Work Environment Flashcards

In assisting aging client, it is important for the nurse to recognize?

Answer: All components of well-being including biological function, psychological function and social function.

Holistic nursing care requires addressing all dimensions of well-being—biological (physical health), psychological (mental and emotional health), and social (relationships and community). Focusing only on ADLs, finances, or prior employment misses critical aspects that affect an older adult's overall health and quality of life.

Medications, slower mobility, lack of proper fluid intake, and poor diet can lead into what common symptom in the elder population?

Answer: Urinary incontinences

Medications (some cause urinary retention or urgency), reduced mobility (difficulty reaching the bathroom in time), inadequate fluid intake (concentrated urine irritates the bladder), and poor diet collectively impair bladder control, leading to urinary incontinence. The other options—skin changes, mental changes, and depression—are not the primary combined result of these specific factors.

The nurse assessing the older population needs to have a basic understanding of which of the following?

Answer: The difference between normal and abnormal for the older age group

Effective geriatric assessment requires knowing what changes are normal with aging (e.g., slower reflexes, mild forgetfulness) versus abnormal findings that signal disease. Without this distinction, nurses may either over-pathologize normal aging or miss true illness. Economic status, sexual dysfunction signs, and cardiac disease signs are narrower concerns that don't form the foundational knowledge base needed.

Which statement would be most appropriate to ask when assessing an aging adult for cognitive function?

Answer: Have you noticed anything different about your memory or thinking in the past few months?

Open-ended questions invite the patient to self-report subjective changes in memory or thinking, which is more sensitive and respectful when screening for cognitive decline. Questions like 'What is today's date?' or 'Who is the president?' are formal cognitive tests, not conversational screening tools, and can feel demeaning rather than inviting honest disclosure.

Which disease or ailment is often under diagnosed and undertreated in the aging population?

Answer: Depression

Depression in older adults is frequently mistaken for normal aging, grief, or dementia, and its symptoms (fatigue, withdrawal, cognitive slowing) overlap with many physical illnesses, causing it to be missed and untreated. Schizophrenia, associative disorders, and ADHD are far less prevalent in this population and are less likely to go systematically underdiagnosed.

Which statement demonstrates normal cognitive function for an aging adult?

Answer: Occasional memory lapses

Occasional forgetfulness—such as misplacing keys or momentarily forgetting a name—is a normal part of aging. Forgetting the names of close family members, current address, or being unable to count are signs of significant cognitive impairment, not normal aging, and would warrant further evaluation.

Dementia and depression are strongly related to:

Answer: A decreased quality of life and functional deficits

Dementia and depression both directly impair a person's ability to perform daily activities, maintain independence, and experience satisfaction in life, resulting in decreased quality of life and functional deficits. Age thresholds and past economic status do not define the relationship; these conditions affect people across various ages and socioeconomic backgrounds.

Which statement reflects the state of drug absorption in the geriatric patient?

Answer: The rate of absorption is slowed

Aging causes decreased gastric motility, reduced blood flow to the GI tract, and lower gastric acid production, all of which slow the rate at which drugs are absorbed into the bloodstream. The mucosa does not cause faster absorption when it thins, the percentage absorbed is generally unchanged, and gastric pH actually increases (becomes less acidic) with age.

The absorption of medication in the geriatric client is most often affected by:

Answer: A decrease in body water and lean body weight

With aging, body water and lean muscle mass decrease while body fat increases; since many drugs distribute into body water or lean tissue, these changes reduce the volume of distribution and alter drug absorption and distribution. Body fat actually increases with age, serum albumin decreases (not increases), and increased body water is the opposite of what occurs.

Which organ is responsible for drug metabolism and must be considered when prescribing medication for an older adult?

Answer: Liver

The liver is the primary site of drug metabolism (biotransformation), and hepatic blood flow and enzyme activity decline with age, slowing the breakdown of medications and increasing the risk of drug accumulation and toxicity. The kidneys handle excretion, the pancreas handles digestion, and the intestines play a minor role in metabolism compared to the liver.

An older adult on digoxin and furosemide is showing signs of toxicity. The gerontology nurse understands that:

Answer: Digoxin and furosemide are excreted by the kidneys and the doses may need to be decreased due to impaired kidney function

Both digoxin and furosemide are primarily excreted by the kidneys; age-related decline in glomerular filtration rate (GFR) slows their elimination, causing drug levels to build up and produce toxic effects. Adjusting the dose downward compensates for reduced renal clearance, making excretion route and kidney function central considerations in geriatric dosing.