NUR 163- Final Exam

If a female is in menopause has sudden onset vaginal bleeding what do you do? - report it when would a uterine prolapse be most likely to occur? - after multiple vaginal births or when anything weakens the muscular tissues of the uterus TX: hysterectomy or can sling it back up What are the signs and symptoms of an enlarged prostate? - decreased urine (stream) painful urination Nocturia frequent urination (you should also schedule an exam if any of these things should occur) What does it mean if you see scattered bruises on the forearms of an older adult? - It is a normal sign of aging, as we age our capillaries become more fragile. (we bruise easier *forearms especially*, called Senile purpura) What common circulation decreasing disease process in the older male population can cause erectile dysfunction? - Diabetes If you are working in a LTCF and an older married couple are roomed together and you walk in on them having sex, what should you do? - Provide Privacy Put a Do Not Disturb sign on door Do older adults get sexually transmitted diseases easier than younger adults/teenagers? - Yes, older adults are at a higher risk because of their weakened immune systems. Can normal age related changes contribute to sexual dysfunction? - yes, due to weakened circulation. Besides abstinence what is the best way to avoid getting an STI? - Condoms (safe sex practices) When an older adult female (menopausal) has painful(dryness) during sexual intercourse, what could possibly alleviate this issue? - water soluble lubricant Pain medications 30 minutes prior to sexual experience Why do older adults procrastinate going to the doctor? - Fear No motivation Transportation Financially unstable What would you question if an older adult is not adhering to a medication or TX regimen? - Ask them why? Are they in denial? Can you afford your tx? Do you need transportation? Do you understand why you need these TX? What type of questioning would you use in the heat of a emergency situation? - Direct questioning (for rapid-blunt responses) Why shouldn't you use medical jargon when speaking to a client/resident or patient? - Not everyone is understanding of medical jargon, could be a communication barrier. If someone is not making eye contact, should you form the preconceived notion that they are not listening? - No, in some cultures eye contact is considered offensive, it is imperative that nurses are culturally sensitive and that we do not judge others. If a patient has been waiting for a long period of time for a procedure to take place (EX: XRAY) what can you do to help them? - you could call down to x-ray to see what the hold up is and see when they will be available for this patient? This is advocating for this patient. What is evidence of good self image? - good hygiene socialization (going to gatherings) What are the feelings/concept associated with ageism? - helplessness elders are handicapped elders are unproductive What are the S/S of ineffective coping? - using drugs/alcohol to cope isolation sexual promiscuity What could revision of a will mean or be a sign of for an elderly individual? - This could be a sign of depression that could be advancing towards signs of possible suicide. What are the normal integumentary changes with age? - skin appears clear pale thinner senile purpura (common but not present in everyone) What musculoskeletal exercise is good for distribution of calcium and phosphorus? - weight bearing exercises What are risk factors for Osteoporosis? - Hip fracture Low estrogen Post-Menopausal Pathological Fractures Smoking Small body frame Gender (more prevalent in women) Sedentary lifestyle Do the elderly have a decrease in fluid throughout the body? - Indeed What is subjective data? - Subjective data is not observable (Ex: pain, nausea) What is Objective data? - Objective data is observable (Ex: BP, foul odor, purulent drainage, swelling) What is on a health history? - Allergies Illnesses Surgeries Immunizations Results of physical exams and tests Health habits such as diets and exercise Which tools assess cognitive function in the elderly? - Mini Cog Montreal Assessment If you should need an interpreter, should you use them for every interaction with patient or just the important medically related things? - Just the Medically related information Which pulses can you do bilaterally (at the same time)? - everyone but Carotid and Apical What are the S/S of HYPERthermia? - Blood vessels dilate Flushed Sweat glands become more active Why do elderly people complain about the room temperature? - Slower Metabolism If someone with cancer wants to attend a trip at the zoo, what should you tell them to do? - Conserve energy by taking frequent breaks. If your patient somehow ends up HYPOthermic after playing in the rain, what is the first thing you need to do? - Remove wet clothing In a healthcare organization to promote a culture of safety what is the one main component to do so? - EFFECTIVE COMMUNICATION Why wouldn't pharmaceutical companies test older adults in there pharmacological studies (new meds)? - younger adults are healthy Medication errors happen more frequently in elders, why is this? - Elders may forget to take their medications Elders may forget and then double up What is the most reliable method of identification for a patient? - Identification wrist band If someone is having a difficult time swallowing their medications (getting caught in back of throat), what should you offer them or promote? - More H2O What do you teach an individual about there new medication? - Explain in great detail what it is, how its taken and, what its used for.