Basic Geriatric Nursing

UNIT ONE OVERVIEW OF AGING,

(60)

Introduction to Geriatric Nursing,

(2)

Historical Perspective on the Study of Aging, l

What Is in a Name. Geriatrics, Gerontology, and Gerontics,

(2)

1 Trends and Issues,

(19)

Who Is "Old';

(1)

Categorizing the Aging Population,

(1)

Attitudes Toward Aging and Older Adults,

(1)

Ageism and the Myths Related to Aging,

(2)

Preparing for Old Age,

(1)

Demographics,

(2)

The Economics of Aging,

(1)

The Role of the Nurse in Financial Issues,

(1)

Housing and Older Adults,

(2)

Health Care and Aging,

(2)

Advance Directives,

(1)

The Aging Family,

(2)

Personal Reflection,

(1)

The Nurse and Family Interactions,

(1)

Elder Abuse,

(3)

Self-Neglect,

(1)

Abuse or Neglect by the Family,

(3)

Abuse by Unrelated Caregivers,

(1)

Prevention of Elder Abuse,

(2)

Support Groups,

(1)

Respite Care,

(1)

2 Theories of Aging,

(3)

Biologic Theories,

(1)

Psychosocial Theories,

(1)

Implications for Nursing,

(2)

3 Physiologic Changes,

(36)

THE INTEGUMENTARY SYSTEM,

(3)

Normal Structure and Function,

(1)

Normal Age-Related Changes,

(1)

Abnormal Conditions Common With Aging,

(2)

Basal Cell Carcinoma,

(1)

Pressure Ulcers,

(1)

Inflammation and Infection,

(2)

Hypothermia,

(1)

THE MUSCULOSKELETAL SYSTEM,

(3)

Normal Structure and Function,

(2)

Bones,

(1)

Vertebrae,

(1)

Joints,

(1)

Tendons and Ligaments,

(1)

Muscles,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(1)

Osteoporosis,

(1)

Degenerative Joint Disease,

(1)

THE RESPIRATORY SYSTEM,

(3)

Normal Structure and Function

(1)

Upper Respiratory Tract,

(1)

Lower Respiratory Tract,

(1)

Air Exchange (Respiration),

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(2)

Chronic Obstructive Pulmonary Disease,

(1)

Influenza,

(1)

Pneumonia,

(1)

Tuberculosis,

(1)

Lung Cancer,

(1)

THE CARDIOVASCULAR SYSTEM,

(4)

Normal Structure and Function,

(1)

Heart,

(1)

Blood Vessels,

(1)

Conduction System,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(3)

Coronary Artery Disease,

(1)

Coronary Valve Disease,

(1)

Cardiac Arrhythmias,

(1)

Congestive Heart Failure,

(1)

Cardiomegaly,

(1)

Peripheral Vascular Disease,

(1)

Occlusive Peripheral Vascular Problems,

(1)

Varicose Veins,

(1)

Aneurysm,

(1)

Hypertensive Disease,

(1)

THE HEMATOPOIETIC AND LYMPHATIC SYSTEMS,

(2)

Normal Structure and Function,

(1)

Blood,

(1)

Lymph System,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(1)

Anemia,

(1)

Leukemia,

(1)

THE GASTROINTESTINAL SYSTEM,

(3)

Normal Structure and Function,

(1)

Oral Cavity,

(1)

Tongue,

(1)

Salivary Glands,

(1)

Esophagus,

(1)

Stomach,

(1)

Small Intestine,

(1)

Large Intestine,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(2)

Hiatal Hernia,

(1)

Gastritis and Ulcers,

(1)

Diverticulosis and Diverticulitis,

(1)

Cancer,

(1)

Hemorrhoids,

(1)

Rectal Prolapse,

(1)

THE URINARY SYSTEM,

(2)

Normal Structure and Function,

(1)

Kidneys,

(1)

Ureters and Bladder,

(1)

Characteristics of Urine,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(1)

Urinary Incontinence,

(1)

Urinary Tract Infection,

(1)

Chronic Renal Failure,

(1)

THE NERVOUS SYSTEM,

(3)

Normal Structure and Function,

(1)

Central Nervous System,

(1)

Peripheral Nervous System,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(2)

Parkinson's Disease,

(1)

Dementia,

(1)

Alzheimer's Disease,

(1)

Transient Ischemic Attack,

(1)

Cerebrovascular Accident,

(1)

THE SPECIAL SENSES,

(5)

Normal Structure and Function,

(1)

The Eyes,

(1)

Refraction,

(1)

Normal Age-Related Changes in the Eye,

(1)

Eye Conditions Common With Aging,

(1)

Diplopia,

(1)

Cataracts,

(1)

Glaucoma,

(1)

Macular Degeneration and Retinal Detachment,

(1)

Normal Structure and Function,

(1)

The Ears,

(1)

Normal Age-Related Changes in the Ear,

(1)

Ear Conditions Common With Aging,

(1)

Otosclerosis,

(1)

Tinnitus,

(1)

Deafness,

(1)

Meniere's Disease,

(1)

Normal Function,

(1)

Taste and Smell,

(1)

Normal Age-Related Changes in Taste and Smell,

(1)

THE ENDOCRINE SYSTEM,

(3)

Normal Structure and Function,

(1)

Pituitary Gland,

(1)

Thyroid Gland,

(1)

Parathyroid Glands,

(1)

Pancreas,

(1)

Adrenal Glands,

(1)

Ovaries and Testes,

(1)

Normal Age-Related Changes,

(1)

Conditions Common With Aging,

(2)

Diabetes Mellitus,

(2)

Hypoglycemia,

(1)

Hypothyroidism,

(1)

THE REPRODUCTIVE AND GENITOURINARY SYSTEMS,

(6)

Normal Structure and Function,

(1)

Female Reproductive Organs,

(1)

Male Reproductive Organs,

(1)

Normal Age Related Changes,

(1)

Conditions Common With Aging,

(6)

Uterine Prolapse,

(1)

Vaginal Infection,

(1)

Breast Cancer,

(1)

Prostate Cancer,

(3)

UNIT TWO BASIC SKILLS FOR GERONTOLOGIC NURSING,

(70)

4 Health Promotion and Health Maintenance,

(10)

Recommended Health Practices for Older Adults,

(3)

Diet,

(1)

Exercise,

(1)

Tobacco and Alcohol,

(1)

Physical Examinations and Preventive Overall Care,

(1)

Dental Examinations and Preventive Oral Care,

(1)

Maintaining Healthy Attitudes,

(1)

Factors That Affect Health Promotion and Maintenance,

(2)

Religious Beliefs,

(1)

Cultural Beliefs,

(1)

Knowledge and Motivation,

(1)

Mobility,

(1)

Importance of Aging,

(1)

Impact of Cognitive and Sensory Changes,

(1)

Impact of Changes Related to

Accessibility,

(1)

Nursing Process for Ineffective Health Maintenance,

(1)

Assessment,

(1)

Nursing Diagnosis,

(1)

Nursing Goals/Outcomes,

(1)

Nursing Interventions, Nursing Process for Noncompliance,

(3)

Assessment,

(1)

Nursing Diagnosis,

(1)

Nursing Goals/Outcomes,

(1)

Nursing Interventions,

(2)

5 Communicating With Older Adults,

(7)

Effective Communication,

(1)

Empathetic Listening,

(1)

Nonverbal Communication,

(3)

Symbols,

(1)

Tone of Voice,

(1)

Body Language,

(1)

Space, Distance, and Position,

(1)

Facial Expressions,

(1)

Eye Contact,

(1)

Pace or Speed of Communication,

(1)

Time and Timing,

(1)

Touch,

(1)

Silence,

(1)

Verbal Communication,

(3)

Informing,

(1)

Direct Questioning,

(1)

Open-Ended Techniques,

(1)

Confronting,

(1)

Social Communication,

(1)

Communication With Visitors and Families,

(2)

6 Nutrition and Fluid Balance,

(3)

Nutrition and Aging,

(7)

Caloric Intake,

(2)

Nutrients,

(5)

Water,

(1)

Meeting the Nutritional Needs of Independent Older Adults,

Social and Cultural Aspects of Nutrition,

7 Medications and Older Adults,

(22)

Risks Related to Drug-Testing Methods,

(1)

Risks Related to the Physiologic Changes of Aging,

(1)

Pharmacokinetics,

(1)

Pharmacodynamics,

(1)

Risks Related to the Use of Multiple Medications,

(1)

Risks Related to Cognitive or Sensory Changes,

(1)

Risks Related to Inadequate Knowledge,

(1)

Risks Related to Financial Factors,

(1)

Medication Administration in an Institutional Setting,

(1)

Nursing Assessment and Medication,

(2)

Medications and the Nursing Care Plan,

(2)

Nursing Interventions Related to Medication Administration,

(2)

Patient Rights and Medication,

101

(1)

Self-Medication and Older Adults,

102

(1)

In an Institutional Setting,

102

(1)

In the Home,

102

(1)

Teaching Older Adults about Medications,

102

(3)

8 Health Assessment of Older Adults'

105

(17)

Health Screening,

105

(1)

Health Assessments,

105

(1)

Interviewing Older Adults,

106

(2)

Preparing the Physical Setting

106

(1)

Establishing Rapport,

106

(1)

Structuring the Interview

107

(1)

Physical Assessment of Older Adults,

108

(1)

Inspection,

108

(1)

Palpation,

108

(1)

Auscultation,

108

(1)

Percussion,

109

(1)

Assessing Vital Signs in Older Adults,

109

(2)

Temperature,

109

(1)

Pulse,

109

(1)

Respiration,

110

(1)

Blood Pressure,

110

(1)

Sensory Assessment of Older Adults,

111

(1)

Psychosocial Assessment of Older Adults,

112

(10)

Special Assessments,

112

(10)

9 Meeting Safety Needs of Older Adults,

122

(9)

Internal Risk Factors,

122

(1)

External Risk Factors,

123

(5)

Nursing Process for Risk for Injury,

128

(1)

Assessment,

126

(1)

Nursing Diagnoses,

126

Nursing Goals/Outcomes,

120

(6)

Nursing Interventions,

126

(2)

Nursing Process for Hypothermia/Hyperthermia,

128

(5)

Assessment,

128

(1)

Nursing Diagnoses,

129

Nursing Goals/Outcomes,

128

(1)

Nursing Interventions,

129

(2)

UNIT THREE PSYCHOSOCIAL CARE ELDERLY,

131

(74)

10 Cognition and Perception,

133

(18)

Normal Cognitive-Perceptual Functioning,

133

(1)

Cognition and Intelligence,

134

(1)

Cognition and Language,

134

(1)

Perception-Cognition and Aging,

134

(1)

Nursing Process for Disturbed Sensory Perception,

135

(3)

Assessment,

135

(3)

Nursing Diagnosis,

138

Nursing Goals/Outcomes,

136

(2)

Nursing Interventions,

138

(1)

Nursing Process for Disturbed Thought Processes,

138

(6)

Assessment,

141

(1)

Nursing Diagnosis,

141

(1)

Nursing Goals/Outcomes,

141

(1)

Nursing Interventions,

141

(3)

Nursing Process for Impaired Verbal Communication,

144

(3)

Assessment,

146

(1)

Nursing Diagnosis,

146

(1)

Nursing Goals/Outcomes,

146

(1)

Nursing Interventions,

146

(1)

Nursing Process for Pain,

147

(4)

Assessment,

148

(1)

Nursing Diagnosis,

149

(1)

Nursing Goals/Outcomes,

149

(1)

Nursing Interventions,

149

(2)

11 Self-Perception and Self-Concept,

151

(12)

Normal Self-Perception and Self-Concept,

151

(1)

Self-Perception/Self-Concept and Aging,

152

(1)

Nursing Process for Disturbed Self-Perception and Self Concept,

153

(1)

Assessment,

153

(1)

Nursing Process for Disturbed Body Image,

153

(1)

Assessment,

154

(1)

Nursing Diagnosis,

154

(1)

Nursing Goals/Outcomes,

154

(1)

Nursing Interventions,

154

(1)

Nursing Process for Risk for Situational Low Self-Esteem,

154

(2)

Assessment,

155

(1)

Nursing Diagnosis,

155

(1)

Nursing Goals/Outcomes,

155

(1)

Nursing Interventions,

155

(1)

Nursing Process for Fear,

156

(2)

Assessment,

157

(1)

Nursing Diagnosis,

157

(1)

Nursing Goals/Outcomes,

157

(1)

Nursing Interventions,

157

(1)

Nursing Process for Anxiety,

158

(1)

Assessment,

158

(1)

Nursing Diagnosis,

158

(1)

Nursing Goals/Outcomes,

158

(1)

Nursing Interventions,

158

(1)

Nursing Process for Hopelessness,

158

(1)

Assessment,

159

(1)

Nursing Diagnosis,

159

(1)

Nursing Goals/Outcomes,

159

(1)

Nursing Interventions,

159

(1)

Nursing Process for Powerlessness,

159

(4)

Assessment,

160

(1)

Nursing Diagnosis,

160

(1)

Nursing Goals/Outcomes,

160

(1)

Nursing Interventions,

160

(3)

12 Roles and Relationships,

163

(9)

Normal Roles and Relationships,

163

(1)

Roles, Relationships, and Aging,

164

(2)

Assessment,

166

(1)

Nursing Process for Dysfunctional Grieving,

166

(2)

Assessment,

166

(1)

Nursing Diagnosis,

166

(1)

Nursing Goals/Outcomes,

167

(1)

Nursing Interventions,

167

(1)

Nursing Process for Social Isolation and Impaired Social Interaction,

168

(1)

Assessment,

168

(1)

Nursing Diagnosis,

168

(1)

Nursing Goals/Outcomes,

168

(1)

Nursing Interventions,

168

(1)

Nursing Process for Interrupted Family Processes,

169

(3)

Assessment,

169

(1)

Nursing Diagnosis,

169

(1)

Nursing Goals/Outcomes,

169

(1)

Nursing Interventions,

169

(3)

13 Coping and Stress,

172

(9)

Normal Stress and Coping,

172

(3)

Physical Signs of Stress,

172

(2)

Stress and Illness,

174

(1)

Stress-Reduction and Coping Strategies,

174

(1)

Coping and Stress With Aging,

175

(1)

Nursing Process for Ineffective Coping,

176

(2)

Assessment,

176

(1)

Nursing Diagnosis,

176

(1)

Nursing Goals/Outcomes,

176

(1)

Nursing Interventions,

176

(2)

Nursing Process for Relocation Stress Syndrome,

178

(3)

Assessment,

178

(1)

Nursing Diagnosis,

178

(1)

Nursing Goals/Outcomes,

178

(1)

Nursing Interventions,

178

(3)

14 Values and Beliefs,

181

(6)

Common Values and Beliefs in Older Adults,

182

(2)

Economic Values,

183

(1)

Intrapersonal Values,

183

(1)

Religious or Spiritual Values,

183

(1)

Nursing Process for Spiritual Distress,

184

(3)

Assessment,

184

(1)

Nursing Diagnosis,

184

(1)

Nursing Goals/Outcomes,

184

(1)

Nursing Interventions,

184

(3)

15 End-of-Life Care,

187

(13)

The American Way of Dying,

187

(1)

Attitudes Toward Death and End-of-Life Planning,

187

(2)

Advance Directives,

188

(1)

Caregiver Attitudes Toward End-of-Life Care,

189

(1)

Values Clarification Related to Death and End-of-Life Care,

189

(1)

What Is a "Good" Death?,

190

(1)

Where People Die,

190

(1)

Palliative Care,

190

(1)

Collaborative Assessment and Interventions for End-of-Life Care,

190

(1)

Communication at the End-of-Life,

191

(1)

Psychosocial Perspectives, Assessments, and Interventions,

192

(2)

Cultural Perspectives,

192

(1)

Spiritual Considerations,

193

(1)

Depression, Anxiety, and Fear,

193

(1)

Physiologic Changes, Assessments, and Interventions,

194

(3)

Pain,

194

(1)

Fatigue and Sleepiness,

195

(1)

Cardiovascular Changes,

195

(1)

Respiratory Changes,

195

(1)

Gastrointestinal Changes,

196

(1)

Urinary Changes,

197

(1)

Integumentary Changes,

197

(1)

Sensory Changes,

197

(1)

Changes in Cognition,

197

(1)

Death,

197

(1)

Funeral Arrangements,

198

(1)

Bereavement,

198

(2)

16 Sexuality and Aging,

200

(5)

Factor That Affect Sexuality of Older Adults,

200

(2)

Normal Changes in Women,

200

(1)

Erectile Dysfunction in Men,

200

(1)

Illness and Decreased Sexual Functioning,

201

(1)

Alcohol and Medications,

201

(1)

Loss of a Sex Partner,

201

(1)

Marriage and Older Adults,

202

(1)

Caregivers and the Sexuality of Older Adults,

202

(1)

Sexual Health and Sexual Orientation,

202

(1)

Privacy and Personal Rights of Older Adults,

202

(1)

Nursing Process for Sexual Dysfunction,

203

(4)

Assessment,

203

(1)

Nursing Diagnosis,

204

(1)

Nursing Goals/Outcomes,

204

(1)

Nursing Interventions,

204

(1)

UNIT FOUR PHYSICAL CARE OF THE ELDERLY,

205

(80)

17 Meeting Nutritional and Fluid Needs,

207

(15)

Nutrition and Aging

207

(1)

Nursing Process for Risk for Imbalanced Nutrition,

208

(5)

Assessment,

209

(1)

Nursing Diagnosis,

210

(1)

Nursing Goals/Outcomes,

210

(1)

Nursing Interventions,

210

(3)

Nursing Process for Risk for Imbalanced Fluid Volume,

213

(4)

Assessment,

214

(1)

Nursing Diagnosis,

215

(1)

Nursing Goals/Outcomes,

215

(1)

Nursing Interventions,

215

(2)

Nursing Process for Impaired Swallowing,

217

(2)

Assessment,

217

(1)

Nursing Diagnosis,

217

(1)

Nursing Goals/Outcomes,

217

(1)

Nursing Interventions,

217

(2)

Nursing Process for Risk for Aspiration,

219

(3)

Assessment,

219

(1)

Nursing Diagnosis,

219

(1)

Nursing Goals/Outcomes,

219

(1)

Nursing Interventions,

219

(3)

18 Care of Aging Skin and Mucous Membranes,

222

(19)

Nursing Process for Impaired Skin Integrity,

222

(7)

Assessment,

229

(6)

Nursing Diagnosis,

229

(1)

Nursing Goals/Outcomes,

229

(1)

Nursing Interventions,

230

(5)

Nursing Process for Impaired Oral Mucous Membrane,

235

(6)

Assessment,

237

(1)

Nursing Diagnosis,

237

(1)

Nursing Goals/Outcomes,

237

(1)

Nursing Interventions,

237

(4)

19 Elimination,

241

(14)

Normal Elimination Patterns,

241

(1)

Elimination and Aging,

241

(2)

Constipation,

241

(2)

Fecal Impaction,

243

(1)

Nursing Process for Constipation,

243

(2)

Assessment,

243

(1)

Nursing Diagnosis,

243

(1)

Nursing Goals/Outcomes,

243

(1)

Nursing Interventions,

243

(2)

Nursing Process for Diarrhea,

245

(2)

Assessment,

245

(1)

Nursing Diagnosis,

245

(1)

Nursing Goals/Outcomes,

245

(1)

Nursing Interventions,

245

(2)

Nursing Process for Bowel Incontinence,

247

(1)

Assessment,

247

(1)

Nursing Diagnosis,

247

(1)

Nursing Goals/Outcomes,

247

(1)

Nursing Interventions,

247

(1)

Nursing Process for Impaired Urinary Elimination,

248

(7)

Urinary retention,

248

(1)

Urinary Incontinence,

248

(1)

Assessment,

249

(1)

Nursing Diagnosis,

250

(1)

Nursing Goals/Outcomes,

250

(1)

Nursing Interventions,

250

(5)

20 Activity and Exercise,

255

(23)

Normal Activity Patterns,

255

(1)

Activity and Aging,

256

(1)

Effects of Disease Processes on Activity,

256

(1)

Nursing Process for Impaired Physical Mobility,

257

(7)

Assessment,

257

(1)

Nursing Diagnosis,

258

(1)

Nursing Goals/Outcomes,

258

(1)

Nursing Interventions,

258

(6)

Nursing Process for Activity Intolerance,

264

(2)

Assessment,

265

(1)

Nursing Diagnosis,

265

(1)

Nursing Goals/Outcomes,

265

(1)

Nursing Interventions,

265

(1)

Nursing Process for Problems of Oxygenation,

266

(3)

Assessment,

266

(1)

Nursing Diagnosis,

266

(1)

Nursing Goals/Outcomes,

267

(1)

Nursing Interventions,

267

(2)

Nursing Process for Self-Care Deficits,

269

(3)

Assessment,

270

(1)

Nursing Diagnosis,

270

(1)

Nursing Goals/Outcomes,

270

(1)

Nursing Interventions,

270

(2)

Nursing Process for Deficient Diversional Activity,

272

(3)

Assessment,

272

(1)

Nursing Diagnosis,

273

(1)

Nursing Goals/Outcomes,

273

(1)

Nursing Interventions,

273

(2)

Rehabilitation,

275

(1)

Negative Attitudes:The Controlling or Custodial Focus,

275

(1)

Positive Attitudes: The Rehabilitative Focus,

276

(2)

21 Sleep and Rest,

278

(7)

Sleep Rest Health Pattern,

278

(1)

Normal Sleep and Rest,

278

(2)

Sleep and Aging,

279

(1)

Sleep Disorders,

279

(1)

Nursing Process for Disturbed Sleep Pattern,

280

(5)

Assessment,

280

(1)

Nursing Diagnosis,

281

(1)

Nursing Goals/Outcomes,

281

(1)

Nursing Interventions,

281

(4)

Appendix A,

285

(5)

Appendix B,

290

(5)

Appendix C,

295

(2)

Bibliography and Reader Reference,

297

(5)

Illustration Credits,

302

(2)

Glossary,

304

(5)

Index,

309

(10)

Student Activities,

319

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