... The Older Adult High-Acuity...
...Objectives: 1. Describe the characteristics of the...
...the characteristics of the aging population. 2....
...Apply knowledge of the age-related changes in...
...Apply knowledge of the age-related changes in...
...Apply knowledge of the age-related changes in...
...Apply knowledge of the age-related changes in...
...impact hospitalization in the older patient. 9....
...patient. 9. Demonstrate the use of common...
...tools. 10. Demonstrate the nursing management of...
...special situations including the culture of caring...
...end-of-life care. I. The Older Adult Patient...
...Adult Patient A. The older adult patient...
...areas should understand the age-related changes that...
...that might impact the outcome of their...
...critically ill. 3. The application of early...
...and provide for the best possible outcomes...
...outcomes for hospitalized elderly patients. B. Characteristics...
...B. Characteristics of the older adult population...
...Demographic characteristics in the U.S. (people are...
...people 85+. (5) The “age wave” will...
...care services by the older population (1)...
...(b) 55% in the intensive care unit...
...Demographics Characteristics in the U.S. Population aged...
...care services by the older population: Older...
...Changes associated with the normal aging process...
...pathological process c) The application of early...
...complications. (4) Provides the best possible outcomes....
...Age-related alterations in the central nervous system...
...not synthesized at the same rate. (3)...
...nervous changes impact the neurologic exam: (1)...
...in all of the sensory receptors: (1)...
...common). c) Smell: The sensitivity to smells...
...Touch: Sensitivity in the fingertips, palms, and...
...to changes in the environment. (1) Decline...
...Changes associated with the normal aging process...
...pathological process 3. The application of early...
...Prevents complications. Provides the best possible outcomes....
...Age-related alterations in the central nervous system...
...not synthesized at the same rate. Declines...
...nervous changes impact the neurologic exam: Mental...
...in all of the sensory receptors. Decline...
...common). 9. Olfactory: The sensitivity to smells...
...Touch: Sensitivity in the fingertips, palms, and...
...to changes in the environment: Decline in...
...a) CHD is the leading cause of...
...Cardiovascular changes alter the function of myocardium...
...Increased stiffness of the arterial walls (3)...
...cardiovascular changes a) Elderly patients with cardiac...
...less reliable in the older patient. a)...
...a) 50% of elderly patients do not...
...might be in the normal range. 6....
...Surface area of the lungs is decreased,...
...of care of the elderly patient on...
...care of the elderly patient on a...
...statistics: CHD is the leading cause of...
...(CV) changes alter the function of myocardium...
...Disease presentation in elderly patients with cardiac...
...less reliable in the older patient: 50%...
...might be in the normal range. 6....
...Therapeutic interventions in the elderly: Therapeutic treatments...
...interventions in the elderly: Therapeutic treatments are...
...Surface area of the lungs is decreased...
...through changes in the skin: a) Wrinkling...
...with aging, predisposing the patient to: a)...
...a contamination of the deep layer of...
...surfaces. (b) Reposition the patient frequently. (c)...
...temperature. (b) Keep the patient covered while...
...musculoskeletal issues in the older adult: a)...
...4. Osteoarthritis is the most common arthritic...
...directly related to the aging process. c)...
...5. Compression of the spinal column or...
...spinal column or the spinal nerves is...
...stenosis (narrowing of the spinal canal). b)...
...b) Thinning of the cartilage between the...
...the cartilage between the vertebrae. c) Development...
...bone spurs around the vertebrae. 6. Nursing...
...support surfaces. Reposition the patient frequently. Optimize...
...room temperature. Keep the patient covered while...
...musculoskeletal issues in the older adult: Decreased...
...11. Osteoarthritis is the most common arthritic...
...stenosis. Thinning of the cartilage between vertebrae....
...a) Changes affecting the teeth include: (1)...
...or atrophy of the jawbone 2. Esophageal...
...pylori) (1) Increases the risk for growth...
...of bacteria in the stomach (2) Increases...
...stomach (2) Increases the risk of aspiration...
...altered. b) Impacts the absorption of vitamins...
...Diminished compliance of the rectum. 6. Pancreas...
...Blood flow to the liver is reduced....
...that relate to the health of the...
...the health of the GI system: (1)...
...(1) Atrophy of the efferent and afferent...
...to reflux of the vesicoureteral junction b)...
...4. Problems in the urination process might...
...f) Sensation of the need to void....
...genitourinary function in the older adult: a)...
...c) Attributed to the presence of indwelling...
...indwelling catheters in the hospital d) Often...
...changes Changes affecting the teeth include: Oral...
...or atrophy of the jawbone. 2. Esophageal...
...is altered. Impacts the absorption of vitamins...
...Diminished compliance of the rectum. 6. Pancreas...
...Blood flow to the liver is reduced....
...to reflux of the vesicoureteral junction. Leads...
...13. Problems in the urination process can...
...Obstruction. Sensation of the need to void....
...genitourinary function in the older adult: Increased...
...bacteremia Attributed to the presence of indwelling...
...d) Increase in the prevalence of diabetes...
...(1) ~25.8% of the population with diabetes...
...Immune system 1. The immune system of...
...might be absent (elderly patients have lower...
...influenza are among the top ten causes...
...pneumococcal vaccines decrease the risk for pneumonia....
...develop sepsis in the U.S. are 65+...
...glucose. Increase in the prevalence of diabetes...
...3. Changes in the thyroid Aging body...
...Heart complications. 6. The immune system of...
...influenza are among the top ten causes...
...Impacting Hospitalization A. The “three Ds”-dementia, depression,...
...one another 3. The normal older adult...
...disease (responsible for the largest percentage) (2)...
...neurofibrillary tangles in the brain d) Course:...
...slow progression of the disease. C. Depression...
...institutional settings. c) The highest rate of...
...very treatable in the older adult. c)...
...(acute confusion) is the rapid onset of...
...an insult to the brain as a...
...status (can be the first sign of...
...older people in the hospital overall b)...
...is treatable in the older adult. Newer...
...10. Delirium is the rapid onset of...
...an insult to the brain as a...
...older people in the hospital overall. Develops...
...patients up in the chair as able....
...pain control for the older adult in...
...older adult in the high-acuity setting can...
...Age-related changes impact the ability to perceive...
...age. c) Impacts the ability to accurately...
...environment to decrease the perception of pain....
...a challenge in the older patient. a)...
...of medications to the older adult is...
...surface area of the small intestine (2)...
...Prescription medications. (2) Over-the-counter medications. (3) Vitamins...
...Inappropriate medications for the elderly—problems, solutions, considerations....
...medications for the elderly—problems, solutions, considerations. b)...
...Identify medications increasing the risk for adverse...
...Medication Use in the Elderly b) When...
...Use in the Elderly b) When an...
...go slow.” c) The therapeutic window might...
...stimuli declines. Impacts the ability to accurately...
...surface area of the small intestine Decreased...
...filtration 9. Special elderly complications—Drug dosage/frequency might...
...Evaluate Prescription medications. Over-the-counter medications. Vitamins and...
...and go slow.” The therapeutic window might...
...Assessment Tools for the High-Acuity Nurse 1....
...methods determine if the person has normal...
...items (2) Draw the face of a...
...try to repeat the original three items...
...Screening instrument walks the nurse through the...
...the nurse through the patient assessment. b)...
...about mood over the past two weeks....
...is based on the number of answers...
...prevented by reducing the risk factors. C....
...patient’s account of the pain. b) Assess...
...pain: impact on the older adult’s ability...
...to recover from the present health condition....
...pain assessment. e) The most important consideration...
...important consideration in the assessment of the...
...the assessment of the presence and severity...
...of pain is the patient’s account of...
...patient’s account of the pain. f) Nurses...
...be aware of the age-related alterations in...
...about mood over the past two weeks....
...or no. Score the number of depressed...
...Patient’s account of the pain. Nurses work...
...of death in the elderly. Contributing factors:...
...death in the elderly. Contributing factors: a)...
...traumatic injuries a) Falls—the most common cause...
...crashes account for the most fatalities. c)...
...mortality rate in the elderly. 3. Nursing...
...rate in the elderly. 3. Nursing considerations...
...aimed at stabilizing the injuries and preventing...
...for care in the high-acuity area include:...
...be obscured, as the heart rate might...
...impaired. 4. Determining the cause a) Perform...
...reserve: (1) Increase the risk of pulmonary...
...wall: (1) Increase the likelihood of abdominal...
...and osteoporosis increase the susceptibility of the...
...the susceptibility of the older adult to...
...very high. b) Elderly tend to have...
...healing (particularly in the presence of malnutrition)....
...of malnutrition). d) Elderly do not scar...
...include: Falls are the most common. MVC...
...common. MVC have the most fatalities. Burns...
...nursing care: Stabilize the injuries, prevent complications:...
...nursing care in the high-acuity area include:...
...impaired. 5. Determining the cause of injury:...
...is very high. Elderly have greater depth/size...
...Nursing, funded by the John A. Hartford...
...b) Provides steps the nurse can follow...
...better care for the older high-acuity patient....
...care 1. End-of-life care—the problem a) In...
...acute care settings, the focus of patient...
...b) Needs of the elderly person at...
...Needs of the elderly person at the...
...elderly person at the end of life...
...care. 2. End-of-life care—the solution a) Palliative...
...resuscitation efforts at the end of life:...
...decisions (1) In the later stages of...
...Nursing responsibilities at the end of life...
...be given to the elderly patient population:...
...given to the elderly patient population: More...
...Nursing, funded by the John A. Hartford...
...issues Provides steps the nurse can follow...
...better care for the older high-acuity patient....
...adults. 3. End-of-life care—the problem In most...
...curative. Needs of the elderly person are...
...Needs of the elderly person are often...
...care. 4. End-of-life care—the solution • Palliative...
...Nursing responsibilities at the end of life:...
...summarizes changes in the central nervous system...
...nervous system in the older adult. Discuss...
...older seniors to the classroom. Specifically, meet...
...centenarian to appreciate the healthy seniors that...
...their health through the years, their secrets...
...treats a large elderly population (or invite...
...administrator to visit the classroom). Ask about...
...classroom). Ask about the most common health...
...care problems of the elderly that they...
...problems of the elderly that they see....
...this compares with the list of problems...