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601 midterm

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 29 pages. Originally published on StudyMerit.

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29
Academic year
2025/2026
Language
English

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Midterm Exam Study Guide NR 601 Week 1 – Foundations of Aging  Approaches to caring for the aging population o Person-centered care: Emphasizes dignity, preferences, and autonomy  The 5M’s  Mobility – crucial for function, quality of life, and fall prevention  Mentation – focuses on assessing cognitive and mental health issues like dementia and depression  Medications – management involves carefully reconciling prescription medications, over-the-counter products, herbal supplements, and deprescribing to avoid polypharmacy  Multicomplexity – addresses the multiple comorbidities common in older adults, ensuring comprehensive care  Matters Most – emphasizes the importance of understanding the client’s priorities and aligning care with the older adult’s personal goals, preferences, and values  Holistic areas for older adults  Biologic wellness o Encouraging healthy eating, proper sleep, managing health issues, avoiding smoking, and accessing quality healthcare  Social wellness o Promoting interactions with others and pets  Functional wellness o Supporting individuals to stay as active and engaged as possible  Environmental wellness o Creating physical spaces that promote healthy living  Psychological wellness o Fostering openness and respect for individuals’ spiritual beliefs o Geriatric syndromes focus – Falls delirium, frailty, incontinence, polypharmacy o Interprofessional teams: NP, social worker, pharmacist, PT/OT o Continuity of care: Home visits, telehealth, and long-term care planning o Function over disease: Prioritize ADLs/IADLs assessment of disease control  Aging theories and how they affect NP practice o Biological theories  Error Theory  Suggests that aging results from cumulative mistakes in DNR and RNA over time  These random errors in RNA copying transmit inaccurate genetic information, impairing cell functions  Although this theory has not been fully supported by research and it has inspired significant scientific investigation  Free Radical Theory  Unstable chemical by-products of normal cell metabolism and environmental pollutants

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 They are highly reactive and usually neutralized by the body’s protective systems  However, some free radicals can accumulate, damaging cells and contributing to aging  The ability to neutralize free radicals decreases with aging  Programmed Aging Theory  In 1961 Hayflick and Moorehead suggested that a biological or genetic clock might control aging  They observed that human fetal fibroblastic cells in vitro could divide about 50 times before deteriorating, indicating programmed aging at the cellular level  This led to the idea that life expectancy is preprogrammed within a species-specific range  Immunological Theory  Focuses on the immune system, which protects the body from foreign materials, viruses, and bacteria  Essential organs include the bone marrow, spleen, thymus gland, and lymph nodes  The thymus gland, crucial for immune development, shrinks with age, leading to decreased immune function  This decline is known as immunosenescence, reduces disease resistance, and increases autoimmune responses  Neuroendocrine Theory  Posits that aging results from a programmed reduction in the functioning of the nervous, immune, and endocrine systems  Researchers are examining hormones such as dehydroepiandrosterone (DHEA) from the adrenal glands and melatonin from the pineal gland, which decreases with age  Other hormones under study include estrogen, testosterone, and growth hormone  The feedback mechanisms between the hypothalamus, pituitary, and endocrine glands are being investigated for their impact on aging o Psychosocial Theories  Life Course Perspective  Examines how we age, relationships, and life changes interact with social structures and historical events to influence the aging process  It highlights how factors like education, relationships, parenting, and broader contexts, such as poverty or war, shape health and aging across different times and socioeconomic backgrounds  Disengagement Theory  Older adults naturally withdraw from social activities and relationships as the recognize their lives are nearing their end, making their absence less impactful on society  Proponents suggest this withdrawal allows for reflection and contemplation, though critics argue it may encourage isolation and withdrawal

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 Activity Theory  Suggests that staying socially active and engaged leads to greater satisfaction and healthier aging  Older adults who maintain their social interactions and activities experience better well-being, while those who do not may face dissatisfaction and identity loss  Activities enhancing quality of life are categorized into informal, formal, and solitary types.  Continuity Theory  Expands on the activity theory suggesting that older adults generally continue the behaviors, activities, and relationships they had in their younger years  It emphasizes maintaining existing relationships and aging in place  However, the theory is criticized for not accounting for changes in psychosocial behaviors due to chronic illness or socioeconomic factors. o Implication for NPs  Recognize normal vs pathological aging  Support independence and encourage engagement  Tailor interventions respecting individual’s aging experience  Anticipatory guidance – lifestyle, fall prevention o Lifestyle  Encourage physical activity – balance and strength training  Nutrition – adequate protein, hydration, vitamin D (1000-2000u/d)  Cognitive Stimulation and social engagement o Fall prevention  Assess home hazards, vision, gait, footwear  Medication review for fall-risk meds (benzos, hypotension, anticholinergics)  Recommend assistive devices, PT referral  Holistic assessment and health promotion for older adults – screening and prevention o Comprehensive Geriatric Assessment  Physical, mental, functional, social, environmental  Screenings – depression (PHQ9), cognitive (MoCA), nutrition (MNA) o Preventive screenings  Cancer – Breast/Colorectal (based on life expectancy)  Yearly screenings for lung cancer with a low-dose CT scan for patients aged 50-80 who smoke or used to smoke and have at least a 20-pack year history of smoking  Prostate cancer screening every 2-4 years for age 50-69  55 and older should receive a mammogram every 2 years  30-65 should get a Pap test every 3 years, and HPV test every 5 years, or an HPV/Pap co-test every 5 years  Cardiovascular – BP and lipid panel  Vaccines  COVID – at least 2 doses for 65+  Flu – annually  RSV – can start at 50, but recommends annually for 75+

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