Deck 34: The Aging Individual

Question 1

Which theory of aging postulates that life span and longevity changes are predetermined?

Answer 1

Genetic theory:
Genetic theory states that aging is an uncontrolled, inherited procedure that operates overtime to change cellular or tissue structures. It suggests that life span and longevity alteration are predetermined.

Question 2

Discuss societal perspectives on aging.

Answer 2

Societal perspectives on aging:
The concept of being old changed significantly over the years because the life expectancy of men and women changed as civilizations developed. Citing the 2012 report of N, the average life expectancy of Americans in 2011 was 78.7 years. However, one simply cannot define "old" with a number. Some individuals who are at 60 look young and some may already look old at 45.
Among the youth-oriented American culture, growing old or aging has not been popular. People are afraid to grow old because of various myths and stereotyping. Their idea of elderly people is depressed, sick, obsessed with death, senile, and incapable. These wrong perceptions change the way the elderly are treated. Rather than these misconceptions, everyone, especially the healthcare providers, must see the elderly as people with specific abilities and needs.

Question 3

Stanley, age 72, is admitted to the hospital for depression. His son reports that he has periods of confusion and forgetfulness. In her admission assessment, the nurse notices an open sore on Stanley's arm. When she questions him about it, he says, "I scraped it on the fence 2 weeks ago. It's smaller than it was." How might the nurse analyze these data?

A) Consider that Stanley may have been attempting self-harm.
B) The delay in healing may indicate that Stanley has developed skin cancer.
C) A diminished inflammatory response in the elderly increases healing time.
D) Age-related skin changes and distribution of adipose tissue delay healing in the elderly.

Answer 3

Aging results in changes in both cell-mediated and antibody-mediated immune responses. The thymus gland progressively decreases in size from puberty resulting in greater vulnerability to infections. So, the weakened inflammatory response resulting in delayed healing. Hence, a wound on the elderly will most likely take longer to heal or increase the healing time.
Thus, the correct option is (c).

Question 4

M, age 76, is seeing her primary physician for her regular 6-month physical exam. Mrs. M's husband died 2 years ago, at which time she sold her home in Kansas and came to live in California with her only child, a daughter. The daughter is married and has three children (one in college and two teenagers at home). The daughter reports that her mother is becoming increasingly withdrawn, stays in her room, and eats very little. She has lost 13 pounds since her last 6-month visit. The primary physician refers Mrs. M to a psychiatrist who hospitalizes her for evaluation. He diagnoses Mrs. M with major depressive disorder.
Mrs. M tells the nurse, "I didn't want to leave my home, but my daughter insisted. I would have been all right. I miss my friends and my church. Back home I drove my car everywhere. But there's too much traffic out here. They sold my car and I have to depend on my daughter or grandkids to take me places. I hate being so dependent! I miss my husband so much. I just sit and think about him and our past life all the time. I don't have any interest in meeting new people. I want to go home!!"
Mrs. M admits to having some thoughts of dying, although she denies feeling suicidal. She denies having a plan or means for taking her life. "I really don't want to die, but I just can't see much reason for living. My daughter and her family are so busy with their own lives. They don't need me-or even have time for me!"
Answer the following question about Mrs. M:
What would be the primary nursing diagnosis for Mrs. M?

Question 5

How is the ability to learn affected by aging?

Question 6

Describe an epidemiological profile of aging in the United States.

Question 7

What is the most appropriate way to communicate with an elderly person who is deaf in his right ear?

A) Speak loudly into his left ear.
B) Speak to him from a position on his left side.
C) Speak face-to-face in a high-pitched voice.
D) Speak face-to-face in a low-pitched voice.

Question 8

M, age 76, is seeing her primary physician for her regular 6-month physical exam. Mrs. M's husband died 2 years ago, at which time she sold her home in Kansas and came to live in California with her only child, a daughter. The daughter is married and has three children (one in college and two teenagers at home). The daughter reports that her mother is becoming increasingly withdrawn, stays in her room, and eats very little. She has lost 13 pounds since her last 6-month visit. The primary physician refers Mrs. M to a psychiatrist who hospitalizes her for evaluation. He diagnoses Mrs. M with major depressive disorder.
Mrs. M tells the nurse, "I didn't want to leave my home, but my daughter insisted. I would have been all right. I miss my friends and my church. Back home I drove my car everywhere. But there's too much traffic out here. They sold my car and I have to depend on my daughter or grandkids to take me places. I hate being so dependent! I miss my husband so much. I just sit and think about him and our past life all the time. I don't have any interest in meeting new people. I want to go home!!"
Mrs. M admits to having some thoughts of dying, although she denies feeling suicidal. She denies having a plan or means for taking her life. "I really don't want to die, but I just can't see much reason for living. My daughter and her family are so busy with their own lives. They don't need me-or even have time for me!"
Answer the following question about Mrs. M:
Formulate a short-term goal for Mrs. M.

Question 9

What is the most common cause of psychopathology in the elderly?

Question 10

Discuss various theories of aging.

Question 11

Why is it important for the nurse to check the temperature of the water before an elderly individual gets into the shower?

A) The client may catch cold if the water temperature is too low.
B) The client may burn himself because of a higher pain threshold.
C) Elderly clients have difficulty discriminating between hot and cold.
D) The water must be exactly 98.6°F.

Question 12

M, age 76, is seeing her primary physician for her regular 6-month physical exam. Mrs. M's husband died 2 years ago, at which time she sold her home in Kansas and came to live in California with her only child, a daughter. The daughter is married and has three children (one in college and two teenagers at home). The daughter reports that her mother is becoming increasingly withdrawn, stays in her room, and eats very little. She has lost 13 pounds since her last 6-month visit. The primary physician refers Mrs. M to a psychiatrist who hospitalizes her for evaluation. He diagnoses Mrs. M with major depressive disorder.
Mrs. M tells the nurse, "I didn't want to leave my home, but my daughter insisted. I would have been all right. I miss my friends and my church. Back home I drove my car everywhere. But there's too much traffic out here. They sold my car and I have to depend on my daughter or grandkids to take me places. I hate being so dependent! I miss my husband so much. I just sit and think about him and our past life all the time. I don't have any interest in meeting new people. I want to go home!!"
Mrs. M admits to having some thoughts of dying, although she denies feeling suicidal. She denies having a plan or means for taking her life. "I really don't want to die, but I just can't see much reason for living. My daughter and her family are so busy with their own lives. They don't need me-or even have time for me!"
Answer the following question about Mrs. M:
From the assessment data, identify the major problem that may be a long-term focus of care for Mrs. M.

Question 13

What are some factors that are thought to contribute to elder abuse?

Question 14

Describe biological, psychological, sociocultural, and sexual aspects of the normal aging process.

Question 15

B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing diagnosis for Mr. B?

A) Complicated grieving
B) Imbalanced nutrition: less than body requirements
C) Social isolation
D) Risk for injury

Question 16

Discuss retirement as a special concern to the aging individual.

Question 17

B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and he lives alone. A suicide assessment is conducted. Why is Mr. B at high risk for suicide?

A) All depressed people are at high risk for suicide.
B) Mr. B is in the age group in which the highest percentage of suicides occur.
C) Mr. B is a white man, recently bereaved, living alone.
D) His son reports that Mr. B owns a gun.

Question 18

Explain personal and sociological perspectives of long-term care of the aging individual.

Question 19

B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing intervention for Mr. B?

A) Take blood pressure once each shift.
B) Ensure that Mr. B attends group activities.
C) Encourage Mr. B to eat all of the food on his food tray.
D) Encourage Mr. B to talk about his wife's death.

Question 20

Describe the problem of elder abuse as it exists in today's society.

Question 21

In group exercise, Mr. B, a 79-year-old man with major depression, becomes tired and short of breath very quickly. This is most likely due to:

A) Age-related changes in the cardiovascular system
B) A sedentary lifestyle
C) The effects of pathological depression
D) Medication the physician has prescribed for depression

Question 22

Discuss the implications of the increasing number of suicides among the elderly population.

Question 23

Clara, an 80-year-old woman, says to the nurse, "I'm all alone now. My husband is gone. My best friend is gone. My daughter is busy with her work and family. I might as well just go, too." Which is the best response by the nurse?

A) "Are you thinking that you want to die, Clara?"
B) "You have lots to live for, Clara."
C) "Cheer up, Clara. You have so much to be thankful for."
D) "Tell me about your family, Clara."

Question 24

Apply the steps of the nursing process to the care of aging individuals.

Question 25

An elderly client says to the nurse, "I don't want to go to that crafts class. I'm too old to learn anything." Based on knowledge of the aging process, which of the following is a true statement?

A) Memory functioning in the elderly most likely reflects loss of long-term memories of remote events.
B) Intellectual functioning declines with advancing age.
C) Learning ability remains intact, but time required for learning increases with age.
D) Cognitive functioning is rarely affected in aging individuals.

Question 26

According to the literature, which of the following is most important for individuals to maintain a healthy, adaptive old age?

A) To remain socially interactive
B) To disengage slowly in preparation of the last stage of life
C) To move in with family
D) To maintain total independence and accept no help from anyone