Week 6: Question for Discussion 

(Wk # 6: June 8 to June 14 – Main post under Assignment by Wed, June 10 at 11:59 PM EST).

Students are required to post a minimum of three times per week (1 main post answering the question 100% before Wednesday at 11:59 PM EST and 2 peer responses by Sunday at 11:59 PM EST). The three posts in each individual discussion must be on separate days (same day postings / replies will not be accepted).

Chapter 11 – Hydration and Oral Care.

Chapter 12 – Elimination.

Questions: 

Choose a condition, disease, disorder affecting the elderly discussed in chapter 11 and 12 of your textbook.

1. Discuss signs and symptoms of the chosen condition, disease, disorder. 

2. Explain possible treatments.

Guidelines: The answer should be based on the knowledge obtained from reading the book, no just your opinion. 

Grading Criteria: Student mentioned a condition, disease, disorder discussed in chapter 11 or 12 of the textbook (25%). Student mentioned at least 3 signs and symptoms of the chosen condition, disease, disorder (45%). Student explained possible treatment(s) of the chosen condition, disease, disorder (30%). 

Chapter 11

Hydration and Oral Care

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Copyright © 2018, Elsevier Inc. All rights reserved.

  • The promotion of an adequate fluid balance, which prevents complications resulting from abnormal or undesirable fluid levels
  • Daily needs for water can usually be met by functionally independent older adults through intake of fluids with meals and social drinks
  • A significant number of older adults drink less than 1 L/day of fluid

Hydration Management

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Copyright © 2018, Elsevier Inc. All rights reserved.

  • A complex condition resulting in a reduction in total body water
  • In older people, it most often develops as a result of disease, age-related changes, or the effects of medication
  • Considered a geriatric syndrome
  • A significant risk factor for a number of conditions

Dehydration

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*

Copyright © 2018, Elsevier Inc. All rights reserved.

Copyright © 2018, Elsevier Inc. All rights reserved.

*

Copyright © 2018, Elsevier Inc. All rights reserved.

  • Assessment is complex in older people because clinical signs may not appear until dehydration is advanced
  • Provide education to older people and their caregivers on the need for fluids and the signs and symptoms of dehydration
  • Identify and quickly treat acute situations such as vomiting, diarrhea, and febrile episodes

Implications for Gerontological Nursing and Healthy Aging

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*

Copyright © 2018, Elsevier Inc. All rights reserved.

Signs and Symptoms of Dehydration

  • Weight loss
  • Orthostasis
  • Dry mucous membranes in the mouth and nose
  • Dysphagia
  • Decreased urine output with dark urine
  • Longitudinal furrows on the tongue
  • Incoherent speech
  • Rapid pulse rate
  • Extremity weakness
  • Dry axilla
  • Sunken eyes

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*

Copyright © 2018, Elsevier Inc. All rights reserved.

Hydration Management

  • Interventions consist of risk identification and hydration management
  • Any individual who develops fever, diarrhea, vomiting, or a nonfebrile infection should be monitored closely by implementing intake and output records and providing additional fluids
  • Keep NPO requirements as short as possible for older adults

Copyright © 2018, Elsevie

Chapter 11

Hydration and Oral Care

Copyright © 2018, Elsevier Inc. All rights reserved.

Copyright © 2018, Elsevier Inc. All rights reserved.

  • The promotion of an adequate fluid balance, which prevents complications resulting from abnormal or undesirable fluid levels
  • Daily needs for water can usually be met by functionally independent older adults through intake of fluids with meals and social drinks
  • A significant number of older adults drink less than 1 L/day of fluid

Hydration Management

Copyright © 2018, Elsevier Inc. All rights reserved.

*

Copyright © 2018, Elsevier Inc. All rights reserved.

  • A complex condition resulting in a reduction in total body water
  • In older people, it most often develops as a result of disease, age-related changes, or the effects of medication
  • Considered a geriatric syndrome
  • A significant risk factor for a number of conditions

Dehydration

Copyright © 2018, Elsevier Inc. All rights reserved.

*

Copyright © 2018, Elsevier Inc. All rights reserved.

Copyright © 2018, Elsevier Inc. All rights reserved.

*

Copyright © 2018, Elsevier Inc. All rights reserved.

  • Assessment is complex in older people because clinical signs may not appear until dehydration is advanced
  • Provide education to older people and their caregivers on the need for fluids and the signs and symptoms of dehydration
  • Identify and quickly treat acute situations such as vomiting, diarrhea, and febrile episodes

Implications for Gerontological Nursing and Healthy Aging

Copyright © 2018, Elsevier Inc. All rights reserved.

*

Copyright © 2018, Elsevier Inc. All rights reserved.

Signs and Symptoms of Dehydration

  • Weight loss
  • Orthostasis
  • Dry mucous membranes in the mouth and nose
  • Dysphagia
  • Decreased urine output with dark urine
  • Longitudinal furrows on the tongue
  • Incoherent speech
  • Rapid pulse rate
  • Extremity weakness
  • Dry axilla
  • Sunken eyes

Copyright © 2018, Elsevier Inc. All rights reserved.

*

Copyright © 2018, Elsevier Inc. All rights reserved.

Hydration Management

  • Interventions consist of risk identification and hydration management
  • Any individual who develops fever, diarrhea, vomiting, or a nonfebrile infection should be monitored closely by implementing intake and output records and providing additional fluids
  • Keep NPO requirements as short as possible for older adults

Copyright © 2018, Elsevie

Chapter 12

Elimination

Copyright © 2018, Elsevier Inc. All rights reserved.

Copyright © 2018, Elsevier Inc. All rights reserved.

The body must remove waste products of metabolism to sustain healthy function

Bowel and bladder functions later in life contribute to the independence of older adults

Nurses are in a key position to implement evidence-based assessment and interventions to enhance continence and improve function, independence, and quality of life for older people

Concepts of Elimination

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  • The involuntary loss of urine sufficient to be a problem
  • Is an underdiagnosed, underreported, and undertreated condition, especially in older adults
  • Treatment is not sought because of embarrassment, normal aging, or the older adult is uneducated about treatment

Urinary Incontinence

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  • Thought to be related to
  • Cognitive impairment
  • Limitations in daily activities
  • Institutionalization
  • Stroke, diabetes, obesity, poor general health, certain medications, and comorbidities are associated with urinary incontinence (UI)

Risk Factors for Urinary Incontinence

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  • Increased risk of falls, fractures, hospitalization, and skin breakdown
  • Loss of dignity and autonomy
  • Increased feelings of depression, anxiety, shame, and embarrassment
  • Increased social isolation
  • Sexual activity is avoided
  • Loss of independence and self-confidence

Consequences of Urinary Incontinence

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  • Incontinence is classified as
  • Transient (acute) or

Sudden onset

Present for 6 months or less

Usually caused by treatable factors such as urinary tract infections (UTIs) or delirium

  • Established (chronic)

Sudden or gradual onset

Includes stress; urge; urge, mixed, or stress UI with high postvoid residual (PVR); functional UI; and mixed UI

Types of Urinary Incontinence

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*

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  • Continence must be routinely addressed in t