adult nursing 128 Test 1
Terms
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- What percent of the population will be over 65 in the year 2030
- 20
- what percent of the population was over 65 in 2000
- 13%
- what is the cause of the increase of people over 65
- baby boomers
- largerst growth in population is who
- ethnic minorities and 85yr olds
- What are the subgroups?
-
young old 65-74
middle old 75-84
old old 85-99
elite old 100 and older - what is the fastest growing subgroup
- old old.
- being admited to a hospital or nursing home is often a traumatic experience known as?
- relocation stress.
- who is most at risk for relocation stress?
- men older then 75 who are physically and mentally impaired
- older adults need what nutritional requirements?
-
calcium
vit a d c
water
protein
carbs and fiber
fats - The most common accident among older clients in a hospital or nursing home setting is?
- falls
- what is the single most important predictor for falls?
- A history of falling
- a nurse must check a client who is restrained how often>?
-
every 30-60 mins
and release every 2 hrs - What is polypharmacy
- use of multiple drugs by older adults
- when a care giver fails to provide for a clients basic needs it is?
- Neglect
- 4 types of abuse are
-
neglect
physical abuse
financial abuse
emotional abuse - dehydration, undernutrition, urin burns , body odor, and listlessness are signs of what?
- neglect
- a chronic progressive disorder
- dementia
- an acute state of confusion, short term
- delirium
- when was the social security act passed>
- 1935
- when was the older americans act passed?
- 1965
- when was the national institute on aging established?
- 1974
- What is healty people 2010?
- goverment standard goals, increase lenght and quality of lives
- the three major methods for assessing the culture of a client are?
-
OBSERVATION
INTERVIEW,
PARTICIPATION - what are some environments ofr care of the older adult
-
home, assisted living retirement commun
acutre care, subacute, skilled
long term - what is prevelent in long term care?
- failure to thrive
- high risk for malnutrition?
-
determine
d isease
e eat poorly
t ooth loss
e conomics
r educed contacts
m any meds
i nvoluntary wt chang es
n eed help
e lderly - slow pregressive cognitive decline not reversable
- dementia
- acute stage of confussion, reversable temporaty short lived
- delerium
- what type of abuse includes threats, humiliation, isolation
- emotional abuse
- care giver role stain
- care giver stresses out over having to care for someone
- Econimical issues (3)
- imcome housing resourses
- ethical legal issues (5)
-
rights
ombudsman org
competency issues
obra
advanced directives - leading cause of disability
- strokes
- What is remission?
- symptomes controlled
- what is exacerbration
- symptoms returned
- factors that effect occurence of chronic illness are (6)
- age, cultuire, cost, race, geography, ethnicity
- what is impairment?
- abnormality of body or alteration in body system functioning
- what is the consequence of impairment>?
- disabiliy
- disadvantages experienced as result of impairment or disability?
- handicap
- living with ones chronic disability with goals of returning to fullest possible capacity
- rehabilitation
- goals of multidisiplinary approach
-
prevent injury
restore function
maximize independance - what assesments are needed to manage illnesses
- history , systems review, functional psychosocial vocational
- disorders of the external eye
- eyelid conjunctiva cornea
- intraocular disorders of the eye
-
cateract
glaucoma - physical assement for external structures are
- symmetry , eye lids, lashes, brows, iris cornea redness, discharge, facial and occular experssions
- physical assesment of the pupils are
-
perrla
pupils equal, round, reactive to light and accomodation - examine retina with what tool?
- opthalmoscope
- asses retina for?
- papilledema, optic disc red reflex
- some diagnostic tests of the eyes are
-
slit lamp exam
corneal staning, ultrasound,tonometry - exam of the anterior ocular structures require this test
- slip lamp exam
- use this test to check for scratches on the cornea
- corneal staning
- this test measures intraocular pressure
- tonometry
- what is the intraocular pressure of the eye?
- 10-21 mmhg
- visualization of the external structures and posterior cavity
- ophthalmosopy
- use this to check for masses or tumors in the eye
- mri , cat, ultrasound
- age related changes of the cornea are
- flatten, cloudy, blurring vision
- age related changes of the lens
- hardens, less elastic, cataracts
- age related changes of the iris/pupil
- decrease dilation, small pupil
- age related changes in appearence in the eye are
- sunken, hazy ring, yellow sclera, decreased tear production and muscle tone
- age related changes in accommodation
- accommodation to near objects reduced
- age related changes in intraocular fluid are?
- fluids reabsorption less-glaucoma
- Clouding of the lens which distorts image progected onto retina is known as?
- cataracts
- symptoms of cataracts are
- blurry vision, decreased color perception, foggy
- 3 surgerys used to remove cataracts are?
-
intracapsular extraction
extracapsulare extraction
intraocular lens implants - surgery where lens and capsul are completely removed
- intracapsular extraction
- surgery most common, posterior capsuld is left
- extracapsular extraction
- a surgery where a prosthetic lens replaces clouded, removed lens
- intraocular lens implant
- nursing considerations for cataracts are?
- dont rub eyes, dont sleep on side of bad eye.Avoid bending or straining. eye drops, eye shields, wet cool compresses
- What is increased tension or pressure within the eye causing progressive structural or fnctional damage to the eye leading to blindness?
- Glaucoma
- primary or open angle glaucoma is diagnosed how
- by tonometry
- how old should a person be when they test for glaucoma
- each year when over 40
- what are the symptoms of glaucoma
- eye discomfort, decreased peripheral vision,k increased iop,k halos around lights, difficulty adjusting to darkness
- what is the second most common cause of blindness
- primary or pen angle glaucoma
- what do beta blockers such as timoptic do?
- reduces aqueous humor production
- what does carbonic anhydrase imhibitors such as diamox do?
- decrease production of aqueous humor
- what does Miotic, such as Pilocarpine do?
- increase the outflow of aqueous humor
- what do meds anticholoinesterases, such as phosphaline iodide or humorsol do?
- incrase the flow of aquous humor
- Sugeries for glaucoma are
-
arogon laser trabeculoplasty
shunts
cyclocrotherapy - what surgery for glaucoma freezes part of the ciliary body, thus decreasing production of aqueous humor?
- cyclocryotherapy
- nursing care for surgery of glaucoma include?
-
wearing of eye shield
head of bed raised
eye dropes to prevent infection - acute closed angle glaucoma symptoms
-
sudden rapid buildup of presure
sever periocular pain, blurred vision - which is less common acute closed angle glaucoma or open angle glaucoma
- acute closed angle glaucoma
- loss of cnetral vision due to decreased blood supply to the macular cell is?
- senile macular degeneration
- 2 types of senile macular degeneration are
- atropic and exudative
- treatments for atropic and exudative are
-
adaptive devices
increased antioxidents and zinc
laser therapy - what is the cause of retinopathy?
- hypertension and/or diabetes
- 4 refractive disorders are
-
mytopia
hyperopia
presbyopia
astigmatism -
speech deterioration
irritable and hypersensitive
complaints of mumbling
social withdrawal are all symptoms of what? - hearing loss
- ringing of the ears (tinnitus) is a sign of what?
- hearing loss
- inspect the ear using what tool?
- otoscope
- to view ear how do you pull it?
- up and back for adult
- inspect ear canal for what?
- wax or cerumen
- inspect eardrum for?
- light reflex
- test auditory acuity how?
- watch ticking weber test rinne test or rhomberg
- what test is done with vibrating fork placed on clients forehead
- weber test
- what test is done with fork placed on mastoid bone and in front of ear canal bc vs ac
- rinne test
- what test is done standing with feet together and eyes closed?
- rhomberg
- audiometery testing measures what?
- freguency/intensity of sounds
- age related changes of appearence in the ear are
- pinna elongated, coarser hear, dry cerumen
- age related changes in the ossicles of the ear include
- decreased movement, stiff, calcification
- age related changes to the tympanic membrane include
- decreased elasticity, atrophy and dull color
- classification of hearing loss include
-
conductive
sensorineural
mixed - what is swimmers ear?
- external otitis or swimmers ear is an infection in the ear canal
- treat external otitis with what ?
- antibiotic ear drops called cortisporin
- how do you treat cerumen in ear canal?
- Debrox to soften was, irrigation of ear
- problems in middle ear include
- otitis media, serous media
- accumulation of steril fluid in the middle ear is?
- serous otitis media
- inflammation of eustachian tube in middle ear
- otitis media
- symptoms of otitis media include
- pain fever, drainage, decreased hearing and bulging ear drum.
- medications for otitis median include
- antibiotics, decongestants, analgesics
- surgery of ear that is done with an incision in ear drum with tube placement
- myringotomy
- surgery of ear that is done by removal of the stapes and replacement with a prosthesis
- otosclerosis
- surgery of ear that is done by removing diseased tissure, ossicales and a graft used to make an ear drum
- tympanoplasty
- problems of the inner ear include (3)
-
acoustic neuroma
labyrinthitis
menieres disease - inner ear problem that has tumor,k benine or malignant and requires surgical removal
- acoustic neuroma
- infection of the inner ear resulting in vertigo tinnitus and hearing loss
- labyrinthitis
- complications of labyrinthitis can lead to what?
- meningitis
- treatment of inner ear problems include
-
medications
diet
surgery - medications to treat inner ear problems include
- diuretics,k antihistamines, anti-emetics
- nursing measures for problems with inner ear
- elevated bed
- auditory prosthesis implanted in the inner ear
- cochlear implant
- guildlines or after ear surgery include
-
blow nose one ostril at a time
cough and sneese with mouth open
position on unoperative side
keep dry - fsdfd
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