NURS 3540 Gerontological Nursing Module 9 Active Learning Guide - PDF

NURS 3540 – Gerontological Nursing Module 9 Active Learning Guide Module 9 Active Learning Guide - Chapters 19-20 Purpose/Overview Active learning guides help students focus their study time using knowledge-level information, then concentrate on applying and analyzing knowledge to provide a context...

NURS 3540 – Gerontological Nursing Module 9 Active Learning Guide Module 9 Active Learning Guide - Chapters 19-20 Purpose/Overview Active learning guides help students focus their study time using knowledge-level information, then concentrate on applying and analyzing knowledge to provide a context concerning the course and career skills. Students should review the active learning guide before engaging with the module content, then work to complete the guide both during and after engaging with the content. An active learning guide is not the same as a study guide or a test blueprint. It serves as a guide to help the student navigate the course and content. The active learning guide is not a complete composite of the information needed for the exam but a guide to navigating the content delivery. Instructions Review the active learning guide before you begin reading and engaging with other content in the module. Looking at the questions beforehand will preview the information you will be learning, including the key concepts and takeaways. As you work through the module content, complete the active learning guide. Some questions may be reflective and require that you finish all content before responding. Students will turn in the completed learning guide on Sunday by 1159 pm. Faculty will review, award points, and return them to students to review prior to the exam. There are a possible 5 earned points for this learning guide. Reading Focus Areas In the text, you will see essential boxes, such as Safety Alerts, which discuss issues related to the care of older adults. Research Highlights contain a summary of pertinent current research related to chapter topics. Resources for Best Practice provide suggestions for further information for chapter topics and tools for practice. Healthy People boxes refer to goals cited in Healthy People 2030. Clinical judgment and next generation NCLEX examination style questions are located at the end of every chapter. Please review these questions as they are good practice for the exam. I. Physical Activity 1. What are the physical activity guidelines for the older adult? 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity every week (anything that gets your breathing harder and your heart beating faster) (e.g., brisk walking, swimming, bicycling, water aerobics, raking leaves or pushing a lawn mower) Muscle-strengthening activities that work all major muscle groups (hips, abdomen, chest, shoulders, and arms) at least 2 days a week Activities to improve balance (e.g., standing on one foot, yoga, tai chi) 2 to 3 times a week or incorporated in other exercises 2. Which of the following statements are true regarding physical activity for older adults? Select all that apply. a. Older people are less likely to receive exercise counseling from their primary care provider b. As little as 10 minutes of exercise can provide health benefits c. Extremely frail individuals should engage in strength and balance training d. Exercise must be performed for 60 minutes per day NURS 3540 – Gerontological Nursing Module 9 Active Learning Guide e. People over the age of 70 are too old to begin a fitness program 3. What type of physical activity is recommended for individuals with arthritis or mobility limitations? a. Yoga b. Dancing c. Biking d. Swimming 4. Before beginning an exercise program, which of the following interventions should be encouraged and taught to the individual? Select all that apply. a. Assume that the doctor will approve the program b. Collaborate with the person to set general goals c. Assess barriers to exercise and provide tips on how to overcome them d. Design a program that can be used at home or elsewhere e. Provide self-monitoring methods to visualize progress II. Falls 1. The second leading cause of hospitalization for older adults is: a. pneumonia b. myocardial infarction c. Cerebrovascular accident d. hip fracture 2. Which of the following are intrinsic risk factors associated with falls? Select all that apply. a. Unsteady gait b. Cognitive impairment c. Condition of floors d. Inappropriate footwear e. Reduced vision and hearing Fall Risk Assessment Instruments. What interview questions should be asked on admission to determine the patient FALL RISK. a. Have you fallen in the past year? b. Do you feel unsteady when standing or walking? c. Are you worried about falling? 3. Hypotension that occurs after ingestion of a carbohydrate-rich meal is known as which of the following? a. Orthostatic NURS 3540 – Gerontological Nursing Module 9 Active Learning Guide b. Malignant c. Postprandial - PPH occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide, but research is needed on its epidemiology and pathophysiology. PPH is usually asymptomatic and may be overlooked. d. Pseudo hypotension 4. What are the components of a post-fall assessment (PFA)? Select all that apply. a. Medication review b. Fall circumstances c. Documentation of incident report in patient record d. Cardiovascular assessment e. Mobility assessment Audio/Video Focus Areas Please watch the following videos and answer the questions provided. #1 Charlie Brown Medley – Piano Guys (3:14)   How many assistive devices are being used in this scenario? I counted (3) Walkers, (1) Motorized Chair, (1) Wheel Chair, and (1) O2 device Would you say that these older individuals still enjoy life? I would say that these older individuals do still enjoy life. They are engaged, participating and all are smiling and freely showing that they are happy. #2 Elderly Fall Prevention (3:05)   List the 7 causes of falls. Obesity, Weakness of lower extremities, Sedentary lifestyle, Medications, Poor lighting or vision problems, Obstructed pathways, Rambunctious pets. List steps to prevent falls. Install grab bars, Proper lighting (especially at night), Avoid trip hazards (chords, throw rugs), Wear proper shoes, Eat foods rich in calcium, drink 6 – 8 glasses of water daily, Vitamin D supplements, Review medications, Evaluate fall risk, Promote good health with exercise, TUG Test. Website Focus Areas National Council on Aging   Did you learn anything from this discussion? I learned that coffee has been found to be a source of hydration. Did any of the MYTHS surprise you? I was not aware that SNAP was available for older adults. I have only seen it marketed to young new mothers. NURS 3540 – Gerontological Nursing Module 9 Active Learning Guide Application Questions or Case Studies The following case studies were retrieved from the textbook: Touhy, T.A., & Jett, K.F. (2020). Ebersole & Hess' toward healthy aging: Human needs & nursing response (10th ed.). Elsevier. Case Study An 88-year-old widow with a diagnosis of pneumonia is admitted to the medical unit where you work. She has a past medical history of adult-onset diabetes mellitus, hypertension, atrial fibrillation, and osteoarthritis. She is on five different medications: an oral hypoglycemic, an antihypertensive, a diuretic, digoxin, and coumadin, and she takes Tylenol as needed for arthritic pain. She lives alone in an apartment where she has lived for 40 years. Her apartment is on the third floor. There is an elevator in the building, but it is frequently in need of repair. She is able to perform all of her activities of daily living (ADLs) independently. Although her three grown daughters live out of state, she has a number of close friends and a niece who live in close proximity to her. When you are helping the woman change into a hospital gown, you note that she has bruises at various stages of healing on her lower back and buttocks. She has a large scab on her left knee and a bandage on her right knee. When you question her about the bandage and the bruises, she states, “Oh, don’t worry about those. I fall sometimes, no big deal.” You observe her when she is walking into the bathroom; you note that she has a widened gait and that she holds on to the furniture in the room. 1. Based on the information in the case study, is this patient at high risk for falls? Yes. What specific pieces of data led you to make those conclusions? a. Hypertension – Can lead to arrhythmia’s, heart attack and stroke. b. Atrial fibrillation – Associated with syncope and falls in older adults. c. Osteoarthritis – Damage to hips and knee joints can interfere with mobility. d. Arthritic pain - Damage to hips and knee joints can interfere with mobility. e. Apt. on 3rd floor. Elevator out of service. f. Widened gait and she holds onto furniture with ambulating. 2. Discuss interventions that you would implement in the hospital setting in order to prevent falls. Fall Risk sign on door Bed alarm Staff and patient education Environmental modifications, Assistive devices, Rehabilitation Medication management Management of cognitive impairment Would you involve other members of the interdisciplinary team? Yes. If yes, which disciplines would you involve and why? Rehabilitation – Help limit more damage and shorten recovery time. Occupational Therapy – Evaluate joint integrity and the need for splints, positioning devices and assistive technology. Physical Therapy – Help limit more damage and shorten recovery time. Home Care – Patient Education and acute level care in patient homes. NURS 3540 – Gerontological Nursing Module 9 Active Learning Guide 3. What are the critical elements of a discharge plan for this patient? Repeat and reinforce patient education to patient and family on how to prevent falls. Reinforce the importance of physical activity to minimize falls. Physical activity and maintenance in groups can also help with socialization due to her immediate family not living in close proximity. Increase opportunities to participate in new experiences to increase confidence and socialize in new places. Provide information on fall risks and the factors that contribute to them in discharge paperwork.