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Spring 2021 UPNS 338/430 Gerontology Exam 1 Blueprint

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Spring 2021 UPNS 338/430 Gerontology Exam 1 Blueprint

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  • February 14, 2022
  • 25
  • 2021/2022
  • Exam (elaborations)
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Spring 2021

UPNS 338/430 Gerontology

Exam 1 Blueprint .


# of Questions Topic
8 Changes of Aging- Assessment and Prevention
5 Pharmacology Considerations
1 Chronic Disease
11 Respiratory
5 Safety- Falls Risks
5 Musculoskeletal

Please remember that some of the questions may be a combination of multiple topics (i.e., assessment
of the aging adult and safety considerations).

Changes of Aging- Assessment and Prevention (8)
Tips for approaching a geriatric patient 
 Priority complaint is your priority
 PROMOTE STRENGTH AND SUPPORT THEIR WEAKNESS!!!

Keys to Assessment 
 hard of hearing “HOH”
 Don’t forget to ask questions about sexual health even if it may be awkward

Cardiovascular System 
 Stiffening or hardening of blood vessels and arteries
o Causes heart to work harder to pump blood through them  causing heart muscles to
change to adjust to increased workload
 Usually diagnosed with cardiomyopathy (large heart) which is a normal change
 From that congestive heart failure can form which is a complication of a normal
change
 Thus, hardening of arteries and vessels causes heart to work harder to pump causing the heart
muscles to change to adjust to increased workload which causes someone to be diagnosed with
a cardiomyopathy as a normal change in the older adult
o If they develop congestive heart failure, it is a complication of these normal changes

 Heart rate at rest will stay the same and not increase as much during activities
o When I walk up a hill fast, my heart rate will increase
o if an older adult walks up a hill fast, we won’t see a change in heart rate like we normally
would which can become concerning
 Even at rest and they become tachycardia, so we want to check TEMPERATURE
 It is uncommon for older adults to have a fever unless they have an
extreme infection or problem

, Spring 2021

UPNS 338/430 Gerontology

Exam 1 Blueprint
 Pay close attention to temperature if they come in with confusion or UTI which
can lead to confusion and an infection/fever

 These changes increase the risk of high blood pressure (hypertension)
o We allow older adults higher thresholds for blood pressure

 Health promotion
o Physical activity
o Healthy diet  sodium restriction; 2 mg or less in diet
 If they live alone and typically eat canned or frozen foods that are high in
sodium, we need to do an assessment for alternatives
o Don’t smoke

Musculoskeletal System 
 Bones tend to shrink in size and density making them susceptible to fracture
o A greater risk for osteoporosis and osteopenia
 Postmenopausal women are at highest risk or anyone previously receiving
radiation and chemotherapy
 Decrease heigh over time
o Their muscles become slightly weaker so shoulders can droop
 Stature even drastically changes
 If head is over heels, they are at risk for falling
 Health promotion
o Vitamin D helps with the absorption of calcium
 Adequate calcium
 At least 1,200 mg of calcium/day
 Dairy products, broccoli, kale, salmon, tofu
 Adequate vitamin D
 800 IU/day
 Sunlight, salmon, eggs, vitamin D-fortified milk and supplements
 Physical activity
 Weight-bearing exercises
o Walking, joking, tennis, climbing stairs, and weight training
 Supports muscles which helps bones

Gastrointestinal System 
 Structural changes in large intestine can result in constipation
o if drier or dehydrated, they are going to have slowed which happens in the emptying of
the stomach, colon, and large intestine  this can cause constipation
 be active, fiber, and fluids
o use of diuretics and iron or medical conditions like diabetes and HF that affect the fluid
in the body


 Health Promotion

, Spring 2021

UPNS 338/430 Gerontology

Exam 1 Blueprint
o Healthy diet  high-fiber foods such as fruits, vegetables, and whole grains
 Limit high-fat meals, dairy products and sweets
 Drink plenty of water
o Physical activity
o Don’t ignore bowel movement  holding bowel movement can cause constipation
 Encourage them to go at least every 2 hours

Genitourinary System 
 Less elastic as you age leading to more frequent urination
o Kidneys decrease in size
 Decrease in GFR (which is normal)
 If you have a decrease in GFR, the concern in BUN Cr

 Weakening of bladder muscles and pelvic floor muscles make it difficult for you to empty or
completely lose control (incontinence)
o Incontinence is never normal, but the risk for is because of weakening pelvic muscles
o Enlarged or inflamed prostate can also cause difficulty emptying or incontinence

 Medications that can cause toxicity if there is a decrease in excretion
o Digoxin  assess if they are seeing halos
 Check heart rate  we want to know if it is above 60 bpm before admin
 On auscultation with digoxin toxicity, the pulse will be lower than 60 bpm so we
would hold next dose
o Vancomycin

 Health Promotion
o Toilet regularly
o Maintain healthy weight
o Avoid bladder irritants  caffeine, acidic foods, alcohol, and carbonated beverages
 Ask about caffeine
o Avoid constipation  fiber

Neurocognitive System 
 Brain undergoes changes as you age that affect memory/thinking skills
o Naturally goes through changes
o Normal for patient to have momentary lapses in memory like losing keys
o It is not normal if they forget things, they should remember such as setting dinner out
they just cooked

 Health promotion
o Treat cardiovascular disease
 High BP, hyperlipidemia and diabetes  these may increase risk of cognitive
disease
o Vitamins for neurological health
 B-complex vitamins

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