Geriatrics: Midterm review

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Questions and Answers

As individuals age, what physiological change typically occurs in the gastrointestinal system?

  • Enhanced nutrient absorption
  • Increased gastric acid production
  • Accelerated metabolism of medications
  • Decreased motility (correct)

What significant risk is associated with a geriatric patient being treated by multiple physicians simultaneously?

  • Enhanced coordination of care
  • Reduced medication costs
  • Polypharmacy (correct)
  • Decreased risk of adverse drug reactions

A physician orders a medication to be administered intravenously (IV), but the medication is only available in oral form (PO). What is the most appropriate nursing action?

  • Administer the usual oral dose via the intramuscular route
  • Administer the oral medication intravenously
  • Contact the physician to clarify the order and determine the appropriate dose and route (correct)
  • Crush the oral medication and administer it via feeding tube

If a patient refuses to take their prescribed medication, what is the most appropriate initial nursing intervention?

<p>Ask the patient to explain the reason for the refusal (D)</p>
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Which term accurately describes a state where an individual exhibits signs and symptoms of intoxication due to a drug remaining in their system?

<p>Hangover (C)</p>
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When crushing medications for ease of administration, which type of medication is generally safe to crush?

<p>Regular pills (B)</p>
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Which type of tablets should never be crushed due to potential adverse effects on the patient?

<p>Tablets that are enteric coated (C)</p>
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Is it considered safe and acceptable for patients to share their prescribed medications with others?

<p>No (C)</p>
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Is it advisable for patients to keep leftover or expired medications at home?

<p>No (D)</p>
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Under what circumstances is it acceptable for a patient to mix multiple medications together?

<p>Only if instructed to do so by a healthcare provider or as prescribed (A)</p>
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Which generation is generally considered to have less concern regarding food and dietary issues, and why?

<p>Baby boomer generation, a lot of foods that were high in sugars were more expensive in that era (D)</p>
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If you are aiming to improve a patient's health wellness, what specific aspect of their lifestyle are you primarily promoting?

<p>Good diet (D)</p>
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If you are promoting functional wellness for a geriatric patient, what key physical activity are you primarily encouraging?

<p>Exercise (B)</p>
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If your goal is to promote mental wellness in a geriatric patient, what specific aspect of their well-being are you prioritizing?

<p>Good mental health (B)</p>
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What theory is being reinforced when you emphasize the importance of maintaining physical activity to a patient?

<p>Activity theory (A)</p>
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What are some appropriate activities you would recommend to a geriatric patient with low activity levels to increase their physical activity?

<p>Walking and weight-bearing exercise (B)</p>
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In a patient care scenario where a family member is not adhering to the established care plan, what should you ask?

<p>&quot;How can we work together to take care of the patient?&quot; (A)</p>
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What is the definition of ageism?

<p>Discrimination against old people (D)</p>
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What is the most effective way to communicate with an older person to ensure they understand the message clearly?

<p>Face to Face (A)</p>
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How should you respond when a patient is sharing personal stories with you, to show that you value their experiences?

<p>Tell them, let them know that you appreciate their stories (D)</p>
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When assessing an older patient experiencing a change in condition, what aspect should you focus on to determine the next steps in care?

<p>You focus on the change (C)</p>
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As people age, is it generally futile to perform diagnostic tests, like bloodwork or imaging?

<p>No, you want to prevent them from getting diseases and facilitate optimal care (C)</p>
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If a patient undergoing chemotherapy has low blood counts across the board, what is a significant risk they are susceptible to?

<p>Falls and bleeding (B)</p>
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What is the typical target range for the International Normalized Ratio (INR) in a patient on warfarin therapy?

<p>2.0-3.0 (C)</p>
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What are the primary signs and symptoms of Tardive dyskinesia?

<p>Facial twitching, lip smacking, and tongue movements (B)</p>
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In a hospital setting, how can you confirm that a patient truly understands the instructions or information you have provided?

<p>Teach them, provide written info, and then have the patient demonstrates it back (D)</p>
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What should you teach patients about herbal supplements?

<p>Dangerous medication interactions (B)</p>
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What is the immediate course of action if a patient, scheduled for surgery, reveals they took an herbal supplement earlier that day?

<p>STOP EVERYTHING, and inform the doctor (B)</p>
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If a patient is admitted to the hospital, what is the most important item you should instruct them to bring with them?

<p>All medications (B)</p>
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What is the definition of ethnocentrism?

<p>You think your culture or group is better than the next culture or group (D)</p>
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If you are in a room with two patients, and both are present for a conversation. However, one patient is hesitant to speak but their family members are vocal, what action should you take?

<p>Focus on the patient and the family (A)</p>
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If a geriatric patient expresses concerns about memory loss, what is the most appropriate initial nursing action?

<p>Monitor their recall ability daily to see if it is true (C)</p>
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When asking an older adult a question, will they answer as quickly as a younger adult? Why?

<p>No, because the mental recall slows down as you age (D)</p>
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A patient exhibits a sudden change in mental status with all blood labs within normal limits. What should be suspected as a potential cause?

<p>UTI infection (B)</p>
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What is the primary goal of promoting 'functional mobility' in geriatric care?

<p>To enhance the ability to perform daily activities independently. (C)</p>
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An elderly patient consistently refuses their prescribed medication, stating they cause nausea. After documenting and notifying the physician, what is the MOST appropriate next step?

<p>Explore alternative medications or routes of administration with the physician, considering the patient's comfort. (C)</p>
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Which intervention is MOST effective in reducing the risk of falls among elderly patients with low blood counts due to chemotherapy?

<p>Instituting frequent monitoring, providing assistance with ambulation, and ensuring a clutter-free environment. (B)</p>
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How does the slowed mental recall commonly seen in older adults PRIMARILY impact their interactions in a healthcare setting?

<p>It requires healthcare providers to allow more time for them to answer questions and make decisions. (D)</p>
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A patient preparing for surgery discloses taking ginger supplements to alleviate arthritis pain. Considering the surgical context, why is is crucial to IMMEDIATELY inform the doctor?

<p>Ginger supplements can increase the risk of bleeding, potentially complicating the surgical procedure. (A)</p>
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When assessing the impact of age-related gastrointestinal changes on medication management in elderly patients, what is the MOST critical consideration?

<p>Evaluating the potential for altered drug absorption, distribution, metabolism, and excretion, that may lead to toxicity or subtherapeutic effects. (A)</p>
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In managing a patient with suspected Tardive dyskinesia induced by long-term antipsychotic use, what is the MOST important IMMEDIATE action after observing the involuntary movements?

<p>Contacting the physician to discuss discontinuing or changing the medication regimen, and documenting the observations clearly. (C)</p>
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When two patients share a room, and one appears hesitant to speak while their family is very outspoken, what strategy BEST demonstrates patient-centered care?

<p>Balancing direct communication with the patient and involving the family to encourage the patient's participation and respect their preferences. (B)</p>
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Flashcards

GI changes with age

Decrease in motility.

Polypharmacy

The use of multiple medications by a single patient, often leading to adverse effects.

Medication Route Change

Clarify the dosage with the prescribing doctor, as IV and PO routes may require different doses.

Patient Refusal of Medication

First, ask the patient why they are refusing the medication to understand their concerns.

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Hangover (Drug-related)

A term for when someone exhibits signs and symptoms of intoxication due to a drug in their system.

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Crushable Medications

Immediate-release pills can be crushed.

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Medications Not to Crush

Enteric-coated tablets.

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Sharing Medications

Medications should never be shared, even if symptoms seem similar.

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Keeping Old Medications

Old medications should be disposed of properly to avoid accidental ingestion or misuse.

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Mixing Medications

Patients should not mix medications without explicit instructions from a healthcare provider.

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Promoting Health Wellness

Promoting a balanced and nutritious diet.

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Promoting Functional Wellness

Promoting activities that maintain physical mobility and independence.

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Promoting Mental Health

Promoting positive psychological well-being and emotional health.

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Lack of physical activity consequence

Activity theory.

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Family Doesn't Follow Care Plan

How can we work together to take care of the patient?

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Ageism

Discrimination and prejudice against individuals based on their age.

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Communicating with Older Adults

Communicate clearly, directly, and face to face to facilitate understanding.

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Responding to Stories

Express your appreciation verbally to validate their experiences and feelings.

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Changed Condition

Focus on the change in condition to identify potential underlying issues.

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Tests on Older Adults

Tests can help prevent diseases and facilitate optimal care at any age.

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Low Blood Counts + Chemo

Increased risk of falls and bleeding due to low blood counts.

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Normal Warfarin INR

2.0-3.0

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Tardive Dyskinesia

Involuntary, repetitive movements, especially of the face, mouth, and limbs.

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Assessing Understanding

Teach the patient or family, provide written information, then have them demonstrate their understanding.

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Herbal Supplements

Herbal supplements can have dangerous interactions with medications.

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Supplement Before Surgery

Stop everything and inform the doctor immediately.

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Hospital Admission

Bring all current medications to ensure accurate medication reconciliation.

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Ethnocentrism

Believing one's own culture or group is superior to others.

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Patient Afraid to Speak

Focus on both the patient and the family

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Patient Memory Loss

Monitor their recall ability daily to assess the extent and nature of the memory loss.

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Recall Speed

No, older adults tend to have slower mental recall due to age-related cognitive changes.

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Sudden mental status change with normal labs

UTI (urinary tract infection)

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Study Notes

  • Geriatrics focuses on the healthcare of aging people.

Gastrointestinal Changes in Aging

  • Gastrointestinal motility decreases with age.

Polypharmacy

  • Polypharmacy, the use of multiple drugs, is a risk when a patient is treated by more than one physician.

Medication Orders

  • Verify the dose if a medication order changes from PO (oral) to IV (intravenous).

Medication Refusal

  • If a patient refuses medication, ask them why.

Hangover Effect

  • Experiencing signs and symptoms of intoxication from a drug still in the system is known as the hangover effect..

Crushing Medications

  • Regular pills can be crushed.
  • Enteric-coated tablets should not be crushed.

Safe Medication Practices

  • Patients should not share medications.
  • Patients should not keep old medications.
  • Patients should not mix medications unless instructed by a healthcare provider.

Generational Dietary Concerns

  • The Baby Boomer generation is generally less concerned about food and dietary issues due to the higher cost of sugary foods during their youth.

Health Wellness Promotion

  • Promoting health wellness includes encouraging a good diet.
  • Promoting functional wellness includes encouraging exercise and functional mobility.
  • Promoting mental health involves fostering good mental health practices.

Activity Theory

  • Informing a patient about the consequences of not maintaining physical activity is related to activity theory.

Encouraging Physical Activity

  • Activities like walking and weight-bearing exercise are good suggestions for someone with low activity levels.

Patient Care Plan

  • If a family member isn't following a patient's care plan, ask how you can work together to provide care.

Ageism

  • Ageism is discrimination against older people.

Communicating with Older Adults

  • Communicate with older adults face-to-face.
  • Show appreciation for a patient's stories by expressing your interest.

Changes in Patient Condition

  • Focus on the specific change when a patient's condition changes.

Diagnostic Testing

  • Performing tests on older patients is important for disease prevention and optimal care.

Chemotherapy Risks

  • Low blood counts in a patient undergoing chemotherapy increase the risk of falls and bleeding.

Warfarin INR Levels

  • The normal Warfarin INR lab level is 2.0-3.0.

Tardive Dyskinesia

  • Tardive dyskinesia is characterized by involuntary, repetitive movements, especially affecting the face, mouth, and limbs.

Tardive Dyskinesia Symptoms

  • Symptoms include facial twitching, lip smacking, tongue movements, chewing motions, rapid blinking, jerky or writhing movements, and speech difficulties.

Patient Understanding

  • Assess patient understanding by teaching them, providing written information, and asking them to demonstrate what they've learned.

Herbal Supplement Education

  • Educate patients about the potential dangers of medication interactions with herbal supplements.

Herbal Supplements Before Surgery

  • Before surgery, if a patient has taken an herbal supplement, stop everything and inform the doctor.

Hospital Essentials

  • Patients should bring all their medications when admitted to the hospital.

Ethnocentrism

  • Ethnocentrism is the belief that one's own culture or group is superior to others.

Patient and Family Communication

  • When one patient is afraid to speak up in a shared room, focus on both the patient and their family.

Memory Loss

  • Monitor a patient's recall ability daily to assess reported memory loss.

Cognitive Processing

  • Older adults may take longer to answer questions because mental recall slows down with age.

Changes in Mental Status

  • Suspect a UTI if a patient has a sudden change in mental status and normal blood labs.

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