Nurs 404 - Exam 1

Front 1

Gerontology

Back 1

- Study of aging/the aged
- Several subfields e.g. financial, social, geropsych, geropharm, etc.

Front 2

Geriatrics

Back 2

- Generic term relating to the aged but specifically refers to medical care of the aged

Front 3

Gerontological Nursing

Back 3

Refers to the application of skills to promote health, wellness; foster independence
- Involves nurses advocating for the health of older persons at all levels of prevention

Front 4

Defining Gero Nursing Practice

Back 4

- Foster independence of older adults across continuum of care
- Interdisciplinary and holistic
- Roles: Provider of care, manager, teacher, advocate, research consumer
- Scope and standards of practice (use E-B practice)
- Responsibility to educate the older adult about wats to decrease risk of certain disorders such as heart disease, CA, and CVA
- Promote best interests and strengthen autonomy and decision making

Front 5

Where do you see stereotypes of the aged?

Back 5

- TV, media, newspapers, film, commercials, magazines, greeting/birthday cards

Front 6

Ageism

Back 6

- Stereotyping/discriminating against people because they are old
- Prejudice against or in favor of an age group

Front 7

Age-bias in Health Care

Back 7

Older adults:
- Get less aggressive treatments
- Not seen as "candidates" for health promotion programs
- Often excluded from health studies
- Reduced care/inadequate treatment due to assumption that an ailment occurs as a natural process of aging

Front 8

Therapeutic Nihilism

Back 8

Belief that many "cures" do more harm than good; idea that body will heal itself by doing nothing

Front 9

Stereotypes are Health Hazards

Back 9

- Results in poorer physiological/functional performance
- Negative self-perceptions associated with mortality

Front 10

Characteristics of the Baby Boomers

Back 10

- Born 1946-1964
- Entering senior years between 2008-2030
- Diverse group
- Becoming less alike/less homogeneity
- Better educated
- Higher incomes
- More tech savvy
- More physically fit
- Informed consumers, independent

Front 11

Race/ethnicity Aging Trends

Back 11

- Older population in the U.S. is growing more racially and ethnically diverse
- Minority will make up 22% of the population in the next 20 years
- Losses are often encountered in aging, coupled with low socioeconomic status and lifetime racial discriminations -- high risk for poor outcomes

Front 12

Chronic Disease (Co-morbidity)

Back 12

- Prevalence of chronic diseases increases with age
- Women: HTN, asthma, chronic bronchitis, arthritis
Men: HD, CA, DM, emphysema

Front 13

Sensory Impairments

Back 13

- More frequent with aging
- Early detection can prevent/postpone physical, social and emotional effects that these changes have
- About 48% of men and 35% of women have visual impairments

Front 14

What is successful aging?

Back 14

- #1 goal is remaining independent
- Active engagement with life/high functional development

Front 15

Secrets of Aging: Protective Factors

Back 15

- No smoking/drinking
- Exercise
- Moderate weight
- Education
- Low BP
- Stable marriage
- Mature defenses (as perspectives change, maturity increases defenses against stress

Front 16

Sociological Theories

Back 16

- Study of society and people
- Changing roles, relationship status and generational cohort
- Impacts older adult's ability to adapt

Front 17

Sociological Theory: Subculture

Back 17

- Elderly prefer to segregate from society in an aging subculture sharing loss of status and societal negativity to the aged
- Health and mobility are key determinants

Front 18

Sociological Theory: Continuity

Back 18

- Personality influences roles and life satisfaction and remains consistent through life. Past coping patterns recur as older adults adjust to physical, financial, and social decline.
- Identifying with one's age group, finding a residence compatible with limitations and learning new roles post-retirement are major tasks

Front 19

Sociological Theory: Person-Environment Fit

Back 19

- Function is affected by ego, strength, mobility, health, cognition, sensory perception, and the environment.
- Competency changes ones ability to adapt to environmental demands

Front 20

Sociological Theory: Age Stratification

Back 20

- Society is stratified by age groups that are the basis for acquiring resources, roles, status and deference from others
- Age cohorts are influenced by similar experiences, beliefs, attitudes and expectations of life course transitions

Front 21

Gerotranscendance

Back 21

Proposes that aging individuals undergo a cognitive transformation from a materialistic, rational perspective toward oneness with the universe

Front 22

Psychological Theories

Back 22

- Characterized by life transitions and stages
- Explains aging by mental processes, emotions, attitudes, motivation and personality development

Front 23

Psychological Theory: Life Course

Back 23

- Stages are predictable and structured by roles relationships, values and goals
- Persons adapt to changing roles and relationships
- Age group norms/characteristics are an important part of Life Course

Front 24

Psychological Theory: Developmental

Back 24

- Personality develops in 8 stages with corresponding life tasks
- Last phase, 'integrity vs. despair' is characterized by evaluating life accomplishments and includes letting go, accepting care, detachment, and physical/mental decline (Erikson)

Front 25

Psychological Theory: Basic Human Needs

Back 25

- Motivates human behavior in a lifelong process toward need-fulfillment (Maslow)

Front 26

Biological Theories: Stochastic Theories

Back 26

- "Error Theory"
- Random events cause cellular damage that accumulates as organism ages

Front 27

Stochastic Theory: Wear and Tear

Back 27

- Cells wear out and cannot function with aging

Front 28

Stochastic Theory: Free Radical Theory

Back 28

- Membranes, nucleic acids, and proteins are damaged by free radicals which causes cellular injury and aging
- H2SO4 - Aging due to oxidative metabolism and effects of free radicals

Front 29

Stochastic Theory: Genotoxic Stress

Back 29

- Cells accumulate genetic damage to the mitochondria and due to free radicals and the loss of self-replication

Front 30

Biologic Theories: Nonstochastic Theories

Back 30

- "Apoptosis!"
- Programmed death perspective
- Based on genetically programmed events caused by cellular damage that accelerates aging of the organism

Front 31

Nonstochastic Theories: Gene Theory

Back 31

- Cells have a genetic programmed aging code

Front 32

Nonstochastic Theories: Programmed Longevity

Back 32

- Cells divide until they are no longer able to; this triggers apoptosis/cell death

Front 33

Nonstochastic Theories: Neuroendocrine

Back 33

- Problems with the Hippocampus-Pituitary-Endocrine Gland Feedback System causes disease; increased insulin and GF increase aging
- Decline in the immune system overtime

Front 34

Nonstochastic Theories: Immune

Back 34

- Programmed decline in immune system leads to increased vulnerability to infection, disease, aging and eventually death

Front 35

Hayflick's Theory/Limit

Back 35

- Set # of times that a cell can replicated
- Ex. One liver cell can ONLY create X-# of liver cells

Front 36

Telomeres and Cell Senescence

Back 36

- Telomeres = end caps of chromosomes
- Cell knows when to stop dividing and undergo apoptosis
- Basically, telomere shortens with each cell division until you are left with free ends
- Free ends allows chromosomes to fuse together/translocate
- Ex. P53 (dysfunction) leads to cancer

Front 37

Immunological Senescence

Back 37

- Stem cels are within out immune system; different regeneration properties
- Reduced B-cells and T-cells; but normal macrophages and granulocytes

Front 38

Nursing Theories of Aging: Functional consequences theory

Back 38

- Environmental and biopsychosocial consequences impact functioning
- Nursing's role is to minimize age-associated disability in order to enhance safety and quality of living

Front 39

Nursing Theories of Aging: Theory of thriving

Back 39

- Failure to thrive results from a discord between the individual and his or her environment or relationships
- Nurses identify and modify factors that contribute to disharmony among these elements
- Change/maximize the environment; minimize age-associated problems

Front 40

Functional Assessment

Back 40

- ADLs
- IADLs
- AADLs
- Physical performance measures

Front 41

Functional Assessment: Grip Strength

Back 41

- Poor grip strength is associated with a higher rate of mortality

Front 42

Percent of Medicare beneficiaries reporting difficulty with IADLs or ADLs

Back 42

- Number of people reporting ADL deficiencies pretty much peaks in the 75s
- Decreases with aging

Front 43

Social Assessment

Back 43

- Critical to holistic development
- Social support (e.g. family, friends, neighbors)
- Living arrangements
- Resources
- Insurance - Medicare vs. medicaid as well as insurance status
- Finances
- Independence vs. need for assistance
- Potential for isolation

Front 44

Spiritual Assessment

Back 44

- Myth: You becomre more spiritual with age
- Spirituality, religion, worship practices, religious artifacts, spiritual leader/advisor
- Check for signs of spiritual distress
- See that patient's needs are met!
- Make adequate referrals!

Front 45

Cognitive Assessment

Back 45

- Foundation for early disease detection!
- Identify specific pathological conditions
- Determine patient's ability to follow directions, retain instructions, express self clearly, and make decisions