GERONTOLOGY NURSING

• Table Of Contents

Learning Objectives

After completing the course, you’ll be able to:

1. Define the older adult population, recognizing stereotypes applied to this population

2. Recognize the complexity of factors that influence the lives of older adults–including health maintenance, available care during illness or disability, and current health care financing and services–and the significance of environmental factors that include geographic location and features of the individual’s community and home

3. Describe sociologic, economic, and educational trends among older adults

4. Recognize current demographic trends among older adults in the United States, identifying present and predictive trends

5. Discuss the history of gerontologic nursing

6. Describe the current status of gerontologic nursing

7. Identify the importance of the nursing process, including nursing diagnosis

8. Recognize several conceptual or theoretic frameworks for nursing

9. Describe the results of the leadership efforts of the American Nurses’ Association in defining standards for gerontologic nursing, initiating and maintaining nursing certification, and defining the nature and scope of nursing

10. Recognize the contributions of the teaching nursing homes

11. Identify what is known about the causes of aging

12. Recognize that overlap and duplication exist among the aging theories that have been reported to date

13. Discuss selected biologic and psychosocial theories about aging

14. Understand that application of theories about aging can enhance the nursing care of older adults

15. Describe social role changes experienced by older adults in the United States

16. Describe changing family roles experienced by older adults in the United States

17. Discuss the patterns of late life marriages

18. Examine the positive and negative consequences of retirement for older adults

19. Discuss physiological age related changes that affect the pharmacologic dynamics of the older person

20. Identify signs and symptoms of adverse drug reactions common in older adults

21. Recognize high risk drugs and their potential for harm and benefit to older adults

22. Identify drug drug interactions in older adults

23. Recognize the risks and benefits of the use of over the counter (OTC) drugs in older adults

24. Discuss methods to increase older adults’ ability to understand and to follow medication prescriptions.

25. Describe sexuality as an integral component of the older adult’s personality

26. Identify age related changes and health deviations that affect sexual function of older adults

27. Describe demographic, physiologic, and social factors that affect the sexual function of older adults

28. Discuss older adults’ needs for closeness, touch, warmth, and sharing

29. Identify age related changes in vision, hearing, smell, and taste

30. Assess the senses of sight, hearing, smell, taste, and touch of the older adult

31. Recognize psychologic and sociocultural factors that interact with sensory functioning

32. Understand the causes of sensory impairment in older people

33. Develop a plan of nursing care for an older person with sensory impairment

34. Provide appropriate nursing interventions for older adults with sensory impairment

35. Identify age related changes in the integument and in the oral mucous membranes

36. Assess the older adult’s integument and oral mucous membranes

37. Recognize risk factors that lead to impaired skin integrity and alterations in oral mucous membranes

38. Describe the causes of integumentary impairment, and oral mucous membrane impairment in older adults

39. Develop a plan of nursing care for an older adult with integumentary impairment or with alterations in oral mucous membranes

40. Implement appropriate nursing interventions for older adults with integumentary impairment and with alterations in oral mucous membranes

41. Evaluate the effectiveness of nursing interventions carried out to resolve integumentary and oral mucous membrane problems

42. Discuss age related changes in the endocrine system

43. Recognize the prevalence of diabetes in the older adult population

44. Describe the nursing care of the older diabetic patient

45. Discuss the vulnerability of an older adult to disorders of temperature regulation

46. Recognize signs and symptoms of hypothermia and hyperthermia in an older adult.

47. Identify age related changes and environmental factors that increase susceptibility to infection in the older adult

48. Describe the nursing care of the older person with an infection

49. Identify age related physiologic changes of the cardiovascular and peripheral vascular system

50. Identify and describe the common pathophysiologic changes that affect the cardiovascular system of the older adult

51. Assess the cardiovascular functioning of older adults

52. Recognize the psychosocial and cultural factors that influence the nursing management of older adults with cardiovascular problems

53. Develop a plan of care for an older adult with cardiovascular impairment

54. Provide appropriate nursing interventions for older adults with cardiovascular impairment

55. Explain the normal structure and function of the respiratory tract

56. Identify age related physiologic changes of the respiratory system

57. Identify and describe the common pathophysiologic changes that affect the respiratory system of older adults

58. Assess the respiratory functioning of older adults

59. Recognize the psychosocial and environmental factors that influence the nursing management of older adults with respiratory problems

60. Develop nursing diagnoses and a plan of care for an older person with respiratory impairment

61. Provide appropriate nursing interventions and evaluations for older adults with respiratory impairment

62. Define mobility

63. Understand the anatomy and the physiology of the musculoskeletal system

64. Know the physical and psychosocial aspects of mobility in the older adult

65. Recognize normal age related changes and common health deviations in the musculoskeletal system that affects mobility of the older adult

66. Specify common psychosocial problems in relation to health deviations in mobility

67. Assess functional mobility of the older adult

68. Use the nursing process in determining the care of people with problems in mobility

69. Develop methods for promoting healthy mobility throughout the adult life span

70. Identify and describe the types and causes of urinary incontinence experienced by older adults

71. Describe and/or perform history taking, and physical and functional assessments for patients with urinary incontinence

72. Describe urodynamic assessment

73. Recognize the psychosocial consequences of urinary incontinence for older adults and their families

74. Identify and describe behavioral therapies for urinary incontinence

75. Provide appropriate nursing interventions, patient education, and advocacy for older adults with urinary incontinence

76. Explain the normal structure and function of the gastrointestinal (GI) system and identify age related changes that influence bowel elimination

77. Recognize the significance and prevalence of constipation in older adults

78. Identify the contributing factors that cause constipation

79. Assess patients for actual or potential constipation

80. Develop a plan of care to manage constipation

81. Discuss appropriate nursing interventions for patients with constipation

82. Promote normal bowel elimination for older adults

83. Evaluate the effectiveness of a plan of care for constipation

84. Recognize the physiologic, psychosocial, and environmental factors that influence the maintenance of the nutritional status of the older adult

85. Discuss drug nutrient interactions and their effect on older adults

86. Discuss pathologic conditions that affect the nutritional status of the older adult

87. Describe the components of nutritional assessment for the older adult

88. Develop a plan of care for the older adult with an alteration in nutrition

89. Design appropriate nursing interventions for older adults with alterations in nutrition

90. Describe strategies for promoting optimum nutrition in the older adult.

91. Identify the stages of normal sleep

92. Understand how aging influences sleep patterns.

93. Describe sleep disorders that occur as people age

94. Recognize what promotes or inhibits sleep in older adults

95. Assess sleep patterns of older adults

96. Develop a plan of care for an older adult experiencing a sleep pattern disturbance

97. Identify appropriate nursing interventions for older adults with sleep pattern disturbance

98. Promote healthy adaptation of older adults to changes in the sleep cycle caused by aging.

99. Discuss three mental disorders that are frequently experienced by older adults and the relationship between increasing age and the prevalence of these disorders

100. Differentiate between two cognitive disorders, dementia and delirium, and specify their distinguishing features

101. Differentiate between cognitive disorders and depression, a mood disorder

102. Describe the effects of cognitive disorders and depression on the older individual.

103. Discuss the role of the caregiver of the cognitively impaired and/or depressed older person

104. Discuss the assessment process as it applies to cognitive impairment and the use of instruments to assist in diagnosing the nursing needs of the cognitively impaired or depressed person

105. Implement nursing interventions that meet the special needs of cognitively older adults

106. Discuss the concept of safety as it applies to the older adult

107. Discuss the incidence of injury in the older population

108. Recognize the older adult who is at risk for falling

109. Discuss interventions to diminish the risk of falling for older adults

110. Identify the susceptibility of the older adult to sustaining an injury as a result of a traffic accident and/or burns

111. Recognize signs and symptoms of elder abuse

112. Discuss the use of restraints with older patients

113. Understand the problem of cancer, its myths, and its biases as they related to the older adult

114. Discuss biologic aspects of aging as they relate to cancer incidence, morbidity, and mortality

115. Recognize major issues (e.g., age, gender, extent of disease, and comorbidity) that may influence decisions concerning eligibility for screening, extent of diagnostic workup, treatment, and treatment aggression for the older adult experiencing cancer

116. Address (1) the major therapeutic modalities employed in cancer treatment; (2) the major cancers affecting the older adult; and (3) the nurse’s role in caring for the older adult experiencing cancer

117. Identify patterns of care for the older adult, family, and community experiencing cancer

118. Project future goals for approaches to cancer prevention, control, treatment, and research in the older adult

119. Define the concepts of loss, bereavement, and grief

120. Describe the relevance of these concepts (loss, bereavement, and grief) to the older population

121. Describe the phases of bereavement, including the physical, psychologic, social, and spiritual manifestations of each

122. Describe the emotional responses to dying, using a dynamic model of coping responses

123. Describe nursing roles related to care of the dying older person and the person’s family in various care settings

124. Describe the care of a person experiencing spiritual distress in relation to death

125. Apply the nursing process to the care of the bereaved and the care of the dying person

126. Discuss the legal aspects of planning that will help older adult patients manage their affairs, and plan for their potential inability to manage their own affairs

127. Identify the public benefit programs that may assist the older adult

128. Describe the main regulations governing nursing homes

129. Compare and contrast four current approaches to studying and applying bioethics: principle-based ethics, virtue theory, communitarianism, and caring

130. Critique age-based rationing as a means to achieve intergenerational justice

131. Counsel frail older adults who seek assistance in making end-of-life treatment decisions

132. Describe the advocacy responsibilities and related competencies of gerontologic nurses

133. Identify strategies to prevent and resolve ethical conflict

134. Use a process of ethical decision making to resolve moral distress and dilemmas

135. Appreciate the importance of stating ideas and contributing suggestions in public policy discussions to advance professional nursing

136. Contribute to the refinement of nursing language, including nursing diagnoses that will improve the understanding of nursing and encourage clear and frequent communication

137. Emulate models of care that enable improved practice, research, and education to be understood and applied in patient care

138. Prepare for and be prepared to cope with the adjustment that are anticipated to be imposed in the twenty-first century