geri week 4
Card Set Information
geri week 4
Geri week 4
Geri week 4
Define commonality and what are the barriers of quality care?
Commonality is the statistical appreciation of differences in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions.
Barriers to quality care range from those related to geographical location to age, gender, race, ethnicity, and sexual orientation.
Ex. of health disparities of African Americans in stroke, heart disease, htn, diabetes, amputations, and ischemic attacks.
50% more likely to have stroke
50% more likely to die of stroke
20% more likely to die of heart disease
1.5 times more likely to have hypertension
2.5 times more likely to have diabetes
30% more likely to have diabetes-related amputations
62% fewer of those who experience transient ischemic
attack (TIA) get anticoagulation
Ex. of Health Disparities of Mexican Americans and Native Americans
Mexicans get 2 times more likely to have diabetes mellitus and 36% fewer prescriptions after myocardial infarction
Native Americans are 5.7 times more likely to have DM than whites living in Hawaii.
How do you reduce health disparities ?
Health care providers must be culturally competent
: able to move smoothly btw the world of the nurse and the world of the patients and requires cultural awareness and sensitivity, knowledge, and skills
Culture awareness is:
Recognizing the presences of isms
What is cultural knowledge?
What a nurse brings to caring situations as well as what a nurse learns about older adults, their families, their communities, their behaviors, and their expectations
Essential knowledge includes elder's way of life
Working with interpreters:
: The process of rendering oral expressions made in one language system into another in a manner that preserves the meaning and tone of the original without adding or deleting anything.
: Addressing the person in the appropriate manner. Using body language that is acceptable in the culture.
Implications for Gerontological Nursing include:
Assessment: listening is key to assessment as nurse tries to understand situation and person, health beliefs, and cultural beliefs
Cross-Cultural Caring in the Long-term care setting
Ensuring that resident has access to professional interpreter services if needed
Developing programs that reflect diversity of residents and staff
Considering monocultural facilities or units where population demographics warrant
Employing staff who reflect diversity of residents or clients
Culture, Nursing, and Maslow's hierarchy of needs
Promoting healthy aging in care of ethnic elders frequently provides gerontological nurse with new challenges, and necessitates different conceptualization of Maslow's hierarchy
Nutrition and Aging: Adequate Nutrition (3)
Critical to preserving the health of older people
An integral part of health, happiness, independence, quality of life, and physical and mental functioning
All of the essential nutrients are adequately supplied and used to maintain optimal health and well-being
Major nutrition-related concerns in older adults:
Obesity and Malnutrition
Factors affection fulfillment of nutritional needs: Age related changes (4)
Regulation of appetite
Factors affecting fulfillment of nutritional needs: Lifelong Eating Habits
Implication for Gerontological Nursing and healthy aging:
Assessment: Good oral hygiene and assessment of oral health are essentials of nursing care.
Implications for gerontological nursing and healthy aging: Interventions
Oral hygiene: When the person is unable to carry out his or her dental/oral regimen, it is the responsibility of the caregiver to provider oral care.
Implications for Geri Nursing: Hospitalization and Institutional living
Assessment of nutritional status to identify malnutrition and the risk factors for malnutrition.
If caloric supplements are used, they should be administered at least one hour before meals or they interfere with meal intake
Attention to the environment in which meals are served is important.
Health conditions affecting nutrition: Chronic Diseases (9)
Cardiovascular and respiratory diseases
Affects adequate nutritional intake, and in late dementia weight loss becomes a considerable concern
Establishing a routine so the elder does not have to remember times and places for eating
Serve well-balanced foods and fluids that the person likes and has always eaten.
May occur as a result of neurologic diseases such as stroke, Parkinson's disease, multiple sclerosis, and dementia
Negative consequences including weight loss, malnutrition, dehydration, and aspiration
Carries a sevenfold increased risk of aspiration pneumonia
Classified as oropharyngeal or esophageal
Implications for gerontological nursing and healthy aging: Assessment
Obtain a careful history of the elders response to dysphagia and observe the person during mealtime
Suctioning equipment should be available
Should have supervision at mealtimes.
Feeding Tube (3)
A common approach to problems with nutritional intake in older.
Percutaneous endoscopic gastrostomy (PEG)
: aspiration pneumonia, diarrhea, metabolic problems, and cellulitis
Nurse and dietician must work closely together to determine the appropriate formula and rate of administer
Most common GI compliant
Constipation is a symptom
: poor habits, postponed passage of stool, chronic illnesses-- both physical and psychological, side effect of medication
The precipitants and causes of constipation
Clarification of what the patient means by constipation
: usual pattern, frequency of bowel movement, size, consistency, and any changes
Physical examination is needed to rule out systemic causes
Examine the medications the person is taking
Positioning during defecation
fecal impaction removal
Protein-Calorie Malnutrition and serious consequences
Most common form of malnutrition in older adults
Characterized by the presence of clinical signs and biochemical indicators indicative of insufficient intake
: Infections, pressure ulcers, anemia, htn, impaired cognition, hip fractures, and increased mortality and morbidity.
Nutritional Assessment (4)
Centered on techniques to increase food intake and enhance and manage the environment to promote increased food intake
Application of Maslow's hierarchy
Food is a basic human need for people of all ages
Not only does adequate nutrition satisfy biological needs, but also the experience of eating provides opportunities for belonging.