treat skin care problems early. These problems could become more serious d/t decreased circulation Differentiation of normal and pathologic causes for skin and hair conditions is essential: Correct answer- Ie seborrheic keratosis vs melanomas What places an older adult at risk for the development of pressure ulcers? Correct answer- Impaired mobility, impaired skin integrity, decreased peripheral circulation, and lack of physical activity What are ways to help prevent or decrease the occurrence of falls? Correct answer- Install adequate lighting, paint the edges of stairs a bright color, place a bell on any residents cats; cats move quickly and can get underfoot, wear proper footwear that supports the foot and contributes to balance, shoes made of non slippery materials Aging and systolic and diastolic blood pressures: increase or decrease with age? Physiology of blood pressure Correct answer- Both SBP and DBP increase with age, but systolic increase more than the DBP. Physiology of BP: expressed as a ratio of systolic to diastolic. Systolic refers to the level of the BP during the contraction phase; whereas diastolic refers to the stage when the chambers of the heart are filling with blood. Why are dysrhythmias particularly serious in older adults? Correct answer- Older adults cannot tolerate decreased C.O., which can result in syncope, falls, and transient ischemia attacks. Pulse may be rapid, slow, or irregular. Angina symptoms in older adults may be confused with what kind of symptoms? Correct answer- Gastrointestinal symptoms. Angina symptoms may be absent or they may be confused with GI symptoms With aging, what happens to the muscles that operate the lungs? Correct answer- The muscles that operate the lungs lose elasticity so that respiratory efficiency is reduced. Vital capacity- the amount of air brought into lungs at one time, decreases. Breathing may become more difficult after strenuous exercise. The rate of decline has been found to be slower in more active people. The nurse should encourage older people to remain physically active for as long as possible. What makes older adults more susceptible to chronic bronchitis, emphysema, and pneumonia? Correct answer- Declining muscle strength may impair cough efficiency. What is a major cause of respiratory disability in older adults? Correct answer- COPD What is a major cause of death in older adults? Correct answer- Aspiration pneumonia What changes contribute to chronic constipation with age? Correct answer- The number of enzymes in the small intestine is reduced, and simple sugars are absorbed more slowly, resulting in decreases efficiency of the digestive process. The smooth muscle content and the muscle tone of the wall of the colon decrease. Anatomic changes in the large intestine result in decreased intestinal motility. Physiologic factors, as well as abuse of over the counter laxatives, are factors Decreases in fluid intake and mobility contribute to constipation Is tooth loss a normal part of the aging process? Correct answer- No. What can prevent tooth loss? Correct answer- Good dental hygiene, good nutrition, and dental care Why do older people tend to feel full before the entire meal is consumed and thus appear to eat smaller quantities of food at mealtime? Correct answer- This is because the digestive system of older people feature a decrease in the contraction time of the muscles, and more time is needed for the cardiac sphincter to open. Therefore, it takes more time for the food to be transmitted to the stomach. `What poses a significant concern in older adults? Correct answer- Poor nutrition or malnutrition. Reason for poor nutrition in older adults: Correct answer- Chronic illness which suppresses the appetite, hospitalization and surgery, difficulty chewing, alcohol use, cognitive changes, depression, grief, loneliness, social isolation, and problems with food procurement. What is an early sign of malnutrition? Correct answer- Changes in weight Why do older adults have a higher risk for development of renal failure? Correct answer- Because of normal age related changes result in compromised renal functioning. The nurse should pay close attention to urinary output in older clients. What is the first sign of loss of renal integrity? Correct answer- Decreased urinary output. What do Kegel exercises consist of? Correct answer- Tightening and relaxing the vaginal and urinary meatus muscles. What exercises should be done to reduce the incidence of urinary incontinence? Correct answer- Kegel exercises. They must be don't consistently and can be done unobtrusively at home Older adults with what medical condition may see isolation? Correct answer- Incontinence, which can predispose them to loneliness Why may older adults be more sensitive to caffeine and alcohol? Correct answer- These substances inhibit the production of ADH. An assessment of sensitivity to bladder problems is essential when planning nursing care. Older adults that live in nursing homes often suffer from difficulties with bladder control. Medication alert with older adults! What happens in renal system in older adult? Correct answer- As one ages, the total number of functioning glomeruli decreases, until renal function has been reduced by nearly 50%. This decrease in the filtration efficiency of the kidneys has grave implications for people who are taking medication. What are 3 important meds that are affected by the decreased filtration of the kidneys in older adults? Correct answer- Of particular importance are penicillin, tetracycline, and digoxin, which are cleared from the bloodstream primarily by the kidneys. These drugs remain active longer in the an older person's system. Therefore, they may be more potent, indicating a need to adjust the dose and frequency of administration Older adults are at risk for what kind of disease? Correct answer- STD's if they are sexually active, and especially with different partners. Normal loss of brain cells is compounded by what 3 factors? Correct answer- Alcohol, smoking, and breathing polluted air. Cognitive and safety issue can develop in the older adult. To help accommodate for normal brain loss, the nurse should teach older clients what: Correct answer- To shop during less crowded times in the stores that are familiar to them, slow down in advance of traffic signals, stay in the slower lane of freeway, avoid freeways during rush hour, and leave for appointments well ahead of time What is the most common irreversible dementia of old age? Correct answer- Alzheimer's disease What is Alzheimer's disease characterized by? Correct answer- Deficits in attention, learning, memory, and language skills. Discuss the problems family members have in dealing with clients with Alzheimer's disease in relation to the following disease manifestations: Depression, night wandering, aggressiveness or passiveness, failure to recognize family members What are the two most common endocrine problems in the older adult? Correct answer- Type 2 diabetes and thyroid dysfunction Diminished eye sight results in the following: Correct answer- Loss of independence- driving and ability to do ADL's, a lack of stimulation, inability to read, fear of blindness When talking to an older person who is hearing impaired, what do you do? Correct answer- Lower your tone. High pitched tones- i.e. a women's voice, are the first to become difficult to hear; therefore lowering the pitch of your voice increases the likelihood an older person with a hearing loss with be able to hear you speak What is the word for age related hearing loss? Correct answer- Presbycusis What does presbycusis result in? Correct answer- Decreased socialization, avoidance of friends and family, decreased sensory stimulation, and hazardous conditions when driving What do you do ti decrease sense of isolation and to compensate for visual and auditory sensory loss? Correct answer- Frequent touch. Make the older adult aware you are going to touch them, so they are not startled, or can let you know if they don't want you to touch them. Be cognizant of cultural differences with direct eye contact, touch, and taste There are many conditions that can imitate dementia in the older adult. A key role of the nurse is to make a complete assessment to rule out other possible causes of particular behavior, such as: Correct answer- UTI, dehydration, electrolyte imbalance, medication, pain, metabolic disorder. The major task of old age according to Erikson is to: Correct answer- Redefine self in relation to a changed role. Those people who ha been in charge of situations most of their lives may now find themselves in dependent positions. Older people undergo a great many of changes, associated with loss such as: Correct answer- Loss of spouse, friends, career, home, health etc. What are older adults extremely vulnerable to: Correct answer- Emotional and mental stress, depression, and substance abuse What is Erikson's final stage of growth and development? Correct answer- Integrity vs despair. The goal of this stage is to feel a sense of meaning of one's life, rather than to feel despair or bitterness that one's life has been wasted. The major task of older adults is to redefine self in relation to a changed role. Role adjustment is a major task of aging. What is the point of reminiscing Correct answer- It is a means of setting one's life in order- accepting life and self, which is the task of this stage according to Erikson.