Gerontology and Pharmacology Exam Review

Jun 3, 2024

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Gerontology Final Exam Review

General Information

  • Exam Structure: 49 items equivalent to 51 points
  • Schedule: First 19 items now, 15 items weekly thereafter

Key Topics and Pages

Post-Mortem Nursing Care

  • Study Pages: 929-930
  • Additional Info: Elsevier publication link (shared in chat)
  • Key Points:
    • Nurses are responsible for initial care of cadavers

Conditions and Care

  1. COPD and Palliative Care: Supplemental oxygen, improving quality of life.
  2. Stage 4 Breast Cancer: Terminal, eligible for hospice care.
  3. Terminal Lung Cancer: Eligible for hospice care.
  4. End-Stage Kidney Disease: Terminal, eligible for hospice care.
  5. Type 1 Diabetes Mellitus: Not terminal.

Perception of Death

  • Influencing Factors: Age, personal relationships, cultural practices, financial concerns, socioeconomic status, religious beliefs, coping strategies.

End-of-Life Care Practices

  • Suctioning: Avoid nasopharyngeal suctioning.
  • Privacy and Empathy: Essential for dignity and respect.
  • Documentation: Details of belongings, notifications, mortician not needed.
  • Opioid Use: No restrictions, necessary to control pain.

Grief Manifestations

  • Physical Symptoms: Heart palpitations, headaches, insomnia, inability to focus.

Hospice and Palliative Care

  • Locations: Home or healthcare facilities.
  • Goals: Comfort, dignity, not curing.

Respite Care

  • Purpose: Support for caregivers, e.g., errands, transportation.
  • Other Care Types:
    • Restorative Care: For regaining function.
    • Home Care: For achieving independence.

Comfort Measures at End-of-Life

  • Opioid Use: Promotes comfort, vasodilation, anxiety relief.
  • Suctioning: Avoid nasotracheal suctioning.
  • Room Setup: Elevated head, fan for air.

Physical Changes at End-of-Life

  • Gastrointestinal: Decreased activity.
  • Circulation: Mottled skin, hypotension.
  • Breathing: Dry mucous membranes.

Spirituality Impact

  • Spiritual well-being associated with positive end-of-life experience, less depression.
  • Additional Info: Hyperlink shared for more details.

Nursing Process for Grieving Clients

  • Assess grieving type: Healthy or complicated.
  • Create and adjust treatment plans.

Conditions and Definitions

  • Compassion Fatigue: Cumulative stress from caring.
  • Prolonged Grief Disorder: Lasts over 6 months.
  • Adventitious Stress: Unexpected natural events.
  • PTSD: Post-traumatic stress disorder.

Types of Grief

  • Normal: Lasts several months to a year.
  • Anticipatory: Before loss occurs.
  • Disenfranchised: Not socially accepted.
  • Prolonged: Lasts over 6 months, unable to accept loss.

Pressure Injury Risks

  • Factors: Nutritional intake, sensory perception, mobility, activity level.

Age-Related Skin Changes

  • Thinning Skin: Increased injury risk.
  • Decreased Elasticity: Increased injury risk.
  • Subcutaneous Tissue: Decreased, risk of injury.
  • Blood Supply: Reduced, risk of injury.
  • Hydration: Reduced, risk of injury.

Body Mass Index (BMI)

  • Normal Range: 18.5 to 24.9
  • Obesity Risk: Pressure injury due to decreased blood flow.
  • Peripheral Neuropathy: Risk due to decreased pain sensation.
  • Immobility: Risk due to difficulty repositioning.
  • Bony Prominences: Skull, scapulae, sacrum, coccyx, calcanei, forehead, rib cage, knees, toes

Pharmacology Review

  • Exam Structure: 60 items, 60 points. Given in sets, first 15 already provided.

Key Topics and Medications

  1. Transdermal Analgesic Cream: Apply minimal amounts to reduce systemic toxicity.
  2. Hyperglycemia and Glyburide: Sulfonylurea agent, management of type 2 diabetes.
  3. Haloperidol: Causes anticholinergic effects; watch for extrapyramidal symptoms.
  4. Lithium: Treats bipolar disorder, monitoring for toxicity.
  5. Neuroleptic Malignant Syndrome: Medical emergency, different from akathisia and tardive dyskinesia.
  6. Valproate and Hypothyroidism: Monitoring liver function, used as a mood stabilizer.
  7. Depression and Suicide: Prioritize safety and immediate evaluation.
  8. Dinoprostone: Used for cervix preparation in labor.
  9. Opioid Analgesics: Euphoria, management of side effects.
  10. Medication Adherence: Best practices, e.g., daily dosing.
  11. Sildenafil Interactions: Do not use with nitrates.
  12. Mood Stabilizers: Paroxetine, lithium, valproate, carbamazepine.
  13. Implied Consent: Applicable in emergency, legal and medical guidelines.

Next Steps

  • Upcoming Reviews: Additional sets of 15 items each week.
  • Additional Reading: Hyperlinks shared in chat for further study.

Questions and Classroom Interaction

  • Queries: Students encouraged to ask questions throughout the review.
  • Corrections/Updates: Addressed as needed during the session.

Note: A thorough understanding of these topics is crucial for the final exams in both gerontology and pharmacology.