Essentials of Gerontological Nursing

0826120520......Page 1
Contents......Page 6
Preface......Page 12
Acknowledgments......Page 14
CHAPTER ONE The Graying of America......Page 15
Issues of Aging......Page 16
Government-Funded Health Care......Page 17
Medical Concerns......Page 18
Myths......Page 19
Ageism......Page 24
Ethnogeriatrics and Health Care......Page 25
Cultural Competence......Page 28
Gerontological Nursing......Page 33
Biological Theories......Page 36
Moral/Spiritual Theories......Page 38
Sociological Theories......Page 39
Summary......Page 40
CHAPTER TWO The Health Care Delivery System......Page 43
Retirement......Page 45
Challenges Within the Current Health Care Delivery System......Page 47
Medicare and Related Plans......Page 52
Medicaid......Page 78
Veteran's Benefits......Page 81
Long-Term Care Insurance......Page 82
Payment Options for Older Adults Without Resources for Health Care......Page 84
Summary......Page 85
CHAPTER THREE Normal Changes of Aging......Page 88
Cardiovascular System......Page 90
Respiratory System......Page 101
Integumentary System......Page 102
Gastrointestinal System......Page 105
Constipation......Page 106
Bowel Incontinence......Page 107
Urinary Incontinence......Page 108
Musculoskeletal System......Page 110
Sexuality/Reproductive System......Page 112
Changes in the Senses......Page 114
Neurological Changes......Page 116
Summary......Page 117
CHAPTER FOUR Assessing Older Adults......Page 119
Systematic Geriatric Assessment......Page 120
Health History......Page 124
Physical Assessment......Page 126
Critical Components of a Comprehensive Geriatric Assessment......Page 129
Function......Page 130
Cognition......Page 131
Summary......Page 132
CHAPTER FIVE Health Promotion......Page 135
Alcohol Usage Among Older Adults......Page 138
Smoking......Page 139
Nutrition and Hydration......Page 140
Risk Factors for Malnutrition......Page 141
Failure to Thrive (FTT)......Page 142
Interventions to Promote Nutrition......Page 143
Exercise......Page 144
Fall Prevention......Page 145
Restraint Usage......Page 147
Influenza......Page 148
Tetanus and Diphtheria......Page 149
Cardiovascular Disease......Page 151
Diabetes......Page 152
Cancer......Page 153
Summary......Page 156
CHAPTER SIX Pathological Disease Processes in Older Adults......Page 159
Osteoarthritis......Page 161
Osteoporosis......Page 162
Hypertension......Page 165
Congestive Heart Failure (CHF)......Page 166
Angina and Myocardial Infarction (MI)......Page 169
Obstructive Airway Diseases......Page 171
Cerebral Vascular Accident (Stroke)......Page 172
Diabetes Mellitus......Page 174
Influenza......Page 176
Pneumonia......Page 177
Sexually Transmitted Disease and Human Immunodeficiency Virus/Acquired Immune Defi ciency Syndrome......Page 179
Cancer......Page 182
Parkinson's Disease......Page 184
Summary......Page 186
CHAPTER SEVEN Medication Usage......Page 189
Pharmacokinetics and Pharmacodynamics......Page 191
Medication Absorption......Page 192
Medication Distribution......Page 194
Hepatic Metabolism......Page 195
Renal Elimination......Page 196
Medication-Disease Interactions......Page 197
Medication-Nutrient Interactions......Page 198
Inappropriate Medications......Page 199
Medication Adherence......Page 201
Over-the-Counter and Illegally Obtained Narcotics and Herbal Medications......Page 204
Summary......Page 208
CHAPTER EIGHT Cognitive and Psychological Issues in Aging......Page 211
Delirium......Page 212
Depression......Page 219
Suicide......Page 223
Alzheimer's Disease (AD)......Page 224
Summary......Page 230
CHAPTER NINE Ethical Issues of Aging and Independence......Page 233
Ethical Principles......Page 235
Autonomy......Page 236
Nonmaleficence......Page 238
Justice......Page 239
Driving......Page 240
Sexuality in Older Adults......Page 243
Gambling......Page 248
Summary......Page 251
CHAPTER TEN Quality of Life Issues Among Older Adults......Page 253
Quality of Life (QOL)......Page 254
Elder Mistreatment......Page 257
Pain......Page 261
Grandparenting......Page 262
Spirituality......Page 263
Summary......Page 266
CHAPTER ELEVEN Environments of Care......Page 269
Home Care......Page 270
Caregiving at Home......Page 274
Acute Care......Page 276
Skilled Nursing Facilities......Page 277
Urinary Tract Infections......Page 278
Pressure (Decubitus) Ulcers......Page 286
Assisted Living......Page 287
Continuing Care Retirement Communities......Page 288
Homeless Older Adults......Page 289
Summary......Page 290
CHAPTER TWELVE End-of-Life Care......Page 293
Advance Directives......Page 294
Dimensions of End-of-Life Care......Page 297
Physical Dimension......Page 299
Spiritual Dimension......Page 302
Communication......Page 304
Widowhood......Page 305
Hospice Care......Page 306
Summary......Page 307
CHAPTER THIRTEEN Future Trends and Needs......Page 309
America Continues to Gray......Page 310
Changes in the Health Care Delivery System......Page 314
Ethical, Legal, and Financial Issues Related to Older Adults......Page 316
Normal Changes of Aging......Page 318
Medication Management......Page 319
Advances in Acute Illnesses and Chronic Disease Management......Page 321
Psychological and Cognitive Issues in Aging......Page 323
Environments of Care......Page 324
Conclusion......Page 325
Web Resources......Page 327
Index......Page 329