{"content":{"sharePage":{"page":0,"digests":[{"id":"20269805","dateCreated":"1266376586","smartDate":"Feb 16, 2010","userCreated":{"username":"graya04","url":"https:\/\/www.wikispaces.com\/user\/view\/graya04","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/teamgreennurses.wikispaces.com\/share\/view\/20269805"},"dateDigested":1532288109,"startDate":null,"sharedType":"discussion","title":"case study V","description":"The information you guys put is great but we need to add the integumentary system.","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"20257791","dateCreated":"1266362023","smartDate":"Feb 16, 2010","userCreated":{"username":"BrandiBurns","url":"https:\/\/www.wikispaces.com\/user\/view\/BrandiBurns","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/teamgreennurses.wikispaces.com\/share\/view\/20257791"},"dateDigested":1532288109,"startDate":null,"sharedType":"discussion","title":"My Work-Case Study Unit 5","description":"1. Describe the changes you would expect to find during a physical exam of the older adult patient.
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\nHead: balding becomes common, women also experience thinning of hair, hair looses pigmentation (presence of gray hair), wrinkling and sagging occur, skin pigmentation,
\nEyes: visual acuity diminishes; more common "near sighted", sensitivity to glare and decreased ability to adjust to darkness, decreased color discrimination and depth perfection. Difficulty reading small print and daytime or night driving may be compromised.
\nEars: hearing acuity diminishes, especially for high-pitched noises
\nThroat and mouth: Tooth decay and loss (may result in a change in eating habits), drier mucous membranes, greater risk for aspiration due to slower GI motility and loss of muscle strength
\nCardiovascular: blood vessels become less elastic. venus return becomes less efficient. Fatty plaque deposits continue to occur in the linings of the blood vessels. Lower extremities may have edema and perphrial pulses may not always be palpable (poor perfusion).
\nRespiratory: decreased elastic recoil of lungs, expiration requiring use of accessory muscles, fewer functioal capillaries and more fibrous tissue in alveoli, decreased skeletal muscle in thorax, reduction in vital capacity and increase in residual volume, drier mucous membranes, impaired mobility and inactivity (effects of medication)
\nGI: gastric PH is less acidic because of a reduction in production of HCL in stomach, gastric emptying decreased because of a decline in smooth muscle tone and motor activity, movement is decreased (peristalisi) because of decreased muscle tone and activity, blood flow reduced because of decreased cardiac output, nutrient absorption decreases,
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\nMusculoskeletal: muscle mass, strength, and agility gradually decrease. Decrease in subcutaneous tissue. Bone demineralization occurs and bones become more brittle. Joints tend to stiffen and loose flexibility. ROM may decrease. Mobility slows and posture tends to stoop.
\nNeurological: CNS responds more slowly to stiumli. Rate of reflexes decreases. Temp\/Pain regulation and pain\/pressure perception become less efficient. Loss of sensation in the extremeties and difficulty with balance, coordination, fine movements resulting in a risk for falls. Sleep at night shorts and the older adult may awaken more easily.
\nGenitourinary: blood flow to the kidneys decreases with diminished cardiac output, number of function nephrons decrease by 50%, fluid and electrolyte balance is fragile, bladder capacity decreases by 50%, voiding becomes more frequent, decrease in bladder and sphincter muscle control may result in stress incontinence or incomplete bladder emptying.
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\nPsychological: risk of developing depression (r\/t deterioration of physical health, financial problems, death of a loved one, living arrangements), patient may abuse substances or feel suicidal. Patients tend to seem more forgetful.
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\n2. Discuss three cognitive changes seen in a number of elderly patients.
\nLonger time to respond to stimulis, espically in new surroundings.
\nLonger time to react to stimulis.
\nMild short-term memory loss\/Forgetfulness
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\n3. Identify six patient behaviors in the elderly you would associate with depression.
\nChanges in sleep patterns (insomnia, hypersomnia)
\nSudden changes in occupational status (retirement)
\nFeelings of hopelessness, uselessness and despair
\nPatient loosing interest in activities that typically would bring them pleasure
\nAlcohol or substance abuse
\nSudden decrease in ADL's
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\n4. What medical conditions in the elderly could present with symptoms of depression?
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\nDepression, drug abuse, alcoholism, substance abuse, and eating disorders.<~~I think this questions was more related in the lines of specific medical conditions. Some medical conditions in the elderly could present with symptoms of depression. Medical conditions included are epilepsies, Parkinson\u2019s disease, MS, Alzheimer\u2019s, IBS, Chronic Liver Disorders, CNS Tumors, Hypothyroidism, Diabetes Mellitus and Vitamin Deficiencies.
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\n5. What patient behaviors would you associate with delirium? Rapid mood swings, anxious or fearful, hallucinations or delusions, increased or reduced restlessness, sun downing, impaired memory or judgment, reduced attention span
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\n6. What patient behaviors would you associate with dementia?
\nmemory loss is most easily recognized.
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\n\u2022 Lack of motivation
\n\u2022 Difficulty concentrating
\n7. What neuroanatomic changes are seen in individuals with Alzheimer\u2019s disease?
\nThe neurons that control memory and thinking are impaired, disrupting the passage of messages between them. These cells develop discrete changes: senile plaques and neurofibrillary bundles, which, over time, cause deterioration of brain tissue.
\nThe cortex of the brain waste and shrink, and the spaces in the center of the brain become distended, consequently reducing its surface.
\nAdditionally, a high concentration of protein is found, called \u201cbeta amyloid\u201d, which forms patches called neuritic plaques.
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\n8. Write three priority nursing interventions for the patient with delirium.
\n-Ensure safety of patient\u2019s environment (clutter-free, no loose tubing\/wires\/clothing, call bell within reach).
\n-Verbally acknowledge patients fears and feelings
\n-Monitor neuro status on an ongoing basis.
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\n
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\n9. Write three priority nursing interventions for the patient with dementia.
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\n-Provide patient with safe environment (clutter-free, no loose tubing\/wires\/clothing, call bell within reach)
\n-ID usual patterns of behavior (sleep pattern, elimination, food intake, med\u2019s, self care)
\n-Reorient patient as needed","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"19937775","dateCreated":"1265678606","smartDate":"Feb 8, 2010","userCreated":{"username":"zambrand04","url":"https:\/\/www.wikispaces.com\/user\/view\/zambrand04","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/teamgreennurses.wikispaces.com\/share\/view\/19937775"},"dateDigested":1532288109,"startDate":null,"sharedType":"discussion","title":"team","description":"hey brandi! it's good that you work in all the questions but you have to let other persons from the team to work on it, so we can add more info. it's good that you go through all the questions but don't do everything! keep the all work for your learning.","replyPages":[{"page":0,"digests":[{"id":"19990929","body":"I just added some things, but I feel like I was just repeating what Brandi said. Thanks for going through these Brandi, but leave some spaces for us too . ;)
\n- Rachel","dateCreated":"1265758367","smartDate":"Feb 9, 2010","userCreated":{"username":"trainerrachel00","url":"https:\/\/www.wikispaces.com\/user\/view\/trainerrachel00","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}},{"id":"20001329","body":"Hey guys.
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\nI spoke to Neketa (I hope I'm spelling it correctly) today and came up with this: Everyone is to create a discussion and place their answers in there. Then, we will copy and paste everyones answers together the day it is due. We can then view everyones discussion and comment that way. I hope this all works.
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\nI decided I will still be answering all the questions because it is a great learning experience, but, it will all just be in a discussion post, not on the main "edit" page.
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\nSorry about answering all the questions. I wanted to supply as much information as possible. Sorry! I hope the new system works and you all find it easier!","dateCreated":"1265770898","smartDate":"Feb 9, 2010","userCreated":{"username":"BrandiBurns","url":"https:\/\/www.wikispaces.com\/user\/view\/BrandiBurns","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}},{"id":"20001785","body":"We can go back to assigning questions. If anyone wants to answer them all, they can place them in a discussion or keep them for their personal study use. What do you guys think?","dateCreated":"1265771547","smartDate":"Feb 9, 2010","userCreated":{"username":"BrandiBurns","url":"https:\/\/www.wikispaces.com\/user\/view\/BrandiBurns","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}},{"id":"20065333","body":"Sounds good to me!","dateCreated":"1265901365","smartDate":"Feb 11, 2010","userCreated":{"username":"trainerrachel00","url":"https:\/\/www.wikispaces.com\/user\/view\/trainerrachel00","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}},{"id":"20121233","body":"i'm all for that. oh and u almost had it its Nekita.","dateCreated":"1265990646","smartDate":"Feb 12, 2010","userCreated":{"username":"ketakandy","url":"https:\/\/www.wikispaces.com\/user\/view\/ketakandy","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}}],"more":0}]}],"more":false},"comments":[]},"http":{"code":200,"status":"OK"},"redirectUrl":null,"javascript":null,"notices":{"warning":[],"error":[],"info":[],"success":[]}}