Gerontological Nursing 10th edition by Charlotte Eliopoulos ISBN 1975161009 978-1975161002

UNIT 1 THE AGING EXPERIENCE

1 The Aging Population

Views of Older Adults Through History

Characteristics of the Older Adult Population

Population Growth and Increasing Life Expectancy

Marital Status and Living Arrangements

Income and Employment

Health Insurance

Health Status

Implications of an Aging Population

Impact of the Baby Boomers

Provision of and Payment for Services

2 Theories of Aging

Biological Theories of Aging

Stochastic Theories

Nonstochastic Theories

Sociologic Theories of Aging

Disengagement Theory

Activity Theory

Continuity Theory

Subculture Theory

Age Stratification Theory

Psychological Theories of Aging

Developmental Tasks

Gerotranscendence

Nursing Theories of Aging

Functional Consequences Theory

Theory of Thriving

Theory of Successful Aging

Applying Theories of Aging to Nursing Practice

3 Diversity

Increasing Diversity of the Older Adult Population

Overview of Diverse Groups of Older Adults in the United States

Hispanic Americans

Black Americans

Asian Americans

Jewish Americans

Native Americans

Muslims

Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults

Nursing Considerations for Culturally Sensitive Care of Older Adults

Nurses’ Feelings and Attitudes

Patients’ Feelings and Attitudes

4 Life Transitions and Story

Ageism

Changes in Family Roles and Relationships

Parenting

Grandparenting

Loss of Spouse

Retirement

Loss of the Work Role

Reduced Income

Changes in Health and Functioning

Cumulative Effects of Life Transitions

Shrinking Social World

Awareness of Mortality

Responding to Life Transitions

Life Review and Life Story

Self-Reflection

Strengthening Inner Resources

5 Common Aging Changes

Changes to the Body

Cells

Physical Appearance

Respiratory System

Cardiovascular System

Gastrointestinal System

Urinary System

Reproductive System

Musculoskeletal System

Nervous System

Sensory Organs

Endocrine System

Integumentary System

Immune System

Thermoregulation

Changes to the Mind

Personality

Memory

Intelligence

Learning

Attention Span

Nursing Implications of Age-Related Changes

UNIT 2 FOUNDATIONS OF GERONTOLOGICAL NURSING

6 The Specialty of Gerontological Nursing

Development of Gerontological Nursing

Core Elements of Gerontological Nursing Practice

Evidence-Based Practice

Standards

Competencies

Principles

Gerontological Nursing Roles

Healer

Caregiver

Educator

Advocate

Innovator

Advanced Practice Nursing Roles

Self-Care and Nurturing

Following Positive Health Care Practices

Strengthening and Building Connections

Committing to a Dynamic Process

The Future of Gerontological Nursing

Utilize Evidence-Based Practices

Advance Research

Promote Integrative Care

Educate Caregivers

Develop New Roles

Balance Quality Care and Health Care Costs

7 Holistic Assessment and Care Planning

Holistic Gerontological Care

Holistic Assessment of Needs

Health Promotion–Related Needs

Health Challenges–Related Needs

Requisites to Meet Needs

Gerontological Nursing Processes

Examples of Application

Applying the Holistic Model: The Case of Mrs. D

The Healer Role of the Nurse

Healing Characteristics

8 Legal Aspects of Gerontological Nursing

Laws Governing Gerontological Nursing Practice

Legal Risks in Gerontological Nursing

Malpractice

Confidentiality

Patient Consent

Patient Competency

Staff Supervision

Medications

Restraints

Telephone Orders

Do Not Resuscitate Orders

Advance Directives and Issues Related to Death and Dying

Elder Abuse

Legal Safeguards for Nurses

9 Ethical Aspects of Gerontological Nursing

Philosophies Guiding Ethical Thinking

Ethics in Nursing

External and Internal Ethical Standards

Ethical Principles

Cultural Considerations

Ethical Dilemmas Facing Gerontological Nurses

Changes Increasing Ethical Dilemmas for Nurses

Measures to Help Nurses Make Ethical Decisions

10 Continuum of Care in Gerontological Nursing

Services in the Continuum of Care for Older Adults

Supportive and Preventive Services

Partial and Intermittent Care Services

Complete and Continuous Care Services

Complementary and Alternative Services

Matching Services to Needs

Settings and Roles for Gerontological Nurses

General

Nursing Homes

Adult Day Care

Support Groups

UNIT 3 HEALTH PROMOTION

11 Nutrition and Hydration

Nutritional Needs of Older Adults

Quantity and Quality of Caloric Needs

Nutritional Supplements

Special Needs of Women

Hydration Needs of Older Adults

Promotion of Oral Health

Threats to Good Nutrition

Indigestion and Food Intolerance

Anorexia

Dysphagia

Constipation

Malnutrition

Addressing Nutritional Status and Hydration in Older Adults

12 Sleep and Rest

Age-Related Changes in Sleep

Circadian Sleep–Wake Cycles

Sleep Stages

Sleep Efficiency and Quality

Sleep Disturbances

Insomnia

Nocturnal Myoclonus and Restless Legs Syndrome

Sleep Apnea

Medical Conditions That Affect Sleep

Drugs That Affect Sleep

Other Factors Affecting Sleep

Promoting Rest and Sleep in Older Adults

Pharmacologic Measures to Promote Sleep

Nonpharmacologic Measures to Promote Sleep

Pain Control

13 Comfort and Pain Management

Comfort

Pain: A Complex Phenomenon

Prevalence of Pain in Older Adults

Types of Pain

Pain Perception

Effects of Unrelieved Pain

Pain Assessment

An Integrative Approach to Pain Management

Complementary Therapies

Dietary Changes

Medication

Comforting

14 Safety

Aging and Risks to Safety

Importance of the Environment to Health and Wellness

Impact of Aging on Environmental Safety and Function

Lighting

Temperature

Colors

Scents

Floor Coverings

Furniture

Sensory Stimulation

Noise Control

Bathroom Hazards

Fire Hazards

Psychosocial Considerations

The Problem of Falls

Risks and Prevention

Risks Associated With Restraints

Interventions to Reduce Intrinsic Risks to Safety

Reducing Hydration and Nutrition Risks

Addressing Risks Associated With Sensory Deficits

Addressing Risks Associated With Mobility Limitations

Monitoring Body Temperature

Preventing Infection

Suggesting Sensible Clothing

Using Medications Cautiously

Avoiding Crime

Promoting Safe Driving

Promoting Early Detection of Problems

Addressing Risks Associated With Functional Impairment

15 Safe Medication Use

Effects of Aging on Medication Use

Polypharmacy and Interactions

Altered Pharmacokinetics

Altered Pharmacodynamics

Increased Risk of Adverse Reactions

Promoting the Safe Use of Drugs

Avoiding Potentially InappropriateDrugs: Beers Criteria

Reviewing Necessity and Effectiveness of Prescribed Drugs

Promoting Safe and Effective Administration

Providing Patient Teaching

Monitoring Laboratory Values

Alternatives to Drugs

Review of Selected Drugs

Analgesics

Antacids

Antibiotics

Anticoagulants

Anticonvulsants

Antidiabetic (Hypoglycemic) Drugs

Antihypertensive Drugs

Nonsteroidal Anti-inflammatory Drugs

Cholesterol-Lowering Drugs

Cognitive Enhancing Drugs

Digoxin

Diuretics

Laxatives

Psychoactive Drugs

UNIT 4 GERIATRIC CARE

16 Respiration

Effects of Aging on Respiratory Health

Respiratory Health Promotion

Selected Respiratory Conditions

Chronic Obstructive Pulmonary Disease

Pneumonia

Influenza

Lung Cancer

Lung Abscess

General Nursing Considerations for Respiratory Conditions

Recognizing Symptoms

Preventing Complications

Ensuring Safe Oxygen Administration

Performing Postural Drainage

Promoting Productive Coughing

Using Complementary Therapies

Promoting Self-Care

Providing Encouragement

17 Circulation

Effects of Aging on Cardiovascular Health

Cardiovascular Health Promotion

Proper Nutrition

Adequate Exercise

Cigarette Smoke Avoidance

Stress Management

Proactive Interventions

Cardiovascular Disease and Women

Selected Cardiovascular Conditions

Hypertension

Hypotension

Congestive Heart Failure

Pulmonary Emboli

Coronary Artery Disease

Hyperlipidemia

Arrhythmias

Peripheral Vascular Disease

General Nursing Considerations for Cardiovascular Conditions

Prevention

Keeping the Patient Informed

Preventing Complications

Promoting Circulation

Providing Foot Care

Managing Problems Associated With Peripheral Vascular Disease

Promoting Normality

Integrating Complementary Therapies

18 Digestion and Bowel Elimination

Effects of Aging on Gastrointestinal Health

Gastrointestinal Health Promotion

Selected Gastrointestinal Conditions and Related Nursing Considerations

Dry Mouth (Xerostomia)

Dental Problems

Dysphagia

Hiatal Hernia

Esophageal Cancer

Peptic Ulcer

Cancer of the Stomach

Diverticular Disease

Colorectal Cancer

Chronic Constipation

Flatulence

Intestinal Obstruction

Fecal Impaction

Fecal Incontinence

Acute Appendicitis

Cancer of the Pancreas

Biliary Tract Disease

19 Urinary Elimination

Effects of Aging on Urinary Elimination

Urinary System Health Promotion

Selected Urinary Conditions

Urinary Tract Infection

Urinary Incontinence

Bladder Cancer

Renal Calculi

Glomerulonephritis

General Nursing Considerations for Urinary Conditions

20 Reproductive System Health

Effects of Aging on the Reproductive System

Reproductive System Health Promotion

Selected Reproductive System Conditions

Problems of the Female Reproductive System

Problems of the Male Reproductive System

21 Mobility

Effects of Aging on Musculoskeletal Function

Musculoskeletal Health Promotion

Promotion of Physical Exercise in All Age Groups

Exercise Programs Tailored for Older Adults

The Mind–Body Connection

Prevention of Inactivity

Nutrition

Selected Musculoskeletal Conditions

Fractures

Osteoarthritis

Rheumatoid Arthritis

Osteoporosis

Gout

Podiatric Conditions

General Nursing Considerations for Musculoskeletal Conditions

Managing Pain

Preventing Injury

Promoting Independence

22 Neurologic Function

Effects of Aging on the Nervous System

Neurologic Health Promotion

Selected Neurologic Conditions

Parkinson’s Disease

Transient Ischemic Attacks

Cerebrovascular Accidents

General Nursing Considerations for Neurologic Conditions

Promoting Independence

Preventing Injury

23 Vision and Hearing

Effects of Aging on Vision and Hearing

Sensory Health Promotion

Promoting Vision

Promoting Hearing

Assessing Problems

Selected Vision and Hearing Conditions and Related Nursing Interventions

Visual Deficits

Hearing Deficits

General Nursing Considerations for Visual and Hearing Deficits

24 Endocrine Function

Effects of Aging on Endocrine Function

Selected Endocrine Conditions and Related Nursing Considerations

Diabetes Mellitus

Hypothyroidism

Hyperthyroidism

25 Skin Health

Effects of Aging on the Skin

Promotion of Skin Health

Selected Skin Conditions

Pruritus

Keratosis

Seborrheic Keratosis

Skin Cancer

Vascular Lesions

Pressure Injury

General Nursing Considerations for Skin Conditions

Promoting Normalcy

Using Alternative Therapies

26 Cancer

Aging and Cancer

Unique Challenges for Older Persons With Cancer

Explanations for Increased Incidence in Old Age

Risk Factors, Prevention, and Screening

Treatment

Conventional Treatment

Complementary and Alternative Medicine

Nursing Considerations for Older Adults With Cancer

Providing Patient Education

Promoting Optimum Care

Providing Support to Patients and Families

27 Mental Health Disorders

Aging and Mental Health

Promoting Mental Health in Older Adults

Selected Mental Health Conditions

Depression

Anxiety

Substance Abuse

Paranoia

Nursing Considerations for Mental Health Conditions

Monitoring Medications

Promoting a Positive Self-Concept

Managing Behavioral Problems

28 Delirium and Dementia

Delirium

Dementia

Alzheimer’s Disease

Other Dementias

Caring for Persons Living With Dementia

29 Living in Harmony With Chronic Conditions

Chronic Conditions and Older Adults

Goals for Chronic Care

Assessment of Chronic Care Needs

Maximizing the Benefits of Chronic Care

Selecting an Appropriate Physician

Using a Chronic Care Coach

Increasing Knowledge

Locating a Support Group

Making Smart Lifestyle Choices

Using Complementary and Alternative Therapies

Factors Affecting the Course of Chronic Care

Defense Mechanisms and Implications

Psychosocial Factors

Impact of Ongoing Care on the Family

The Need for Institutional Care

Chronic Care: A Nursing Challenge

UNIT 5 SETTINGS AND SPECIAL ISSUES IN GERIATRIC CARE

30 Spirituality

Spiritual Needs

Love

Meaning and Purpose

Hope

Dignity

Forgiveness

Gratitude

Transcendence

Expression of Faith

Assessing Spiritual Needs

Addressing Spiritual Needs

Being Available

Honoring Beliefs and Practices

Providing Opportunities for Solitude

Promoting Hope

Assisting in Discovering Meaning in Challenging Situations

Facilitating Religious Practices

Praying With and For

31 Sexuality and Intimacy

Attitudes Toward Sex and Older Adults

Realities of Sex in Older Adulthood

Sexual Behavior and Roles

Intimacy

Age-Related Changes and Sexual Response

Menopause as a Journey to Inner Connection

Symptom Management and Patient Education

Self-Acceptance

Andropause

Identifying Barriers to Sexual Activity

Unavailability of a Partner

Psychological Barriers

Medical Conditions

Erectile Dysfunction

Medication Adverse Effects

Cognitive Impairment

Promoting Healthy Sexual Function

32 Rehabilitative and Restorative Care

Rehabilitative and Restorative Care

Living With Disability

Importance of Attitude and Coping Capacity

Losses Accompanying Disability

Principles of Rehabilitative Nursing

Functional Assessment

Interventions to Facilitate and Improve Functioning

Facilitating Proper Positioning

Assisting With Range of Motion Exercises

Assisting With Mobility Aids and Assistive Technology

Teaching About Bowel and Bladder Training

Maintaining and Promoting Mental Function

Using Community Resources

33 Acute Care

Risks Associated With Hospitalization of Older Adults

Surgical Care

Special Risks for Older Adults

Preoperative Care Considerations

Operative and Postoperative Care Considerations

Emergency Care

Infections

Discharge Planning for Older Adults

34 Long-Term Care

Development of Long-Term Institutional Care

Before the 20th Century

During the 20th Century

Lessons to Be Learned From History

Nursing Homes Today

Nursing Home Standards

Nursing Home Residents

Nursing Roles and Responsibilities

Other Settings for Long-Term Care

Assisted Living Communities

Community-Based and Home Health Care

Looking Forward: A New Model of Long-Term Care

35 Family Caregiving

The Older Adult’s Family

Identification of Family Members

Family Member Roles

Family Dynamics and Relationships

Scope of Family Caregiving

Long-Distance Caregiving

Protecting the Health of the Older Adult and Caregiver

Family Dysfunction and Abuse

Rewards of Family Caregiving

36 End-of-Life Care

Definitions of Death

Family Experience With the Dying Process

Supporting the Dying Individual

Stages of the Dying Process and Related Nursing Interventions

Rational Suicide and Assisted Suicide

Physical Care Challenges

Spiritual Care Needs

Signs of Imminent Death

Advance Directives

Supporting Family and Friends

Supporting Through the Stages of the Dying Process

Helping Family and Friends After a Death

Supporting Nursing Staff

Appendix A: Next Generation NCLEX-Style Case Studies and Questions Available on

Appendix B: Answers to Next Generation NCLEX-Style Questions Available on

Index