Care for the Older Person
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Transcript of Care for the Older Person
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7/29/2019 Care for the Older Person
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Care of the OlderPerson
Maria Thresa Jader
Princes Joy LabanzaAnjelika Eurelle Mapili
Bryan Sadol
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Developmental Aspects of
AgingRisk for Activity Intolerance related to DeconditionedStatus (Aging)
Note presence of medical diagnosis and/or therapeuticregimens
Determine current activity level and physical conditionwith observation, exercise tolerance testing, or use offunctional level classification system (e.g. Gordons)
Discuss with client the relationship of illness ordebilitating condition and ability to perform desiredactivities.
Provide information regarding potential interferingfactors with activity
Instruct client in unfamiliar activities and in alternateways of doing familiar activities
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Acute Confusion related to Over 60 years of age
Note presence of agitation, fear, and anxiety
Evaluate sleep and rest status, noting insomnia,sleep deprivation, and over sleeping.
Evaluate mental status, noting extent ofimpairment in orientation, attention span, ability tofollow directions, ability to send and receivecommunication, appropriateness of response.
Monitor/adjust medication regimen and noteresponse. Determine medication that can bechanged or eliminated.
Orient client to surroundings, staff, necessaryactivities, as needed. Avoid challenging illogicalthinking.
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Death Anxiety
Determine how client sees self in usual lifestyle role functioningand perception and meaning of anticipated loss to the client.
Ascertain current knowledge of situation
Observe behavior indicative of the level f anxiety present
Identify coping skills currently used and how effective they are.Be aware of defense mechanisms being used by the client.
Note clients religious and spiritual orientation, involvement inreligious activities, presence of conflicts regarding spiritualbeliefs.
Listen for expression of inability to find meaning in life or suicidalideation
Provide open and trusting relationship
Direct clients thoughts beyond present state to enjoyment ofeach day and the future when appropriate.
Encourage expression of feelings. Acknowledge anxiety/fear. Donot deny or reassure client that everything will be alright. Behonest on answering questions/providing information.
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Impaired memory related to Age
Note clients age and potential for depression
Perform or review results of cognitive testing
Orient/reorient client as needed Implement appropriate memory-retraining
techniques
Provide for and emphasize importance of pacing
learning activities and getting sufficient rest. Assist client to establish compensation strategies
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Risk for Situational Low Self-Esteem related to
Functional Impairment
Determine individual factors that could contribute
to diminish self-esteem Note clients perception of threat to self in current
situation.
Verify clients concept of self in relation to cultural
or religious ideals.
Assess negative attitudes and/or self-talk.
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Biophysical & Physiological
AgingDecreased Cardiac Output related to Altered HeartRate/Rhythm
Evaluate clients reports and evidence of extreme
fatigue, intolerance for activity, sudden or progressive
weight gain, swelling of extremities, and progressiveshortness of breath
Determine vital signs/hemodynamic parameters
including cognitive status.
Provide for adequate rest, positioning client for
maximum comfort.
Monitor cardiac rhythm continuously
Asses potential for/type of developing shock states
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Activity Intolerance
Note clients report of weakness, fatigue, pain,
difficulty accomplishing tasks, and/or insomnia.
Assess emotional and psychological factorsaffecting the current situation
Adjust activities
Provide and monitor response to supplemental
oxygen, medications, and changes in treatment
regimen
Promote comfort measures
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Imbalanced Nutrition: less than body requirementrelated to Inability to ingest or digest food
Determine clients inability to chew, swallow, and tastefood. Evaluate teeth and gums for poor oral health, and
note if denture fits, as indicated. Determine psychological factors, perform psychological
assessment
Assess weight
Encourage client to choose foods or have family
member bring foods that seem appealing Assist with or provide oral care before and after meals
and at bedtime.
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Constipation
Review medical, surgical, and social history for
conditions often associated with constipation
Note general oral/dental issues Note energy and activity levels and exercise
pattern
Instruct in and encourage a diet of balanced fiber
and bulk and fiber supplements
Encourage and activity and exercise within limits
of individual ability.
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Risk for Impaired Skin Integrity related of
extremes of age
Assess skin routinely, noting moisture, color, and
elasticity Note presence of conditions or situations
Change position in bed or chair on a regular
schedule.
Keep bedclothes dry
Provide safety measures during ambulation and
other therapies that might cause dermal injury
Provide preventive skin care to incontinent client
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Psychological Aspects of
AgingImpaired Memory implement appropriate memory retraining
techniques
encourage ventilation of feelings of frustration
monitor clients behavior and assist in use of
stress management techniques
assist client t establish compensation strategies
to improve functional lifestyle and safety
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Disturbed Thought Process
evaluate mental status
note behavior such as untidy personal habit;
slowing and slurring of speech assess clients anxiety level in relation to situation
assist with treatment with underlying problems
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Impaired Verbal Communication
review history for neurological conditions that
could affect speech such as CVA, tumor, hearing
loss and so forth
evaluate mental status
note level of anxiety level present
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Chronic Sorrow related to Experiences chronicillness or disability
Look for cues of sadness
Determine level of functioning
Encourage verbalization about situation
Encourage expression of anger, fear, and anxiety
Acknowledge reality of feelings of guilt/blame
Discuss healthy ways of dealing with difficulties
situation Encourage involvement in usual activities,
exercise, and socialization within limits of physicaland psychological state.
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Disturbed Sensory Perception
Identify client with condition that can affectsensing, interpreting, and communicating stimuli
Assess ability to speak, hear, interpret, and
respond to simple commands
Observe for behavioral responses
Determine response to stimuli
Interpret stimuli and offer feedback
Reorient to person, place, time, and events, asnecessary
Promote meaningful socialization
Provide safety measures
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Successful Aging
Death Anxiety
Determine how client sees self in usual lifestyle
functioning
Note physical/ mental condition
Determine ability to manage own self-care
Identify coping skills currently used and howeffective they are
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Risk for Loneliness
Differentiate ordinary loneliness and a state of
consent sense of disphoria
Determine how individual perceives/ deals withsolitude
Assess sleep/appetite disturbances
Establish nurse/client relationship in which client
feels free to talk about feelings
Discuss importance of emotional bonding
Encourage involvement in special interest groups
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Ineffective Role Performance
Maintain positive attitude toward client
Make information available for client to learn
about expectations that may occur Refer to support groups as indicated by individual
needs
Use techniques of role rehearsal to help the client
develop new skills to cope with changes
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Readiness for Enhanced Spiritual Well-Being
Determine spiritual motivation for growth
Explore meaning and relationship of spirituality
life/ death and illness to lifesjourney Determine influence of cultural beliefs
Encourage client to take time to be introspective
in the search of peace and harmony
Discuss use of relaxation/ meditative activities
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Effective Therapeutic Regimen Management
Identify individuals perception of adaptation to
treatment changes
Discuss present resources used by client Identify steps necessary to reach self goals
Promote client/ care giver choices and
involvement in planning and implementing added
responsibilities
Provide for follow up home visit as appropriate
Mobilize support system
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Geriatric Nutrition
Impaired Nutrition: less than body requirement
Determine ability to chew, swallow and taste
-discuss eating habits
-assess drug interactions
-assess weight, age, body build, strength
-note total daily intake
-small feedings with snacks
- use flavoring agents to enhance food satisfaction andfood appetite
- encourage clients to choose food that are appealingto improve appetite
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Impaired Swallowing related to decrease gag
reflex
Encourage a rest period before meals to minimize
fatigue Determine food preferences of client to
incorporate as possible enhancing intake.
Ensure temperature of food/fluid which will
stimulate sensory receptors
Provide a consistency of food/fluid that is most
easily swallowed
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Impaired Oral Mucus Membrane
Determine nutrition/ fluid intake and reported
changes
Encourage adequate fluid to prevent dehydration Recommend avoiding alcohol, smoking/ chewing
tobacco which may further irritate mucosa
Encourage use of chewing gum, hard candy and
so forth to stimulate saliva
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Risk for Imbalanced Fluid Volume
Measure and record intake and output
- monitor Blood pressure responses
- assess for clinical signs of dehydration - maintain fluid/ sodium restrictions when needed
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Deficient Fluid Volume
determine effects of age
- assess vital signs
- note strength of peripheral pulses - monitor blood pressure
- observe urinary output; color, and measure
amount and specific gravity
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Impaired Memory r/t neurological disturbances
Observe patients thought process every after shift.
Changes indicate progressive improvement or a decline in patients underlyingcondition.
Implement appropriate safety measures to protect patient from injury. He orshe may be unable to provide his/her needs.
Call the patient by name and introduced your name. Provide backgroundinformation (place, time and date) frequently throughout the day to providereality orientation.
Spend sufficient time with the patient to allow him/her to become comfortablediscussing memory loss and establish a trusting relationship.
Be clear. Be concise and direct in establishing goals to promote maximal useof patients remaining cognitive skills. Offer short, simple explanations topatient each time you carry out a medical and nursing procedure to avoidconfusion.
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Self care deficit r/t frustration over loss of independence
Assist patient in accepting necessary amount of dependence. Ifdisease, injury, or illness resulting in self-care deficit is recent, patientmay need to grieve before accepting that dependence is possible.
Encourage independence, but intervene when patient cannotperform. To decrease frustration.
Provide positive reinforcement for all activities attempted; notepartial achievements. This provides the patient with an externalsource of positive reinforcement.
Set short-range goals with patient. To facilitate learning anddecrease frustration.
Use consistent routines and allow adequate time for patient tocomplete tasks. This helps patient organize and carry out self-careskills.
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Self care deficit r/t frustration over loss of independence
Assist patient in accepting necessary amount of dependence. If
disease, injury, or illness resulting in self-care deficit is recent,
patient may need to grieve before accepting that dependence is
possible.
Encourage independence, but intervene when patient cannot
perform. To decrease frustration.
Provide positive reinforcement for all activities attempted; notepartial achievements. This provides the patient with an external
source of positive reinforcement.
Set short-range goals with patient. To facilitate learning and
decrease frustration.
Use consistent routines and allow adequate time for patient tocomplete tasks. This helps patient organize and carry out self-
care skills.
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