NUR 163 Final Exam

If someone is in menopause for awhile and they have vaginal bleeding, should it be reported? - Yes What is a uterine prolapse and when does it happen? - Usually happens after multiple vaginal births, A hysterectomy is a treatment for - Multiple Vaginal Births Signs and symptoms of an enlarged prostate: - Decreased urine output Weak stream of urine Nocturia Frequent UTI'S What happens if you see scattered bruising areas on patients fore arms - Normal Age related change for bruising, this is due to capillaries becoming fragile FVD - causes- not enough in, too much out (Lasix), alcohol, hypernatremia, D/V, sweating/hemorrhaging S/S- Decrease in BP, increase ing HR, headache, dry mucous membranes, confusion/altered mental status, concentrated urine, decreased UO, weak thready pulse Interventions- IV fluids (cautious of elderly, can cause pulmonary edema if done too quickly), oral fluids, hold diuretic, treat underlying cause, monitor i/o, monitor vitals, decrease sodium intake stress - s/s- decreased in immune resonse, lose/gain weight, decrease output, increased frequency, constipation/diarrhea, teeth grinding, mood swings vitals- increased HR, BP, RR fatiguues/insomnia, gastic ulcer, blood glucose increased elderly and stress - #1 cause - loss of loved one- child unexpected financial loss, loss of independence, lack of support. Elderly do not tend to fear/stress about death themselves at risk ineffective coping - substance abuse, tobacco, alcohol, prescriptions, cognitive impairment, poor coping in younger years, poor support systems, chronic illness Can normal age changes contribute to sexual dysfunction? - Yes what is the most effective form to prevent STI's besides abstinence? - Condoms If an older female is experiencing vaginal dryness, what can we recommend? - Water Based lube and pain medication 30 minutes before Why don't older people want to go to the doctor? - No motivation, transportation and financial issues What would you question if a patient is being non-adherent with medication? - As k them why, and how it makes them feel and if there are other contributing factors Why cant you use medial terminology with anyone who is familiar with it? - It can become a communication barrier Is it normal for other cultures to not make eye contact? - Yes A patient is waiting to get a chest X-ray, they have been waiting for 3-4 hours and they are becoming agitated, what do we do? - Advocate for your patient by calling down to the x-ray department to see what is going on Evidence of a positive self image - Self grooming, proper hygiene what is the concept of agism? - Useless, helpless, and they are "all the same", physical impaired examples of ineffective coping: - Maladaptive behaviors, such as substance abuse, isolating themselves If someone is doing a sudden revision of will and they are giving away priced possessions, what are they at risk for? - Sucide What types of exercises would keep calcium and potassium in the bones? - Weight bearing exercises (low impact) Benefits of exercise - bone strength, weight loss, muscles, cardiac, resp, decrease blood glucose How do you speak to someone who is hard of hearing? - low tone, eye level, face the patient What do we ask for when asking for a health history? - medications (previous and current) Family history Chief complaint advance directives (if any) Hypervolemia and hypovolemic shock - increased blood volume When you lose more than 20% of your bodies fluid supply cant pump enough blood measure fluid status daily by weight Normal pH levels - 7.35-7.45 Hyperkalemia: Causes: Signs/Symptoms: Treatment/interventions: - Potassium overloadC: Burns, too much K intake (IV, foods), kidney failure S/s: N/V/D, skeletal muscle WEAKNESS, arrhythmia/dysrythmias, T: Diuretics, sodium bicarb, low potassium diet Hypokalemia Causes S/s: Treatment/interventions: - Not enough potassium C: Low potassium diet, diarrhea, alcohol, lassie, sweating, diuretics S/S: ABD dissection, muscle cramps, skeletal muscle weakness, constipation/vomiting prostate exams - At 40 years yearly Mini-Cog Test - Determines alertness, tests for cognitive impairment Nursing Interventions for non adherence: - ▪ Motivate them ▪ Teach them ▪ Ask questions; "why are you not taking your medication" ▪ Find resources- medicare/Medicaid, HHA ▪ Unpaid Caregivers: educate them, be mindful of their stress, give praise ▪ Offer Respite care HDL cholesterol - good cholesterol, helps protects blood vessels "happy cholesterol" LDL cholesterol - bad. low density lipoprotein. low protein, high fatbad for blood vessels NAPNES - delegation too much isn't good Pt education on assistive devices - stop if pain occurs, hydration/diet, comfortable clothing, non slip shoes, if temps are hot exercise early or later in the evening Swimming, walking, weight bearing exercise (no strenuous exercise What does a persons experience as stress increases: - Decreased problem solving ability Indecisiveness Irrational behavior Delirium vs dementia - Delirium: rapid onset, decreased level of consciousness, memory impairment Dementia : slow onset, loss of judgment, apashia motor skills, agnostic, non reversible Expressive aphasia - Can't express words Hyperthermia - Risks: endocrine problems S/s: confusion, sweating then stopping, increased heart rate/cramps Interventions: ice packs in auxiliary/groin region, encourage fluids SPICES - Sleep Problems eating Incontinenece Confusion Evidence of falls