NUR 257 midterm
What are common not normal behaviors in an older adult? - answer severe mood
swings, uncontrolled laughing or crying, changes in cognitive ability and excessive
forgetfulness
true or false: changes in mental status are part of the normal aging process -
answerfalse
the most common affective or mood disorder of old age - answer depression
what might cause depression in an older adult? - answer precipitating events/loss,
chronic illness, or chronic pain
what are s/s of depression in the older adult? - answerfatigue, diminished
memory/concentration, irritability, somatic complaints, behavioral changes, feelings of
worthlessness, sleep disturbances, appetite disturbances with excessive weight
loss/gain, restlessness, impaired attention span, and suicidal ideation
why might depression go untreated in an older adult? - answerit goes unrecognized or
the patient does not want to seek medical treatment for it
how can we combat the high suicide risk in the older adult population? - answerroutine
assessments/screenings
what assessment/screening tool is used for depression in older adults? -
answergeriatric depression scale (GDS)
what is the treatment/management of depression? - answertreat underlying medical
condition (chronic illness, chronic pain)
antidepressant medications
what can older adults on antidepressants become at risk for? - answeradverse effects:
anticholinergic, cardiac and orthostatic adverse effects
drug interaction: med toxicity, hypotensive, falls
what patient education is needed for older adults on antidepressants? - answerelders to
understand that it may take even longer than the typical 4-6 weeks for symptoms to
diminish
change positions slowly
,maintain adequate hydration to avoid common side effects (nausea, dizziness, and
constipation)
acute confusional state - answerdelirium
what type of delirium has a higher mortality rate and why? - answerstupor (hypoalert-
hypoactive) delirium because it tends not to be recognized; it is quiet and often
mistaken for depression
which type of delirium is easier to diagnose? - answerexcessive activity (hyperalert-
hyperactive) delirium
require more attention because patient's thinking is disoriented
in what setting is delirium most commonly seen in older adults? why? - answerthe
hospital setting because it often indicates a medical illness
what happens if delirium is left untreated? - answerchanges in LOC, irreversible brain
damage, and death
what vital assessment piece do you need to know to determine dementia from delirium?
- answerthe patient's baseline
dementia is long term
delirium is abrupt onset
what screening tool is used for delirium in the hospital? - answerCAM
what are the common causes of delirium? - answerphysical illness
infection (UTI or pneumonia)
medication polypharmacy
imbalanced fluid and electrolytes
alcohol or drug withdrawal
(it can be more than one of these at the same time)
why is delirium a medical emergency? - answerit is acute, quick onset, with an
underlying cause
if left untreated, it can cause death or brain damage
how is delirium treated? - answertreat underlying cause
manage patient safety
manage behavioral problems
what is the most common type of dementia? - answerAD
, what are symptoms of early (mild) stages of AD? - answerforgetfulness and subtle
memory loss
small difficulties in work or social activities but have adequate cognitive function to
compensate for the loss and continue to function independently.
what are symptoms of moderate stage of AD? - answerforgetfulness is manifested in
many daily actions
impulsive behavior
difficulty with IADLs
personality changes
what are symptoms of terminal (severe) AD? - answerpatients are usually immobile and
require total care with ADLs
how does death occur with a patient diagnosed with AD? - answercomplications such
as pneumonia, malnutrition, or dehydration
second most common cause of dementia - answervascular dementia
how is vascular dementia caused? - answerreduced blood flow to the brain, which
damages and eventually kills brain cells
how is vascular dementia characterized? - answerby variable impairment dependning
on the affected sites in the brain
what are the prevention and management for vascular dementia? - answersimilar to CV
disease
measure BP, control diabetes, lower cholesterol levels
what are AD nursing interventions aimed at? - answerpromoting patient function and
independence for as long as possible.
what are interventions for the early stages of AD? - answerminimal cuing and guidance
may be all that are needed for the patient to function fairly independently for a number
of years
what is the job of the nurse when he/she suspects neglect or abuse? - answerthe
responsibility of the nurse is to report the suspected abuse, not to prove it.
problems commonly experienced by older adults - answergeriatric syndromes (skin
impairment, poor nutrition, falls or functional decline, urinary incontinence, defecation
incontinence, cognitive impairment, sleep disturbances
What are common not normal behaviors in an older adult? - answer severe mood
swings, uncontrolled laughing or crying, changes in cognitive ability and excessive
forgetfulness
true or false: changes in mental status are part of the normal aging process -
answerfalse
the most common affective or mood disorder of old age - answer depression
what might cause depression in an older adult? - answer precipitating events/loss,
chronic illness, or chronic pain
what are s/s of depression in the older adult? - answerfatigue, diminished
memory/concentration, irritability, somatic complaints, behavioral changes, feelings of
worthlessness, sleep disturbances, appetite disturbances with excessive weight
loss/gain, restlessness, impaired attention span, and suicidal ideation
why might depression go untreated in an older adult? - answerit goes unrecognized or
the patient does not want to seek medical treatment for it
how can we combat the high suicide risk in the older adult population? - answerroutine
assessments/screenings
what assessment/screening tool is used for depression in older adults? -
answergeriatric depression scale (GDS)
what is the treatment/management of depression? - answertreat underlying medical
condition (chronic illness, chronic pain)
antidepressant medications
what can older adults on antidepressants become at risk for? - answeradverse effects:
anticholinergic, cardiac and orthostatic adverse effects
drug interaction: med toxicity, hypotensive, falls
what patient education is needed for older adults on antidepressants? - answerelders to
understand that it may take even longer than the typical 4-6 weeks for symptoms to
diminish
change positions slowly
,maintain adequate hydration to avoid common side effects (nausea, dizziness, and
constipation)
acute confusional state - answerdelirium
what type of delirium has a higher mortality rate and why? - answerstupor (hypoalert-
hypoactive) delirium because it tends not to be recognized; it is quiet and often
mistaken for depression
which type of delirium is easier to diagnose? - answerexcessive activity (hyperalert-
hyperactive) delirium
require more attention because patient's thinking is disoriented
in what setting is delirium most commonly seen in older adults? why? - answerthe
hospital setting because it often indicates a medical illness
what happens if delirium is left untreated? - answerchanges in LOC, irreversible brain
damage, and death
what vital assessment piece do you need to know to determine dementia from delirium?
- answerthe patient's baseline
dementia is long term
delirium is abrupt onset
what screening tool is used for delirium in the hospital? - answerCAM
what are the common causes of delirium? - answerphysical illness
infection (UTI or pneumonia)
medication polypharmacy
imbalanced fluid and electrolytes
alcohol or drug withdrawal
(it can be more than one of these at the same time)
why is delirium a medical emergency? - answerit is acute, quick onset, with an
underlying cause
if left untreated, it can cause death or brain damage
how is delirium treated? - answertreat underlying cause
manage patient safety
manage behavioral problems
what is the most common type of dementia? - answerAD
, what are symptoms of early (mild) stages of AD? - answerforgetfulness and subtle
memory loss
small difficulties in work or social activities but have adequate cognitive function to
compensate for the loss and continue to function independently.
what are symptoms of moderate stage of AD? - answerforgetfulness is manifested in
many daily actions
impulsive behavior
difficulty with IADLs
personality changes
what are symptoms of terminal (severe) AD? - answerpatients are usually immobile and
require total care with ADLs
how does death occur with a patient diagnosed with AD? - answercomplications such
as pneumonia, malnutrition, or dehydration
second most common cause of dementia - answervascular dementia
how is vascular dementia caused? - answerreduced blood flow to the brain, which
damages and eventually kills brain cells
how is vascular dementia characterized? - answerby variable impairment dependning
on the affected sites in the brain
what are the prevention and management for vascular dementia? - answersimilar to CV
disease
measure BP, control diabetes, lower cholesterol levels
what are AD nursing interventions aimed at? - answerpromoting patient function and
independence for as long as possible.
what are interventions for the early stages of AD? - answerminimal cuing and guidance
may be all that are needed for the patient to function fairly independently for a number
of years
what is the job of the nurse when he/she suspects neglect or abuse? - answerthe
responsibility of the nurse is to report the suspected abuse, not to prove it.
problems commonly experienced by older adults - answergeriatric syndromes (skin
impairment, poor nutrition, falls or functional decline, urinary incontinence, defecation
incontinence, cognitive impairment, sleep disturbances
