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A gerontologic nurse has been working hard to change the perceptions of the elderly, many of which are negative, by other segments of the population. What negative perceptions of older people have been identified in the literature? Select all that apply.
- A. As being the cause of social problems
- B. As not contributing to society
- C. As draining economic resources
- D. As competing with children for resources
- E. As dominating health care research
Correct Answer: B,C,D
Rationale: Retirement and perceived nonproductivity are responsible for negative feelings because a younger working person may falsely see older people as not contributing to society and as draining economic resources. Younger working people may actually feel that older people are in competition with children for resources. However, the older population is generally not seen as dominating health care research or causing social problems.
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The presence of a gerontologic advanced practice nurse in a long-term care facility has proved beneficial to both the patients and the larger community in which they live. Nurses in this advanced practice role have been shown to cause what outcome?
- A. Greater interaction between younger adults and older adults occurs.
- B. The elderly recover more quickly from acute illnesses.
- C. Less deterioration takes place in the overall health of patients.
- D. The elderly are happier in long-term care facilities than at home.
Correct Answer: C
Rationale: The use of advanced practice nurses who have been educated in geriatric nursing concepts has proved to be very effective when dealing with the complex care needs of an older patient. When best practices are used and current scientific knowledge applied to clinical problems, significantly less deterioration occurs in the overall health of aging patients. This does not necessarily mean that patients are happier in long-term care than at home, that they recover more quickly from acute illnesses, or greater interaction occurs between younger and older adults.
You are the nurse planning an educational event for the nurses on a subacute medical unit on the topic of normal, age-related physiological changes. What phenomenon would you include in your teaching plan?
- A. A decrease in cognition, judgment, and memory
- B. A decrease in muscle mass and bone density
- C. The disappearance of sexual desire for both men and women
- D. An increase in sebaceous and sweat gland function in both men and women
Correct Answer: B
Rationale: Normal signs of aging include a decrease in the sense of smell, a decrease in muscle mass, a decline but not disappearance of sexual desire, and decreased sebaceous and sweat glands for both men and women. Cognitive changes are usually attributable to pathologic processes, not healthy aging.
An 83-year-old woman was diagnosed with Alzheimers disease 2 years ago and the disease has progressed at an increasing pace in recent months. The patient has lost 16 pounds over the past 3 months, leading to a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this patients plan of care?
- A. Offer the patient rewards for finishing all the food on her tray.
- B. Offer the patient bland, low-salt foods to limit offensiveness.
- C. Offer the patient only one food item at a time to promote focused eating.
- D. Arrange for insertion of a gastrostomy tube and initiate enteral feeding.
Correct Answer: C
Rationale: To avoid any playing with food, one dish should be offered at a time. Foods should be familiar and appealing, not bland. Tube feeding is not likely necessary at this time and a reward system is unlikely to be beneficial.
A nurse is planning discharge teaching for an 80 -year-old patient with mild short-term memory loss. The discharge teaching will include how to perform basic wound care for the venous ulcer on his lower leg. When planning the necessary health education for this patient, what should the nurse plan to do?
- A. Set long-term goals with the patient.
- B. Provide a list of useful Web sites to supplement learning.
- C. Keep visual cues to a minimum to enhance the patients focus.
- D. Keep teaching periods short.
Correct Answer: D
Rationale: To assist the elderly patient with short-term memory loss, the nurse should keep teaching periods short, provide glare-free lighting, link new information with familiar information, use visual and auditory cues, and set short-term goals with the patient. The patient may or may not be open to the use of online resources.
An 84-year-old patient has returned from the post-anesthetic care unit (PACU) following hip arthroplasty. The patient is oriented to name only. The patients family is very upset because, before having surgery, the patient had no cognitive deficits. The patient is subsequently diagnosed with postoperative delirium. What should the nurse explain to the patients family?
- A. This problem is self-limiting and there is nothing to worry about.
- B. Delirium involves a progressive decline in memory loss and overall cognitive function.
- C. Delirium of this type is treatable and her cognition will return to previous levels.
- D. This problem can be resolved by administering antidotes to the anesthetic that was used in surgery.
Correct Answer: C
Rationale: Surgery is a common cause of delirium in older adults. Delirium differs from other types of dementia in that delirium begins with confusion and progresses to disorientation. It has symptoms that are reversible with treatment, and, with treatment, is short term in nature. It is patronizing and inaccurate to reassure the family that there is nothing to worry about. The problem is not treated by the administration of antidotes to anesthetic.