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Handouts - Geria (MR. Aguirre)
Special Education (Ateneo de Manila University)
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COMPREHENSIVE PHASE
HANDOUTS
GERIATRIC NURSING
Prepared By: Mr. Ian Rocky Aguirre, RN
NOV 2024 Philippine Nurse Licensure Examination Review
GERIATRIC NURSING RA 7432= 60 yrs. old ●inc. Bone formation
● Geriatrics: care of the older people ○ Diet: ________________________
inc. calcium, inc. Vit. D
● Gerontology: study of the aging process ○ Exercise: weight bearing,like= walking, gardening,
________________________
smoking, alcohol, caffeine
○ AVOID: ________________________
RN RESPONSIBILITIES IN GERIATRICS
1) Promote safety risk for falls ●dec.Bone resorption
2) Health promotion modifiable diseases ○ Calcitonin Contra seafood allergy
3) Compensate for age-related impairments Bisphophanales (dronate)
○ DOC: ________________________
4) End-of-life care Alendronate (Fosamax)
To sleep
NEUROLOGICAL
dec. 1. Drink warm milk
THEORIES OF AGING explain why and how do we age ● Short-term memory: ________
maintained 2. Avoid stimulants
BIOLOGICAL THEORIES WHY DO WE AGE ● Long-term memory: ________ 3. Instruct short day
a. Gene theory biological timeline __ neurons → ________
● dec. for complex learning
naps
b. Immunologic theory dec. immune system and inc. risk of diseases ● dec. __ melatonin → ________
poor sleep
c. Endocrine theory dec. in brain function **master gland= pituitary dec.
● __ conduction speed of nerve fibers → ________slowed reflexes
d. Wear-and-tear theory the more you useyour body the quicker you die dec. endocrine
__ cerebral blood flow → ________________
● dec. hormones
e. Free-radical theory unstable molecules--cell damage 1. Small frequent feeding
f. Cross-linkage theory strong bond between proteins= dec. elasticity ENDOCRINE 2. high calorie balanced diet
● dec. anorexia
__ thyroid → ↓ metabolic rate → ________
PSYCHOLOGICAL THEORIES HOW DO WE AGE dec.
● __ insulin resistance → ________ in increase blood glucose
resistance
a. Disengagement theory isolate from society =this justify ageism ● dec__ sex hormones → ________________
menopause, androphare
b. Activity theory inc. productivity= successful aging
c. Continuity theory maintain the values, habits, and behaviors SPECIAL SENSES
d. Erikson’s psychosocial theory ego integrity vs. despair Vision:
ego is postive and death is okay because● inc. senile cataract
__ lens opacity → _____________
PHYSIOLOGICAL CHANGES they have a successful life and self __ lens elasticity → ________________
● dec. dec. accoomodation= presbyopia
INTEGUMENTARY acceptance senile miosis= poor night vision
__ pupil size → ________________
● dec.
● __ epidermis → thin, fragile
__________ despair is negative and not ready to ● inc.drusens → ________________
die __ DRY
dec. pigment in
__ melanin →dec.__________
collagen because of full of regrets
skin and
● hair
__ dermis → __________ 1. avoid rough texture Hearing:(CONDUCTIVE HEARING LOSS)
__
LOW sweat glands → __________
dryness 2. soft clothes ● __ hair cells in the inner ear → ________________
dec. hair cells---presbycusis
PREVENT SKIN CANCER
__ blood supply → __________
bed ulcers 1. Avoid additional salt and sugar
__ hypodermis →prone hypothermia 1. Apply SPF >15, 30 mins before,
__________
●LOW re-apply every 2 hrs. Taste: 2. Use herbs and spices
● __ nail growth → thickness
__________ 2. Avoidn4am-10 pm ● __
dec. tongue → atrophy, dec. taste buds
_____________
LENTIGO SENILIS 3. Wear protected clothing
● ____________: brown spots in sun-exposed areas Smell:
____________:
●SINILE PURPURA bruising, bleeding under the skin in older ● dec.
__ olfactory bulb → _____________
atrophy
adults
XEROSIS
● Seborrheic dermatitis due to ____________ Touch:
dec. sensation, pain, temp
__ nerve conduction → _____________
● dec.
CARDIOVASCULAR at risk for burns
maintained
● Heart rate: _____________ < activity tolerance
● Myocardium:dec __ contractility → _____________
dec. stroke volume
● Heart valves:dec __ rigidity & thickness → __________
murmurs
SARCOPENIA dec.
● Arteries: __ elasticity → _____________
high BP
MUSCULOSKELETAL peripheral edema
strenght, mobility, coordination--paired balance ● Veins: __ elasticity → _____________
dec
__ muscles → dec.
● dec. __________
__ cartilage: → dryness
● dec. __________
--joint stiffness---Osteoarthritis ● Poor baroreceptor response:dec. response= orthostatic
_____________
hypotension
● bone resorption > bone formation → 1. remove high slip hazards
__________
2. Use nou. slip footwear RESPIRATORY
OSTEOPOROSIS
3. use high seat toilet ● Respiratory rate: _____________
maintained
— loss of bone mass ● Thoracic muscles dec. = weakness
Cause:
Physiology: bone formation = bone resorption 1. Bariatric Surgery Cough risk for pneumonia INCENTIVE
● Bone formation Calcium Absorption and 2. Vit. C Deficiency Depth dec. vital capaciry SPIROMETRY
● Alveoli: dec.= hypoxemia, hypercarpia
_____________
● Bone resorption calcium metabolism 3. Kidney Disease
4.Hypothyroidism MNGT:
Assessment 5. Menopause GASTROINTESTINAL 1. oral care
● Hallmark: Kyphosis/ Dowagers Hump
___________ 6.Immobility ● Mouth 2. frequent sips of water
Wide= weak bearing bones
● Gait: ________ 7. Parathyroid Gland Teeth dec.= difficulty swallowing 3. sugar freehard candy
● Confirmatory: Dexa= dual energy x-ray
__________ 8. Hyperthyroidism Salivary gland dec.= xerostomia
absorptiometry 9. Aging ● Stomach: _____________
dec. enzymes & acid= indigestion
MD Management ● Intestines: _____________
dec. peristalsis= constipation
1. High fiber, 2.Exercise, 3. Avoid straining
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RENAL *** Always assess for drug interaction
gradual, irreversible
● Kidneys: ________
dec.= rapid, reversible
Tubules dec. to concentrate urine
Nephrons dec. Glomerular Filtration Rate Altered LOC Normal LOC
● Bladder: ________
dec. tone and capcity= UTI, urinary
incontinence Assist the patient every 2hrs. got to reversible memory loss irreversible memory loss
REPRODUCTIVE the bathroom
● Sexual desire: _____________
maintained ABUSE
● Testes: __ size → _____________
dec. andropause ● Primary risk factor: _____________
dependent= altered mental status, immobility
● Penis:dec.
__ blood supply → _____________ at home
Maintained =impotence not fully erected ● Domestic mistreatment: _____________
● Prostate: inc.
__ size → urinary
_____________
incontinence hospital on long term care
● Institutional mistreatment: _____________
● Female:dec.
__ estrogen → _____________
atrophy of sex organs--- ● Self-neglect:_____________
mentally dependent, disregard self care
menopause-- infertility
PSYCHOSOCIAL ISSUES RN INTERVENTIONS:
MENTAL HEALTH ● Priority: _____________
Assess and treat the injury first
● Isolation encourage pt. & fam to interact ● NEVER leave the victim alone
● Depression increase dependency and decrease self worth ● Respect maintain confidentiality
● Suicide ● Safety remove from threat
● Delirium ● Report to authorities follow agency policy
● Dementia PRIORITY= Safety!!!
● Document evidence
Delirium Dementia
imparment of neurons death of neurons
TYPES
1. Neglect= Dehydration, Malnutrition,
ex. in DELIRIUM Poor Hygiene
= Shock 2. Physical Abuse= inflict pain, and harm
3. Sexual= without consent
4. Psychological= verbal threat or
humiliation
5. Economic= exploitation, anaka kumukha
ng pension kahit walang consent sa prents
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