Exam 3 Flashcards

Question

Nursing interventions for tinnitus?

Answer 1

* Identify when sounds are most irritating * Keep log/diary * Reduce/eliminate * ETOH, caffeine, cigarettes, stress, and fatigue

Answer 2

*Permission *Limited Information *Specific Suggestions *Intensive Therapy

Answer 3

* An insurance plan for persons who are age 65, blind or totally disabled, including persons with ESRD * Includes A, B, C, & D

Answer 4

inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care, inpatient psychiatric care

Answer 5

Services from doctors and other health care providers. Outpatient care. Home health care. Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)

Answer 6

brand-name prescription drugs and generic drug coverage.

Answer 7

Health insurance program jointly funded by federal and state governments using tax dollars *Provides health services for low- income children, pregnant women, those who are permanently disabled, and persons age 65 and older who are eligible (eligibility decided by state)

Answer 8

* Observe for obvious bruises or body marks * Observe and ask about medications * Looks for signs of restraints * Note body odor, dirty clothing or body, or other signs of neglect * Observe for pressure ulcers, dehydration, or malnutrition * Photograph injuries and general conditions (follow facility policy)

Answer 9

moments of intermittent sadness – often with triggers (anniversary of event)

Answer 10

when a person cannot openly acknowledge or publicly mourn a loss – socially disallowed or unsupported – same sex, AIDS, suicide

Answer 11

* 1. Normal Existence * 2. Receipt of Bad News * 3. Denial * 4. Anger – Aggression * 5. Depression – Confusion, early bargaining, and continued anger and denial * 6. Bargaining * 7. Acceptance

Answer 12

* Control * Composure * Communication – p. 481 Read this section! – Type & content varies by patient – Auditory, visual & tactile – Verbal & Non-verbal – Closed awareness – Suspected awareness – Mutual pretense – Open awareness * Continuity * Closure

Answer 13

* Care needed is received expertly and in a timely manner * One is able to control one’s life and environment to extent desired and possible and in a way culturally consistent with one’s past life * One is able to maintain composure when necessary and to the extent desired * One is able to initiate and maintain communication with significant others for as long as possible - Life continues as normally as possible while dying with added tasks needed to deal with and adjust to inevitable death * One maintains desirable hope at all times * One reaches sense of closure that is culturally consistent with one’s practices and life patterns Know This

Answer 14

when 2 physicians have agreed the person has 6 months or less to live

Answer 15

* Recognize physical changes preceding eminent death * Deal with own feelings * Deal with angry patients and families * Be knowledgeable and deal with ethical issues in administering end-of-life palliative therapies * Be knowledgeable and inform patients about advance directives * Be knowledgeable of legal issues in administering end-of-life palliative care * Be adaptable and sensitive to religious and cultural perspectives * Explain meaning of hospice

Answer 16

highest expression of one’s individual potential and implies inner motivation that has been freed to express the most unique self or the “authentic person”

Answer 17

* Time competent: The person uses past and future to live more fully in the present. * Inner directed: The person’s source of direction depends on internal forces more than on others. * Flexible: The person can react situationally, without unreasonable restrictions. * Sensitive to self: The person is responsive to his or her own feelings. * Spontaneous: The person is able and willing to be himself or herself. * Values self: The person accepts and demonstrates strengths as a person. * Accepts self: The person approves of self, in spite of weaknesses or deficiencies. * Positively views others: The person sees both the bad and the good in others as essentially good and constructive. * Positively views life: The person sees the opposites of life as meaningfully related. * Acceptance of aggressiveness: The person is able to accept own feelings of anger and aggressiveness. * Capable of intimate contact: The person is able to develop warm interpersonal relationships with others.

Answer 18

Human aging brings about a general potential for gerotranscendence, a shift from the material world to cosmic, and (concurrent with that), life satisfaction

Answer 19

* Have high degrees of life satisfaction * Engage in self-controlled social activity * Experience satisfaction with self-selected social activities * Social activities not essential to their well-being * Midlife patterns and ideals no longer prime motivators * Demonstrate complex and active coping patterns * Have greater need for solitary philosophizing * May appear withdrawn when engaged in inner development * Have accelerated development of gerotranscendence fomented by life crises * Feel shifts in perception of reality

Answer 20

a broader concept than religion and encompasses a person’s values or beliefs, search for meaning, and relationships with a higher power, with nature, and with other people

Answer 21

* Individuals experiencing events or conditions that affect the ability to participate in spiritual rituals * Diagnosis and treatment of a life-threatening, chronic, or terminal illness * Expressions of interpersonal or emotional suffering, loss of hope, lack of meaning, need to find meaning in suffering * Evidence of depression * Cognitive impairment * Verbalized questioning or loss of faith * Loss of interpersonal support

Answer 22

* Does your religion/spirituality provide comfort or serve as a cause of stress? (Ask to explain in what ways spirituality is a comfort or stressor.). * Do you have any religious or spiritual beliefs that might conflict with health care or affect health care decisions? (Ask to identify any conflicts.) * Do you belong to a supportive church, congregation, or faith community? (Ask how the faith community is supportive.) * Do you have any practices or rituals that help you express your spiritual or religious beliefs? (Ask to identify or describe practices.) * Do you have any spiritual needs you would like someone to address? (Ask what those needs are and if referral to a spiritual professional is desired.) * How can we (health care providers) help you with your spiritual needs or concerns?

Answer 23

Discuss retirement with clients (esp in primary care) Discuss transition to retired status Health issues affecting retirement Resources for planning and support

Answer 24

MDS – Minimum Data Set QAPI - Quality Assurance Performance Improvement Nursing Home Compare – 5-Star Advancing Excellence in America’s Nursing Homes INTERACT - Interventions to Reduce Acute Care Transfers

Answer 25

wrap around and linear bruises

Answer 26

* Make professionals aware of potentially abusive situations. * Help families develop and nurture informal support systems. * Link families with support groups. * Teach families stress management techniques. * Arrange comprehensive care resources. * Provide counseling for troubled families. * Encourage the use of respite care and day care. * Obtain necessary home health care services. * Inform families of resources for meals and transportation. * Encourage caregivers to pursue their individual interests.

Answer 27

Inability to perceive/understand speech Reading and writing impaired Receptive aphasia

Answer 28

Impaired speaking Speech is effortful Expressive aphasia

Answer 29

Difficult to get brain signals to speech muscles Frequently occurs with aphasia

Answer 30

Severe word finding difficulties

Answer 31

Can’t understand or express Says meaningless things

Answer 32

Have "slurred" or "mumbled" speech that can be hard to understand Speak slowly Talk too fast Speak softly Not be able to move your tongue, lips, and jaw very well Sound robotic or choppy

Answer 33

Collaboration with SLPs for speech therapy

Answer 34

Imbalance between inflow and outflow of aqueous humor>pressure increases>vision impaired>possible blindness if not treated

Answer 35

Oxidative damage to lens Protein and fat deposits By age 80, more than half have a cataract Usually bilateral

Answer 36

Drusen deposits in retinal epithelium>atrophy and degeneration of macular cells>vision impairment

Answer 37

orange and red

Answer 38

Damage to inner ear or neural pathways Presbycusis (age-related hearing loss) Most common hearing loss Progressive and often permanent Bilateral

Answer 39

1st Sign is difficulty hearing in noisy environment (restaurant) Intolerant to loud noises Difficulty in distinguishing between consonants Raised (louder) voices – make it worse High frequency sounds lost first Difficulty filtering background noises (hospital) Can’t hear women and children …WHY?

Answer 40

Hearing aids Cochlear implants

Answer 41

Intimate, vulnerable, consent, and social zones

Answer 42

face, neck, front of body

Answer 43

mouth, wrists, feet

Answer 44

hands, arms, shoulders, back

Answer 45

- stimulation of rocking - slowly stroking an animal’s fur -wearing something that provides sensory stimulation -Music and dancing

Answer 46

Encompasses more than just sexuality Commitment Affective intimacy Cognitive intimacy Physical intimacy Love and affection Examples: Touch, holding, cuddling, being present

Answer 47

Specific type of intimate activity Sexual acts Sexual desire Activity Attitudes Body image Gender-role activity Acceptance and Companionship

Answer 48

3 million ,expected to double by 2030

Answer 49

“Do you have a romantic partner?” not “Do you have a boyfriend/girlfriend or married?” “How do you identify with regard to your sexuality?” Don’t assume heterosexuality

Answer 50

Dyspareunia (painful intercourse) from vaginal dryness and thinning of the vaginal tissue

Answer 51

Refractory period extended between episodes of intercourse

Answer 52

Endocrine problems CV problems Depression Neurological problems

Answer 53

Phosphodiesterase (PDE) inhibitors such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) Revolutionized treatment for ED ABSOLUTE – CONTRAINDICATION with nitrates/nitroglycerin – LIFE-THREATENING

Answer 54

Water soluble lubricants, low-dose estrogens introduced into the vagina may also help restore tissues and restore lubrication

Answer 55

Medicare in 2010 began covering HIV screening for high risk individuals All adults should have an HIV test at least once

Answer 56

caucasians and asiansq

Answer 57

hearing loss

Answer 58

High education High occupational status Gov’t employees Employed in companies with pensions

Answer 59

Poor health Minorities Women Lower socioeconomic status Lower education

Answer 60

American citizens or legal residents, at a predetermined age, who are totally and permanently disabled (including blind) or who are married to or an eligible partner of or dependent of someone receiving Social Security are eligible to receive Social Security benefits.

Answer 61

current cohort of older adults, this calculation has been most beneficial to white men, who are more likely to have worked the most consistently and at higher salaries than all other groups of workers.

Answer 62

provide a minimal level of economic support to persons age 65 and older such as Aida (above), those who are blind, or disabled regardless of their earning power in early life or when capable of working. SSI either provides “total support” or supplements a low Social Security benefit

Answer 63

Help with high Medicare co-payments Cover only deductibles and part of coinsurance amounts based on Medicare Approved amounts contracted with providers

Answer 64

medicaid, medicare, priv LTC insurance, out-of-pocket spending

Answer 65

Skilled nursing facilities (sub-acute) Chronic care (long-term/custodial)

Answer 66

PACE - Program for All Inclusive Care for the Elderly

Answer 67

NICHE – Nurses Improving Care for Healthsystem Elders

Answer 68

acute care for the elderly

Answer 69

Home like, directed by residents, relationships fostered

Answer 70

Med mgmt., discharge planning/teaching, etc. (RNs and APRNs)

Answer 71

provides comprehensive medical and social services to certain frail, community-dwelling elderly individuals, most of whom are dually eligible for Medicare and Medicaid benefits. Age 55 or older Live in the service area of a PACE organization Eligible for nursing home care Be able to live safely in the community

Answer 72

stresses nurse involvement in hospital decision-making regarding care of older adults. (acute care)

Answer 73

Beginning Physical and psychological manifestations Middle Day to day functioning affected End Griever emerges refocused and adjusted

Answer 74

sharing caring words reminiscence listening to life stories validating their lives praying with and for reading scripture referring clergy providing for religious objects and rituals

Exam 3 Flashcards

(102 cards)