Care Alternatives for Older Adults - Nursing home: 24 hr nursing care, total care; Assisted living: Can do for themselves, mostly independent but help available; good for company or socialization; Home health: Help comes to pt's house, medical or nursing help at home; Adult Day Care: Dropped off in the day but cared for by family at night, also for socialization or company, keeps them busy during the day; Rehab: To get better after injuries, short term care, Elder Mistreatment - Neglect: Malnourished, not providing proper care or basic needs, pressure ulcer can form; Abandonment: Leaving pt, dropping them off and not coming back; Physical: Hitting, slapping, bruises, unreported fractures; Verbal/Psychological: Calling them names, being mean, silent treatment; When to Assess/What to Ask: Ask when alone; ask "do you feel safe at home?", Special Older Adult Groups - Homeless Older Adults: Need access to social services/workers, resources for food banks, shelters, etc; Rural Older Adults: Support and resources for transportation, tele health, education, social support, how to get food (meals on wheels, etc); Frail Older Adults:3 of 5 criteria, walk slow, loss of 10 lbs, weakness, get tired easily, low level of activity, Older Adults and Medications - Polypharmacy = risk of OD, harm to body, underdose; keeping up to date list; doing med recs (admission, discharge/transfer, at doctor's office/outpatient); Questions: do they know purpose, how often they take, any supplements, OTC meds, herbals, interactions, Phases of Chronic Illness - Onset (sx start to show), stable (dz under control, maintaining), acute (small setback, may need hospitalization), comeback (start feel better, regain normalcy and will return to stable), crisis (emergency, life threatening, need hospitalization), unstable (unable to keep dz under control, up and down, trying tx out), downward (gradual decline, can't do what they did before), dying (can't do anything, let go of everything), Tasks of Chronic Illness - Take medications as prescribed, make lifestyle changes, understand the illness, proper education of illness, need family support, proper nutrition, understand worsening symptoms and when to call for help, Benign vs Malignant Tumors - Benign: encapsulated, normally differentiated and looks like parent cells, unlikely to reoccur or metastasis; Malignant: not encapsulated, poorly differentiated and looks abnormal, can metastasize and reoccur, Staging of Cancer - T = size and depth of tumor, N = lymph node involvement, M = metastasis present in distant sites; can up stage but no down stage, Warning Signs of Cancer - Change in bowel and bladder habits; A sore that does not heal; Unusual bleeding or discharge from any body orifice; Thickening or a lump in the breast or elsewhere; Indigestion or difficulty swallowing; Obvious change in a wart or mole; Nagging cough or hoarseness, Cancer Treatment: Surgery - remove cancer completely, control it and remove as much as possible, palliation to provide comfort, Cancer Treatment: Radiation - How it works: Burns the DNA bonds, localized treatment,External Beam: passes through skin to tumor below, tattoo markings in place to hit the right spot, don’t wash markings off; Brachytherapy: Radiation seeds directly inside the tumor, place on radiation precautions, if falls out-pick up with tongs, wear dosimeter and lead apron, use separate facilities, avoid children and pregnant women, don't prepare food, use plastic utensils, no more than 30 mins of exposur, dispose linens properly in hazard/radiation bag, Cancer Treatment: Chemotherapy - How it works: Kills cells but doesn't discriminate between good and bad cells, good poison, systemically, like to administer via Central line but has various routes, must get certification to administer, Cancer Treatment: Immunotherapy - Use own body to fight cancer, can have flu like sx = give acetaminophen, Cancer Pain - Can't be cured but can be managed, want to get to comfortable level for pt, ask what's comfortable pain level for client, admin opioids for pain, use nonpharm techniques: music, guided imagery, pet, distraction, etc, Reproductive Effects - Risk of infertility with radiation treatments, Wear lead diapers to protect during treatment, need to be done with full bladder to push; send to fertility specialist/counselor, Integumentary Effects - Desquamation; dry looks like sunburn/rash; wet looks like weepy, skin falling off, infection risk, open; wet = Vaseline gauze; dry = aloe vera; loose and light clothing; avoid sun; no perfumed lotion; wash gently and pat dry; use nonscented moisturizing lotion; Extravasation; Chemo needs to be administered via CVAD; alopecia/hair loss (wigs, hats, etc, provide support and resources), Gastrointestinal Effects - Nausea/Vomiting, loss of appetite, mouth sores, diarrhea, GI bleeding, metabolic alkalosis, malnutrition, admin antiemetics, replace electrolytes, enteral or parenteral nutrition if cannot take anything by mouth; monitor intake/output, Hematological Effects - Pancytopenia (neutropenia, anemia, thrombocytopenia); bleeding precautions (no sharp utensils, soft toothbrushes, no contact sports); if anemic, transfuse PRBCs as ordered; neutropenic precautions (wear mask when leaving room, everyone else wears mask when near patient, no uncooked foods, no fruits or flowers, hand hygiene, avoiding crowds, private room, Psychosocial Management - Feelings; ask about suicidal ideation; therapeutic communication; have open/caring attitude; give tender loving care; active listening; be honest; bring in chaplain and involve family; pets for comfort/affection; support groups; social worker,

Cancer and Older Adults Flashcards

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