NR 226- Exam 2 Study Guide ALL ANSWERS 100% CORRECT SPING FALL-2022 SOLUTION GUARANTEED GRADE A+
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Course
NR 226 (NR226)
Institution
Chamberlain College Of Nursing
Older Adults
1. Principles for promoting older adult learning
Make sure they are ready to learn; are they well enough to learn; sit in front of pt so they can watch your lips move & facial expression; speak slowly & in normal tone; say one idea at a time straight & to the point; give them enough ...
2 presentation of illness in older adults acute care
restorative care presentation of illness – confusion
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Chamberlain College Of Nursing
NR 226 (NR226)
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NR 226- Exam 2 Study Guide ALL ANSWERS 100%
CORRECT SPING FALL-2022 SOLUTION GUARANTEED
GRADE A+
Topics
Older Adults
1. Principles for promoting older adult learning
Make sure they are ready to learn; are they well enough to learn; sit in front of pt so they can watch your lips move &
facial expression; speak slowly & in normal tone; say one idea at a time straight & to the point; give them enough time
to answer; minimal distractions w/ proper lighting & comfortable settings; if tired or distracted stop teaching; invite
another family to talk; audio, visual & tactile cues to help w/ learning & memory; ask for feedback to know they
understand; using past experiences to connect to new learning.
2. Presentation of illness in older adults; acute care, restorative care
Presentation of illness – confusion, occurrence & reasons for fall, dehydration, decreased appetite, loss of function,
dizziness, incontinence
Acute care – (short term hospital stay) risk for delirium, dehydration, malnutrition, nosocomial infections, urinary
incontinence & falls.
Restorative care - (recovering from acute illness or surgery & support of chronic conditions that effect day-to-day)
stabilize chronic conditions, promote health and promote independence w/ ADL’s & IADL’s; prevent, improve, reduce
or eliminate problems
3. Comparison of clinical presentation of delirium, dementia and depression; nursing implications
Delirium – sudden onset; short fluctuations, worse by night & waking; abrupt progression; last hours to less than
month (longer if untreated); consciousness is reduced; alertness fluctuates (lethargic or hypervigilant); attention
fluctuates; orientation impaired (severity varies); forgetful; disorganized thinking (speech slow or fast); delusions &
hallucinations; psychomotor movements varies; disturbed sleep (reverse). medical emergency & prompt assessment.
Bedside 24/7 and ready to recognize development to report. Cognitive impairment reversed once doc identify and
treat cause
Dementia – slow onset & often unrecognized; long & progressively stable; slow but even progression; last moths to
years; consciousness is clear; generally normal alertness; generally normal attention; orientation is normal to person
but not place or time; memory impaired; thinking is impaired; misperceptions; normal psychomotor movements (may
have apraxia, which is inability to perform purposeful actions); fragmented sleep. Always consider safety, physical &
psychosocial needs. Enhance quality of life & maximize functional performance (cognition, mood &behavior)
Depression – major life changes, can be sudden or gradual; during day, worse in morning, fluctuations w/ situation;
varied progression; last at least 6 weeks or several months to years; consciousness is clear; normal alertness; attention
is easily distracted; selective disorientation; sections of intact memory; thinking intact but w/ hopelessness &
helplessness; intact perception(delusions & hallucinations in severe cases); varied psychomotor; disturbed sleep
(wakes up early).
4. Sexuality in the older adult
Changes in reproductive structure & function does not affect libido; still have desires, thoughts & actions for decades.
Less activity because illness, death of partner & decreased socialization. Involves love, warmth, sharing and touching.
Important role to help maintain self-esteem. understand physical changes in sexual response, provide privacy for
discussion of sexuality, be nonjudgmental, ask open-ended questions. Talk about prevention of STI. Touch has many
meaning and is an alternative sexual expression.
, 5. Health concerns; health promotion and maintenance, stroke, smoking, alcohol abuse, safety; nursing implications
Health promotion & maintenance – (genetics, good health habits & preventative measures) participate in screenings;
exercise regularly; within weight limits; eat low-fat & well balanced diet; low use of alcohol; dental visits; stop
smoking; have immunizations. Give info on nutrition, exercise, meds, safety, some med conditions & self-care.
Stroke – 3rd leading cause of death; brain ischemia (not enough blood to brain because arterial blockage) or brain
hemorrhage; risk factor: hypertension, hyperlipidemia, diabetes, history of ischemic attacks & history of CVA. Impairs
functional abilities; inability to be independent. Teach about risk-reduction, to look for early warning signs, ways to
support pt inn recovery & rehab.
smoking – 4th leading cause of death; preventable; if stopped can stabilize COPD & coronary artery disease; stopping
after 65 can add 2-3 more yrs of life; within 1 yr coronary heart disease reduced by 50%; if rejects stopping then at
least ask to reduce
Alcohol abuse – there are two patterns: lifelong heavy drinking or new pattern heavy drinking late in life; causes from
depression, loneliness, & lack of social support; suspicion if history of repeated falls & accidents, social isolation,
recurring memory loss & confusion, failure to meet obligations, skipping meals or meds, and unable to manage
finances. Encourage to be involved in activities of interest & increase self-worth.
Safety - drink water when exercising, good support shoes, avoid outdoor exercise if weather is too hot or cold, exercise
w/ partner, stop if feeling bad. Teach about different meds, combining& managing. Assess environment for risks at
home (temp on water heater, throw rugs, slippery floor)
6. Therapeutic communication; reality orientation, validation therapy, reminiscence
Therapeutic communication – respect them, their uniqueness & health expectations
Reality orientation – communication technique to make them aware of time, place & person; improving awareness &
orientation.
Validation therapy – used w/ confused older adults; accepting the time & place the confused pt states it is.
Reminiscence – remembering the past; using it to give meaning & understanding to present or resolve current
conflicts
7. Older adults in the acute care setting vs restorative care
Acute care setting is short term as in hospital stay, they need help adjusting to environment. Risks of delirium,
dehydration, malnutrition, health care associated infections, urinary incontinence & falls.
Restorative care has two types of on-going care: continued recovery from acute illness or surgery that started in acute
care setting and support of chronic conditions that affect day-to-day functions. Can be in private home or long-term
care setting. (this is basically a rehab)
The Grief Response
1. Types of loss
Necessary loss – a part of life; needs to happen & be replaced w/ something different or better
Maturation loss – form of necessary loss; happens throughout life span as normally expected (mother sad because kid
goes to college)
Situational loss – sudden & unpredictable external event (car accident, injured so cant work )
Actual loss – no longer see, hear, feel or know person or object. (death in family, loss of body part, loss of job, loss of
home)
Perceived loss – defined uniquely by the person that experienced the loss & less obvious to others. (how intensely you
feel about the loss)
Death is ultimate loss and part of the continuation of life
2. Grief; stages of grief, mourning, bereavement; therapeutic communication, nursing implications
Stages of grief – (dying) denial, anger, bargaining, depression & acceptance
Grief – emotional response to loss; unique experience per individual; based on personal experience, cultural and
spiritual belief.
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