Tiêu đề NCM 114 MIDTERMS RLE ✅

NCM 114 MIDTERMS RLE BY TONS AND MADS MIDTERMS COVERAGE LEC ● Planning for Health Promotion, Health Maintenance, and Home health Considerations ○ Planning for successful aging ○ Home care and hospice ○ Community-based services ○ Assisted living ○ Special care units ○ Geriatric Units ● Implementation ○ Physical care of older adults ○ Aging skin and mucous membranes ○ Elimination ○ Activity and Exercise ○ Sleep and rest ● Long-term care ● Palliative care ● Advance directives/DNR ● End-of life care RLE ● IV and Drug computations with gerontologic considerations ● Pre-operative and post-operative considerations in gerontology nursing ● Nursing process in the care of older adults

NCM 114 MIDTERMS BY TONS and MADS 1. Renal function and rate of excretion decline → digoxin concentrations toxic levels → nausea, vomiting, diarrhea and cardiac arrhythmias. 2. Severe toxicity prevented by observing early signs: appetite loss, confusion or depression. F. Corticosteroid toxicity 1. Short-term effects: fluid retention, psychological manifestations ranging from mild euphoria to acute psychotic reactions. 2. Long-term effects: osteoporosis (prednisone or related compounds for months or years) 3. Prevention: observe subtle changes in appearance, mood, mobility, signs of impaired healing and fluid and electrolyte disturbances. G. Sleep medication toxicity - 1. Sedatives or sleeping aids, such as flurazepam, cause excessive sedation or residual drowsiness. H. Nonprescription drug toxicity 1. Aspirin and aspirin-containing analgesics used in moderation, toxicity is minimal a) prolonged use: GI irritation and gradual blood loss resulting in severe anemia. b) Anemia from chronic aspirin consumption - elderly most vulnerable (reduced iron stores) 2. Laxatives: diarrhea in elderly patients who are extremely sensitive to drugs such as bisacodyl. 3. Chronic oral use of mineral oil as lubricating laxative → lipid pneumonia due to aspiration of small residual oil droplets in the patient’s mouth. I. Patient noncompliance 1. 1/3 third of elderly fail to comply with prescribed doses or to follow the correct schedule. 2. Medication regimen should be reviewed with him/her. The patient must clearly understand the dose and the time and frequency of doses. Ch 8 Pg 260 in Gerontology Book if You Want to Read TERMS ● Drug-drug Interactions – alteration of pharmacokinetics and pharmacodynamics of drug A when taken at the same time as drug B ● Drug-disease Interactions – the worsening of a disease by a medication ● Polypharmacy – prescription, administration, or use of more medications than are clinically indicated in a given patient Questions to Ask to Avoid Inappropriate Prescribing for Elderly Patients: 1. Is the treatment necessary? 2. Is this the safest drug possible? 3. Is this the most appropriate dose, route, and dosage form? 4. Is the frequency appropriate? 5. Does the benefits outweigh the risks? Medication Blood Levels ● Random levels – not dependent upon the administration time of the medication; drawn when the order is received ● Trough levels – dependent upon administration times; drawn at the time that the blood level is expected to be at its lowest (right before a dose is due) ● Abnormally high trough levels → time between doses should be lengthened ● Abnormally low trough levels → time between doses should be shortened ● Peak levels – dependent upon time of administration; drawn within a set time after a dose is given ● Abnormally high peak level → dosage needs to be reduced ● Abnormally low peak level → dosage should be increased Pre-op and post-op considerations in gerontology nursing Perioperative Management of Geriatric Patient: https://emedicine.medscape.com/article/285433-overview Gerontologic Considerations PREOP ● The hazards of surgery for elderly are proportional to the number and severity of coexisting health problems and the nature and duration of the operative procedure. ● Less physiologic reserve (ability of an organ to return to normal after disturbance in its equilibrium) than younger patients. ● Respiratory and cardiac complications - leading causes of postop morbidity and mortality in older adults ● Cardiac reserves are lower, renal and hepatic functions are depressed, and GI activity reduced. ● Sensory limitations - reasons for falls ● Arthritis - common in older people; affect mobility, difficult for to turn1 or ambulate ● Ability to perspire decreases → dry, itchy skin that becomes fragile and is easily abraded 2