NUR163 FINAL Exam

What type of pain meds are ibuprofen and tylenol? - Analgesics -anti-inflammatories - muscle relaxers What are the 3 types of prevention? - Primary: prevents illness before it begins Secondary: catches illness and treats it before it worsens; screenings Tertiary: Rehabilitation; After disease or injury is established Elderly patients should have a well-balanced diet with an intake around ________ calories. A) 1500 B) 2000 C) 1200 D) 1300 - C) 1200 How much exercise should an elderly person get? - 30 minutes a day Ex - walking, gardening, swimming How many times a day should the elderly brush their teeth? A) 4 B) 3 C) 2 D) 1 - C) 2 How close is intimate space? A) 18-48 inches B) 0-18 inches C) 48 inches to 12 feet D) greater than 12 feet - B) 0-18 inches How close is personal space? A) 18-48 inches B) 0-18 inches C) 48 inches to 12 feet D) greater than 12 feet - A) 18-48 inches How close is social space? A) 18-48 inches B) 0-18 inches C) 48 inches to 12 feet D) greater than 12 feet - C) 48 inches to 12 feet the partial or total loss of the ability to communicate Affects the ability to understand/ express through words, gestures, and writing use visual aids Most common in older adults - aphasia How close is public space? A) 18-48 inches B) 0-18 inches C) 48 inches to 12 feet D) greater than 12 feet - D) greater than 12 feet Speaking to elderly like children - uses terms like honey, dearie, and sweetie patronizing/ demeaning way to speak to older adults slow speech with simple vocabulary. - elder speak a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes - causes both cognitive and language defects - slow onset; uncurbable - use gestures and Y/N questions Caused by damage to cerebral cortex Characteristics include: limited attention span, inability to focus on more than one thing at a time, confusion of reality and fantasy, inability to follow complete directions - Dementia Which type of diabetes is insulin dependent? A) Type 1 B) Type 2 - A) Type 1 What do the letters in ISBAR-R stand for? - Introduction Situation Background Assessment Recommendation Read book Which type of diabetes is more diet dependent? A) Type 1 B) Type 2 - B) Type 2 information that is seen, heard, felt, or smelled by an observer Collected by exams, assessments, labs, and diagnostic tests Ex: Rashes, Vital signs, S/s of infections - objective data (signs) things a person tells you about that you cannot observe through your senses Ex - Nausea, pain - Subjective data (symptoms) Which order is correct when you first assess a patient? A) Palpation, inspection, ausclation B) Inspection, ausclation, palpation C) Ausclation, inspection, palpation D) Inspection, palpitation, ausclation - D) Inspection, palpitation, ausclation What is the normal pulse range? - 60-100 bpm What is the average temperature? - 98.6 - plus / minus 1 degree 36.5 - 37.2 degrees C What are the average respirations? - 12-20 breaths/min A temporary fall in blood pressure when a person rapidly changes from a sitting position to a standing position - Orthostatic (postural) hypotension is another screening tool that can be administered in 5 minutes or less and requires minimal training. 3 item recall, clock drawing test (CDT) - Mini-Cog What do the letters in SPICES stand for? - Sleep disorders Problems with eating/ feeding Incontinence Confusion Evidence of falls Skin breakdown Drugs must be water soluble in order to dissolve in the watery contents of the GI tract. Tend to remain in higher concentrations in bloodstream because it is less than the total amount of water in the body - water soluble drugs These store in the fatty areas of the body and can have longer lasting traces in the body that water-soluble drugs do not. Become trapped in fatty tissue because decreased muscle mass and increased adipose tissue - fat soluble drugs List some most common safety problems that occur with older adults: - Falls (most common) Choking Burns Automobile accidents Extreme temperatures impaired physical mobility Hazardous environments A neural structure lying below the thalamus Directs several maintenance activities (eating, drinking, body temperature) Helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward. - Hypothalamus Clouding of consciousness (dull cognition, impaired alertness) - disturbances in cognition, memory, attention, and perception inattentive, incoherent, impaired recent memory, may be agitated or with hallucinations - usually caused by physiological processes that affect the autonomic nervous system - Acute Confusional State (Delirium) What are 4 types of dementia? - 1. Alzheimer's Disease (most common) 2. Parkinson's Disease 3. Frontotemporal Lobar Degeneration (FLD) 4. Lewy Body Dementia (FTLD) difficult poorly articulated speech resulting from interference in the control over the muscles of speech - Dysarthia What are some factors that affect calorie intake? - Activity patterns Gender ( effects males more than females) Age Body temperature What are two types of carbohydrates? - simple and complex (sugars/ starches) Complex carbs contain other nutrients and fiber - Fiber helps reduce cholesterol levels About how many grams of protein do women need? A) 56g B) 46g - B) 46g About how many grams of protein do men need? A) 56g B) 46g - A) 56g An organic compound that is made of one or more chains of amino acids and that is a principal component of all cells Red meats, poultry, fish, eggs contain essential amino acids Plant based foods like legumes (beans/ peas), nuts, and whole grains do not individually carry amino acids - Protein What are the 3 types of fats? - triglycerides, phospholipids, sterols (saturated, unsaturated, trans) HDL "healthy" helps protect blood vessels LDL "unhealthy" VLDL "Very low" Vitamins A, D, E, K - stored in fat - can cause kidney damage - Fat soluble vitamins Vitamins B and C -eliminated through fluids - water soluble vitamins lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream - pernicious anemia A substance that dissolves in water to give a solution that conducts electric current includes: -potassium -calcium -phosphate - iron -sodium -zinc - Electrolyte What are some nutritional sources of calcium? - milk and dairy - needed for nerve impulses, transmission, bone and tooth formation, and muscle contractions What are some nutritional sources of phosphorus? - dairy, meat, egg yolks, nuts/ seeds - needed for bone and tooth formation, neuromuscular functioning, and acid/ base balance What is the difference in iron-deficiency anemia and pernicious anemia? - irondeficiency anemia is caused by a lack of iron pernicious anemia is caused by a deficiency in intrinsic factor secreted by the stomach What are some nutritional sources of Sodium? - processed by canned/ processed foods - needed for acid/ base balance, fluid balance, nerve impulses, muscle contractions, and levels are regulated by the kidney What are some nutritional sources of potassium? - Citrus fruits, bananas, baked potatoes, apple juice, spinach, and green leafy vegetables - needed for acid/ base balance, fluid balance and electrolyte balance, and neuromuscular function How much water should you drink a day? (in mL) - mL How much does body fluid decrease in older adults A) 10-15% B) 8-10% C) 15-20% D) 1-8% - B) 8-10% What does water help aid in? - Digestion and transportation of electrolytes/ nutrition Necessary for formation of the body secretions, tears, saliva, and perspiration Inadequet intake/ excessive loss of fluids -hypovolemia, dehydration, diarrhea S/s: ^HR, hypotension, dysrhythmias, ^RR, dyspnea, lethargic, weakness, decreased UO, tenting, constipation, dry mucous membranes, thirst, decreased skin turgor, rapid weight loss, altered cognition, sunken eyes Rx: IVF, O2 - fluid volume deficit hypervolemia: water intoxication d/t excessive Na intake, IVF,CRF, CHF, SIADH, S/s: ^HR, ^BP, distended neck veins, dysrthymias, ^RR, altered LOC, ^UO, pitting edema, diarrhea, Rx: diuretics, restrict fluid/Na, monitor I&O, monitor daily weight - fluid volume excess Breathing fluid, food, vomitus, or an object into the lungs - aspiration What are the 2 types of stress? - eustress: "positive stress" getting married, starting new job, creating family distress: "negative stress" physical threat, trauma Experience is perceived as manageable but requires mobilization of resources; is not harmful, and equilibrium is maintained - Scope of Stress: Challenging Experience is perceived as easily manageable, and equilibrium is not disrupted. - Scope of stress: no stress Experience is perceived as taxing; exceeds existing resources; causes disruption to equilibrium; can impact health. - Scope of Stress: Threatening Stress that force your body to optimize brain cognition and body function -able to pay attention to detail -learn and problem solve - mild stress Can miss obvious details and forget information, tunnel vision, and alertness decreases - severe stress the feeling of psychological strain and uneasiness produced by situations of danger, threat, and loss of personal security or by internal conflicts, frustrations, loss of self-esteem, and grief. feelings that arise -anger -fear -anxiety -depression - Emotional stress Attempting to alleviate stress directly by changing the stressor or the way we interact with that stressor. - attempt to change/ eliminate Methods: - identifying/ examining stressor - proactive stance - reactive stance - problem-focused coping attempting to alleviate stress by avoiding or ignoring a stressor and attending to emotional needs related to one's stress reaction - attempt to change response to stressor - emotional focused coping a worsening of symptoms associated with the stress of moving to a new environment characterized by a combination of: -anxiety -confusion -loneliness - Relocation syndrome (transfer trauma) How would you educate a patient to use a cane? - Hold cane on strong side of body , move cane with weak side, support weak side with cane What are some nursing interventions of a patient on bedrest? - reposition q2h -straighten sheets protein diet - monitor nutrition moisture barriers -sacrum pressure relieving mattress A serious disease that destroys lung tissue and causes breathing difficulties. - Emphysema T/F - The ability to perform activities and exercise requires the musculoskeletal, respiratory, cardiovascular, and nervous system to all work together - true T/F - Appropriate nursing interventions confuse older adults when trying to maintain the highest level of functioning - False - Appropriate nursing interventions help older adults achieve and maintain the highest level of functioning What type of patterns affect sleep/ rest? - shifts time zones illness stress medications lightest sleep, lasts for a few minutes, person is drowsy and relaxed, easily aroused -Most common in elderly Decreased heart rate, respiration, body temperature and muscle tension, and hypnic jerk Approximately 5-10 minutes. - Stage 1: NREM sleep last about 20 to 30 minutes and is characterised by brief bursts of higher-frequency brain waves (called sleep spindles). -period of sleep Dreams occasionally occur in this stage however are usually very brief and meaningless - Stage 2: NREM sleep The start of the deepest periods of sleep, and lasts for about 15-30 minutes. -initial phase of deep sleep heart rate, body temperature and blood pressure continue to drop individual becomes less responsive/ difficult to arouse - Stage 3: NREM sleep The deepest stage of sleep This stage lasts about 15- 30 minutes Sleepwalking and enuresis (bed wetting) may occur - Stage 4: NREM sleep a stage of sleep characterized by rapid eye movements and a high level of brain activity begins 90 minutes after sleep vivid, fully colored dreaming may occur average 20 minutes then gets longer less restorative/ refreshing sleep - REM sleep Difficulty in falling asleep or staying asleep