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adult nursing 128 Test 1


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What percent of the population will be over 65 in the year 2030
what percent of the population was over 65 in 2000
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?
vit a d c
carbs and fiber
The most common accident among older clients in a hospital or nursing home setting is?
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?
4 types of abuse are
physical abuse
financial abuse
emotional abuse
dehydration, undernutrition, urin burns , body odor, and listlessness are signs of what?
a chronic progressive disorder
an acute state of confusion, short term
when was the social security act passed>
when was the older americans act passed?
when was the national institute on aging established?
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?
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?
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
acute stage of confussion, reversable temporaty short lived
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)
ombudsman org
competency issues
advanced directives
leading cause of disability
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>?
disadvantages experienced as result of impairment or disability?
living with ones chronic disability with goals of returning to fullest possible capacity
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
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
pupils equal, round, reactive to light and accomodation
examine retina with what tool?
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
what is the intraocular pressure of the eye?
10-21 mmhg
visualization of the external structures and posterior cavity
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?
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?
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
what surgery for glaucoma freezes part of the ciliary body, thus decreasing production of aqueous humor?
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
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?
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?
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
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
surgery of ear that is done by removal of the stapes and replacement with a prosthesis
surgery of ear that is done by removing diseased tissure, ossicales and a graft used to make an ear drum
problems of the inner ear include (3)
acoustic neuroma
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
complications of labyrinthitis can lead to what?
treatment of inner ear problems include
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

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