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Flashcards by Nestor Malundu, updated more than 1 year ago
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| Question | Answer |
| Society often views old age as? | Decline, disease, disability, decrepitude or death. (this isn't the case) |
| What are the main causes of death for older Australians? | Heart Disease Stroke Cancer |
| What is the main contributor for burden of disease for people aged over 85 years | Dementia |
| What is WHO's definition of active ageing? | ‘the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age’ allowing people to ‘realize their potential for physical, social and mental well-being throughout the life course’ |
| What is included in an age-friendly city? | Outdoor spaces and buildings Transportation and Housing Social participation Respect and social inclusion Civic participation and employment Communication and information Community and health services |
| What is Person Centred Care? | holistic care; realistic (collaborative) goal setting; interdisciplinary care. |
| What can you do as a nurse to insure optimal age care? | -Advocate on behalf of older people and challenge ageism -Understand and integrate health, community and government resources -Focus on person centred care |
| Define STROKE | term describing neurological changes caused by an interruption of blood supply to a part of the brain (decrease in oxygen to a localised area=neural tissue destruction=brain damage) |
| What are the two main stroke types | Ischemic and Haemorrhagic |
| Lack of oxygen to the brain can result in irreversible brain damage after how long? | 5 mins |
| what is an Ischaemic Stroke | artery blocked by a blood clot (embolic and thrombotic) |
| what is a haemorrhagic stroke | Artery bursts causing a bleed (subarachnoid and intracerebral) |
| what does TIA stand for? and what is it? | Transient Ischaemic Attack when blood supply to the brain is interrupted for a short period of time |
| TRUE or FALSE Do mini-strokes (TIA) resolve within 24 hours? | TRUE |
| What are the impacts of a stroke | Mobility daily activities relationships and family emotional psychological |
| FACTS | 1 in 6 people will have a stroke 2nd biggest killer and leading cause of disability in Australia |
| FACT | stroke victims- 1/3 die within 12 months 1/3 full recovery 1/3 left with a disability |
| Non modifiable risk factors of a stroke | age, sex (more in males), race and family history |
| Modifiable risk factors for stroke | hypertension hypercholesteremia diabetes mellitus cardiac disease TIA tobacco use, pill, obesity, alcohol, diet, stress |
| How do you know if someone is having a STROKE? | F.A.S.T face, arms, speech, time |
| Signs and Symptoms of STROKE | weakness/numbness vision loss difficulty speaking/swallowing headache/dizziness facial droop loss of consciousness |
| what is penumbra? | zone of compromised cells that are unable to function but remain viable |
| what is the pathophysiology of an Ischaemic stroke | Ischaemia>Infarction> Necrosis |
| TRUE OR FALSE The brain doesn't depend of glucose for metabolism | FALSE totally dependant |
| NURSES ROLE in stroke management | primary and secondary prevention of stroke initial management rehabilitation discharge planning pt education |
| Goal of acute stroke management | adequate airway and O2 stable and slightly ^ BP serum glucose maintained aseptic techniques |
| Required vital signs for a stroke patient | 2/24 GCS 4/24 vitals continuous cardiac monitoring BGL monitoring |
| what does ICP stand for? | Intracranial pressure |
| reasons for deterioration post stroke | progression of stroke extension of stroke ^ICP- cerebral oedema haemorrhagic transformation of infarcted brain seizures |
| signs and symptoms of ^ICP | decreased level of consciousness ^ severity of headache nausea and vomiting cushings triad |
| Thrombolysis with Alteplase after acute ischemic stroke | given with 3-4.5 hours |
| Recognising and responding to acute deterioration in older adults | Physiological observations recorded at the time of admission/initial assessment or regular observation − clear documentation of the assessment and a monitoring plan. The plan should take account of the: ◊ patient’s diagnosis ◊ presence of comorbidities ◊ agreed treatment plan. |
| what are the four steps of Recognising and responding to acute deterioration | 1.Awareness and utilisation of established recognition and response systems 2.Escalation of care 3. Responses to clinical deterioration 4. Communicating with patients and carers |
| what are the contexts of acute deterioration in older persons | frailty disability co-morbidity |
| what is frailty? | Frailty syndrome: accumulation of physiological deficits which individually may be reversible but collectively can represent an intractable burden of disease |
| what are the contributions to frailty syndrome? | Chronic undernutrition Sarcopenia Decreased metabolic rate Reduced energy expenditure |
| what is the Comprehensive Geriatric Assessment (CGA) | CGA is an evidenced based model for the provision of co-ordinated, interdisciplinary acute medical care for older patients. CGA is both diagnostic and therapeutic -identifies the multiple overlapping problems of older patients |
| What are the domains of the CGA | medical mental health functional capacity social circumstances environment |
| What is the AMBER care bundle used for? | help clinicians identify patients whose recovery is uncertain and, while continuing treatment, initiate discussions between clinicians, patients and families about their preferences and putting plans in place should their health deteriorate. |
| what does AMBER care bundle stand for? | A- assessment M- management B- best practice E- engagement R- recovery uncertain |
| Definition of a wound | a break in the epithelial integrity of the skin the disruption could be deeper, extending into the dermis, subcutaneous fat, fascia, muscle or even the bone’1 |
| what are the phases of wound healing | 1. haemostasis/inflammatory (0-10) 2. proliferative (1-30) 3. remodelling (10-300) |
| types of wound closure | primary delayed primary (due to inflammation etc) secondary skin graft flap repair |
| Local factors affecting wound healing | necrotic burden wound temp wound exudate wound moisture |
| systematic factors affecting wound healing? | underlying disease e.g.. diabetes oedema sepsis stress medications smoking obesity |
| Wound assessment | Wound history Medications Type: acute/chronic Stage: location pain assessment infection characteristics |
| Skin Tear Management | Attempt to replace tissue if viable e.g. roll back skin, use moistened cotton bud and gently syringe with saline Dress with non-adherent dressing e.g. Mepitel or Mepilex range of products which can be left intact for 5 days, mark direction for removal If non-healing, refer to GP, Wound CNC, Plastics/Surgical Team for further advice |
| What is a pressure injury? | A pressure injury (PI) is a “localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction.” |
| Leg ulcer treatment | Direct management Venous = compression, surgery Arterial = re-purfusion Vasculitic = treat underlying condition Neoplastic = treat according to lesion |
| What are the factors of Wound management | -Patient position for delivery of care -Dressing Schedule, e.g. the dressing type, amount of wound exudate -Treatment objective/goal of wound care -Pain score/analgesic use -Cleansing Solution and techniques for cleaning the wound -Surrounding Skin Care, e.g. moisturiser, barrier wipes |
| Types of dressings | Primary Dressing, e.g. hydrofibre, gel, foam, silicone product Secondary Dressing e.g. foam, gauze, super-absorbant pads Fixation/Retention e.g. tapes, stockingette, bandage, velband/softban |
| Define Dementia | “Dementia is the term used to describe the symptoms of a large group of illnesses which cause a progressive decline in a person’s functioning. It is a broad term used to describe a loss of memory, intellect, rationality, social skills and what would be considered normal emotional reactions.” There are a variety of causes. The most common cause of dementia is Alzheimer’s disease |
| FACTS- DEMENTIA | Dementia is NOT a normal part of ageing. However, the longer a person lives, the more likely they are to develop dementia. Dementia is more common after the age of 65 years. The risk is one person in four over the age of 85 years. |
| Normal brain functions and parts | Frontal lobe – Planning, organisation and decision-making. Social behaviour and starting and stopping tasks. Temporal lobe – Memory of what is read, seen or heard. Parietal lobe – Language, speech, reading, maths, spatial awareness, recognition and naming. Occipital lobe - Vision Cerebellum – Balance, coordination of voluntary movement Brain stem – Breathing, heart rate, swallowing, reflexes, temperature, blood pressure, etc. |
| Common causes of dementia | Alzheimer’s disease (50%-70% of cases) Vascular dementia Dementia with Lewy bodies Fronto Temporal Lobar Degeneration |
| Rare causes of dementia | Parkinson’s disease Alcohol related dementia (Korsakoff’s syndrome) Creutzfeldt-Jacob disease (mad cow disease) AIDS related dementia Huntington’s disease |
| List the therapeutic approaches to communication with people with dementia | reality therapy reminisce therapy validation therapy |
| Risk factors for incontinence | age obesity pregnancy, child birth UTI Diabetes dementia/cognitive impairment menopause chronic illness mobility impairment |
| Types of urinary incontinence | 1. stress 2. urinary 3. mixed (1+2) 4. nocturnal enuresis 5. continuous leakage 6. overactive bladder 7. functional |
| management of incontinence | determine the cause and reverse where possible. Voiding and defecation diaries Bladder and bowel training Pelvic floor muscle exercises Prompted toileting. Dietary modifications. Pharmacological management Continence aids and appliances |
| Aetiology of constipation in older persons. | Cardiac disorders.-Congestive cardiac failure Dietary causes- Low fibre in diet, fluid depletion. Endocrine and metabolic- Diabetes mellitus, hypothyroidism etc. Myopathic disorders-Amyloidosis, systemic sclerosis. Neurological.-Dementia, depression, autonomic neuropathy etc Gastrointestinal disorders-Anal fissure, external compression (e.g. from a tumour), diverticular disease, strictures, (inflammatory, post diverticulitis, post ischaemic, post-radiotherapy) General- Bedridden status. |
| Medications associated with constipation | Anticholinergics , Antidepressants, Antihistamines, Anticonvulsants Antipsychotics, Calcium-channel blockers Clonidine (Catapress), Diuretics, Iron, Levodopa, NSAIDS, Opioid, Psychotrophics |
| What are the ethical principles? | autonomy- consent, confidentially beneficence- relevant skills non-maleficence- relevant skills justice- respect law and rules |
| What is an advance directive | A person with capacity indicates wishes re treatment – relevant for possible future time when no longer competent |
| What is a substituted decision maker | A SDM is an authorised representative for a person who lacks capacity Nominated Appointed |
| Palliative care definition(WHO) | Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. |
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