N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide or emotional abuse or neglect. • Drug and alcohol abuse continues to be an area of which to be aware. • As fat reserves decrease and circulation decreases, the older adult may be at increased risk for hypo and hyperthermia. • The elderly may be on many medications prescribed by multiple providers. These drugs may interact with each other producing unexpected results. The nurse must help the patient understand that it is critical to fill all prescriptions at one pharmacy so that a registered pharmacist can evaluate all medications and determine interactions to prevent problems. • Incontinence can be an issue for the elderly as urinary muscle tone diminishes. • Dementia and other mental and psychological issues may become apparent during this stage and may be progressive. The nurse must be able to identify the stage of dementia as listed below: o Early dementia: This stage is characterized by minor impairments with decreased ability to learn and remember new things. o Middle stage: In this stage, the elderly person may not recognize people they have not seen in a while and may start to have mood changes. o Late dementia: In the final stage, the individual is totally dependent on others for care, including activities of daily living. Often confused, the person in late dementia may be combative with family and healthcare team members. Havighurst’s Developmental Tasks During this period, the developmental tasks include managing decreasing physical strength and health, adjusting to retirement and potentially reduced income, adjusting to the death of a spouse, adapting to changing social roles in a flexible way, fulfilling civic and social responsibilities, and establishing satisfactory physical living arrangements. Much of life is preparing for the middle adulthood stage and the last stage is recovering from it. Perhaps that is because older adults can look back on their lives with happiness and contentment, feeling fulfilled with a deep sense that life has meaning and that they have made a contribution to life, a feeling called integrity. Strength comes from a wisdom that the world is very large and the older adult now has a detached concern for the whole of life, accepting death as the completion of life. On the other hand, some adults may reach this stage and despair at their experiences and perceived failures. The older adult struggles to complete a previously easy task and needs to feel this sense of accomplishment. The significant relationship is with all of mankind. The older adult may begin to experience age-related changes (sight and hearing deficits) that make communication and learning more difficult. It is critical for the nurse to communicate slowly as these deficits are identified. Kohlberg’s Moral Development Post-conventional level: As adults, individuals begin to understand that people have different opinions about morality and that rules and laws vary from group to group and culture to culture. Morality is seen as upholding the values of a group or culture. Understanding personal beliefs allows Erikson’s Psychosocial Development Expected outcome: Integrity vs. despair

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