Gerontological nursing

Unit 1: The aging experience. The aging population ; Theories of aging ; Diversity ; Life transitions and story ; Common aging changes --

Unit 2: Foundations of gerontological nursing. The specialty of gerontological nursing ; Holistic assessment and care planning ; Legal aspects of gerontological nursing ; Ethical aspects of gerontological nursing ; Continuum of care in gerontological nursing --

Unit 3: Health promotion. Nutrition and hydration ; Sleep and rest ; Comfort and pain management ; Safety ; Safe medication use --

Unit 4: Geriatric care. Respiration ; Circulation ; Digestion and bowel elimination ; Urinary elimination ; Reproductive system health ; Mobility ; Neurologic function ; Vision and hearing ; Endocrine function ; Skin health ; Cancer ; Mental health disorders ; Delirium and dementia ; Living in harmony with chronic conditions --

Unit 5: Settings and special issues in geriatric care. Spirituality ; Sexuality and intimacy ; Rehabilitative and restorative care ; Acute care ; Long-term care ; Family caregiving ; End-of-life care --

Appendix A: Next generation NCLEX-style case studies and questions --

Appendix B: Answers to next generation NCLEX-style questions.

Understanding the aging experience --

Aging population --

Theories of aging --

Diversity --

Life transitions and story --

Common aging changes --

Foundations of gerontological nursing --

Specialty of gerontological nursing --

Holistic model for gerontological nursing --

Legal aspects of gerontological nursing --

Ethical aspects of gerontological nursing --

Continuum of care in gerontological nursing --

Self-care for the gerontological nurse --

Fostering connection and gratification --

Sexuality and intimacy --

Spirituality --

General care concerns --

Nutrition and hydration --

Rest and sleep --

Comfort and pain management --

Safety --

Safe medication use --

Facilitating physiological balance --

Respiration --

Circulation --

Digestion and bowel elimination --

Urinary elimination --

Reproductive system health --

Movement --

Neurologic function --

Sensation --

Endocrine function --

Integumentary function --

Immune function --

Multisystemic disorders --

Infections --

Cancer --

Mental health disorders --

Delirium and dementia --

Gerontological care issues --

Living in harmony with chronic conditions --

Rehabilitative care --

Acute care --

Long-term care --

Family caregiving --

End-of-life care.

Unit 1: Understanding The Aging Experience:

Aging population:

Views of older adults through history

Characteristics of the older adult population

Population growth and increasing life expectancy

Marital status and living arrangements

Geographic distribution

Income and employment

Education

Health status

Implications of an aging population

Impact of the baby boomers

Provision of and payment for services

Theories of aging:

Biological theories of aging

Genetic theories

Cross-linking theory

Evolutionary theories

Free radicals and lipofuscin theories

Autoimmune reactions

Wear and tear theories

Stress

Biogerontology

Neuroendocrine and neurochemical theories

Radiation theories

Nutrition theories

Environmental theories

Implications of biological theories for nursing

Psychosocial theories of aging

Disengagement theory

Activity theory

Continuity theory

Developmental tasks

Gerotranscedence

Implications of psychosocial theories for nursing

Applying theories of aging to nursing practice

Diversity:

Increasing diversity of the older adult population

Overview of diverse groups of older adults in the United States

Hispanic Americans

Black Americans

Asian Americans

Jewish Americans

Native Americans

Older prisoners

Nursing considerations for culturally sensitive care of older adults

Life transitions and story:

Ageism

Changes in family roles and relationships

Parenting

Grandparenting

Loss of spouse

Retirement

Loss of the work role

Reduced income

Changes in health and functioning

Cumulative effects of life transitions

Shrinking social world

Awareness of mortality

Responding to life transitions

Life review and life story

Self-reflection

Strengthening inner resources

Common aging changes:

Changes to the body

Cells

Physical appearance

Respiratory system

Cardiovascular system

Gastrointestinal system

Urinary system

Reproductive system

Musculoskeletal system

Nervous system

Sensory organs

Endocrine system

Integumentary system

Immune system

Thermoregulation

Changes to the mind

Personality

Memory

Intelligence

Learning

Attention span

Nursing implications of age-related changes.

Unit 2: Foundations Of Gerontological Nursing:

Specialty of gerontological nursing:

Development of gerontological nursing

Core elements of gerontological nursing practice

Evidence-based practice

Standards

Principles

Gerontological nursing roles

Healer

Caregiver

Educator

Advocate

Innovator

Advanced practice nursing roles

Future of gerontological nursing

Lessons from the past

Challenges for the future

Holistic model for gerontological nursing:

Holistic gerontological care

Holistic assessment of needs

Health promotion-related needs

Health challenges-related needs

Requisites to meet needs

Gerontological nursing interventions

Examples of application

Assessing needs: the case of Mr R

Applying the holistic model: the case of Mrs D

Legal aspects of gerontological nursing:

Laws governing gerontological nursing practice

Legal risks in gerontological nursing

Malpractice

Confidentiality

Patient consent

Patient competency

Staff supervision

Medications

Restraints

Telephone orders

No-code orders

Advance directives and issue related to death and dying

Elder abuse

Legal safeguards for nurses

Ethical aspects of gerontological nursing:

Philosophies guiding ethical thinking

Ethics in nursing

External and internal ethical standards

Ethical principles

Ethical dilemmas facing gerontological nurses

Changes increasing ethical dilemmas for nurses

Measures to help nurses make ethical decisions

Continuum of care in gerontological nursing:

Services in the continuum of care for older adults

Preventive services

Partial and intermittent care services

Complete and continuous care services

Complementary and alternative services

Matching services to needs

Settings and roles for gerontological nurses

Self-care for the gerontological nurse:

Characteristics of nurse healers

Presence

Availability

Connections

Models of holism

Self-care and nurturing

Following positive health care

Practices

Strengthening and building connections

Committing to a dynamic process.

Unit 3: Fostering Connection And Gratification:

Sexuality and intimacy:

Attitudes toward sex and older adults

Menopause as a journey to inner connection

Symptom management and patient education

Self-acceptance

Realities of sex in older adulthood

Sexual behavior and roles

Intimacy

Age-related changes and sexual response

Identifying barriers to sexual activity

Unavailability of a partner

Psychological barriers

Medical conditions

Erectile dysfunction

Medication adverse effects

Cognitive impairment

Promoting healthy sexual function

Spirituality:

Spiritual needs

Love

Meaning and purpose

Hope

Dignity

Forgiveness

Gratitude

Transcendence

Expression of faith

Assessing spiritual needs

Addressing spiritual needs

Being available Honoring beliefs and practices

Providing opportunities for solitude

Promoting hope

Assisting in discovering meaning in challenging situations

Facilitating religious practices

Praying with and for

Summary: Importance of spiritual care.

Unit 4: General Care Concerns:

Nutrition and hydration:

Nutritional needs of older adults

Quantity and quality of caloric needs

Nutritional supplements

Special needs of women

Hydration needs of older adults

Promotion of oral health

Threats to good nutrition

Indigestion and food intolerance

Anorexia

Dysphagia

Constipation

Malnutrition

Addressing nutritional status and hydration in older adults

Rest and sleep:

Age-related changes in sleep

Circadian sleep-wake cycles

Sleep stages

Sleep efficiency and quality

Sleep disturbances

Insomnia

Nocturnal myoclonus and restless leg syndrome

Sleep apnea

Medical conditions that affect sleep

Drugs that affect sleep

Promoting rest and sleep in older adults

Pharmacologic measures to promote sleep

Nonpharmacologic measures to promote sleep

Pain control

Comfort and pain management :

Comfort

Pain: a complex phenomenon

Prevalence of pain in older adults

Types of pain

Pain perception

Effects of unrelieved pain

Pain assessment

Integrative approach to pain management

Complementary therapies

Dietary changes

Medication

Comforting

Safety:

Aging and risk to safety

Importance of the environment to health and wellness

Impact of aging on environmental safety and function

Lighting

Temperature

Colors

Scents

Floor coverings

Furniture

Sensory stimulation

Noise control

Bathroom hazards

Psychosocial considerations

Problem of falls

Risk and prevention

Risk associated with restraints

Interventions to reduce intrinsic risks to safety

Reducing hydration and nutrition risks

Addressing risk associated with sensory deficits

Addressing risks associated with mobility limitations

Monitoring body temperature

Preventing infection

Suggesting sensible clothing

Using medications cautiously

Avoiding crime

Promoting safe driving

Promoting early detection of problems

Addressing risks associated with functional impairment

Safe medication use:

Effects of aging on medication use

Polypharmacy and interactions

Altered pharmacokinetics

Altered pharmacodynamics

Increased risk of adverse reactions

Promoting the safe use of drugs

Avoiding potentially inappropriate drugs: beer's criteria

Reviewing necessity and effectiveness of prescribed drugs

Promoting safe and effective administration

Providing patient teaching

Alternatives to drugs

Review of selected drugs

Analgesics

Antacids

Antianxiety drugs (anxiolytics)

Antibiotics

Anticoagulants

Anticonvulsants

Antidepressants

Antidiabetic drugs

Antihypertensive drugs

Anti-inflammatory drugs

Nonsteroidal (NSAIDs)

Antipsychotics

Cholesterol-lowering drugs

Cognitive enhancing drugs

Digoxin

Diuretics

Laxatives

Sedative/hypnotics.

Unit 5: Facilitating Physiological Balance:

Respiration:

Effects of aging on respiratory health

Respiratory health promotion

Selected respiratory conditions

Asthma

Chronic bronchitis

Emphysema

Lung cancer

Lung abscess

General nursing considerations for respiratory conditions

Recognizing symptoms

Preventing complications

Ensuring safe oxygen administration

Performing postural drainage

Promoting productive coughing

Using complementary therapies

Promoting self-care

Providing encouragement

Circulation:

Effects of aging on cardiovascular health

Cardiovascular health promotion

Proper nutrition

Adequate exercise

Cigarette smoke avoidance

Stress management

Proactive interventions

Selected cardiovascular conditions

Hypertension

Hypotension

Congestive heart failure

Pulmonary emboli

Coronary artery disease

Arrhythmias

Peripheral vascular disease

General nursing considerations for cardiovascular conditions

Prevention

Keeping the patient informed

Preventing complications

Promoting circulation

Providing foot care

Managing problems associated with peripheral vascular disease

Promoting normality

Integrating complementary therapies

Digestion and bowel elimination:

Effects of aging on gastrointestinal health

Gastrointestinal health promotion

Selected gastrointestinal conditions and related nursing considerations

Dry mouth (xerostomia)

Dental problems

Dysphagia

Hiatal hernia

Esophageal cancer

Peptic ulcer

Cancer of the stomach

Diverticular disease

Cancer of the colon

Chronic constipation

Flatulence

Intestinal obstruction

Fecal impaction

Bowel incontinence

Acute appendicitis

Cancer of the pancreas

Biliary tract disease

Summary

Urinary elimination:

Effects of aging on urinary elimination

Urinary system health promotion

Selected urinary conditions

Urinary incontinence

Bladder cancer

Rental calculi

Glomerulonephritis

General nursing considerations for urinary conditions

Reproductive system health:

Effects on aging on the reproductive system

Reproductive system health promotion

Selected reproductive system conditions

Problems of the female reproductive system

Problems of the male reproductive system

Summary

Movement:

Effects of aging on musculoskeletal function

Musculoskeletal health promotion

Promotion of physical exercise in all age groups

Exercise programs tailored for older adults

Mind-body connection

Prevention of inactivity

Nutrition

Selected musculoskeletal conditions

Fractures

Osteoarthritis

Rheumatoid arthritis

Osteoporosis

Gout

Podiatric conditions

General nursing considerations for musculoskeletal conditions

Managing pain

Preventing injury

Promoting independence

Neurologic function:

Effects of aging on the nervous system

Neurologic health promotion

Selected neurologic conditions

Parkinson's disease

Transient ischemic attacks

Cerebrovascular accidents

General nursing considerations for neurologic conditions

Promoting independence

Preventing injury

Sensation:

Effects of aging on sensory function

Sensory health promotion

Promoting vision

Promoting hearing

Assessing problems

Selected sensory conditions and related nursing interventions

Visual deficits

Hearing deficits

General nursing considerations for sensory deficits

Endocrine function:

Effects of aging on endocrine function

Selected endocrine conditions and related nursing considerations

Diabetes mellitus

Hypothyroidism

Hyperthyroidism

Hyperlipidemia

Integumentary function:

Effects of aging on the integument

Integumentary health promotion

Selected integumentary conditions

Pruritus

Keratosis

Seborrheic keratosis

Skin cancer

Vascular lesions

Pressure ulcers

General nursing considerations for integumentary conditions

Promoting normalcy

Using alternative therapies

Immune function:

Effects of aging on immune function

Immunologic health promotion

Diet

Exercise

Immunization

Stress management

Mind-body connection

Careful use of antibiotics.

Unit 6: Multisystemic Disorders:

Infections:

Unique manifestations of infection in older adults

Common infections

Urinary tract infection

Prostatitis

Pneumonia

Influenza

Tuberculosis

Vaginitis

Herpes zoster

Scabies

HIV and AIDS

Clostridium difficile infection

Antibiotic-resistant microorganism

Cancer:

Aging and cancer

Unique challenges for older persons with cancer

Explanations for increased incidence in old age

Cancer risk factors

Heredity

Diet

Drinking water

Tobacco

Alcohol

Radiation

Ultraviolet radiation

Occupational exposure to carcinogens

Radon

Special risk for women

Other contributing factors

Prevention and screening

Treatment

Conventional treatment

Complementary and alternative medicine

Nursing considerations for older adults with cancer

Providing patient education

Promoting optimum care

Providing support to patients and families

Mental health disorders:

Aging and mental health

Promoting mental health in older adults

Selected mental health conditions

Depression

Anxiety

Alcohol abuse

Paranoia

Hypochondriasis

Nursing considerations for mental health conditions

Monitoring medications

Promoting a positive self-concept

Managing behavioral problems

Delirium and dementia:

Delirium

Dementia

Alzheimer's disease

Other dementias

Caring for persons with dementia.

Unit 7: Gerontological Care Issues:

Living in harmony with chronic conditions:

Chronic conditions and older adults

Goals for chronic care

Assessment of chronic care needs

Maximizing the benefits of chronic care

Selecting an appropriate physician

Using a chronic care coach

Increasing knowledge

Locating a support group

Making smart lifestyle choices

Using complementary and alternative therapies

Factors affecting the course of chronic care

Defense mechanisms and implications

Impact of ongoing care on the family

Need for institutional care

Chronic care: a nursing challenge

Rehabilitative care:

Need for rehabilitation

Living with disability

Importance of attitude and coping capacity

Losses accompanying disability

Principles of rehabilitative nursing

Functional assessment

Interventions to facilitate and improve functioning

Facilitating proper positioning

Assisting with range-of-motion exercises

Teaching about mobility aids

Teaching about bowel and bladder training

Maintaining and promoting mental function

Using community resources

Acute care:

Risks associated with hospitalization of older adults

Surgical care

Special risks for older adults

Preoperative care considerations

Operative and postoperative care considerations

Emergency care

Infections

Discharge planning for older adults

Long-term care:

Development of long-term institutional care

Before the 20th century

During the 20th century

Lessons to be learned from history

Long-term institutional care today

Nursing facility standards

Facility residents

Nursing roles and responsibilities

Assisted living facilities

Looking forward: a new model of long-term care

Family caregiving:

Older adult's family

Identification of family members

Family member roles

Family dynamics and relationships

Scope of family caregiving

Protecting the health of the older adult and caregiver

Family dysfunction and abuse

Reward of family caregiving

End-of-life care:

Definitions of death

Family experience with the dying process

Supporting the dying individual

Stages of the dying process and related nursing interventions

Physical care needs

Spiritual care needs

Signs of imminent death

Advance directives

Supporting family and friends

Supporting through the stages of the dying process

Helping family and friends after a death

Supporting nursing staff

Index.