Secondary preventions for the elderly should include which of the following Quizlet

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Terms in this set (25)

Define "U.S. Preventive Services Task Force (USPSTF)."

The USPSTF was convened by the U.S. Public Health Service to
systematically review the evidence of effectiveness of clinical preventive services. The task force is an independent panel
of private-sector experts in primary care and prevention whose mission is to evaluate the benefits of individual services and create age-, gender-, and risk-based recommendations about services that should routinely be incorporated into
primary medical care.

Define "health promotion activities."

...

Define "Healthy People 2020."

Healthy People 2020 is an initiative of a federal interagency workgroup with input from many
governmental and private agencies. It is a set of healthcare objectives designed to improve the health of individuals and
communities, eliminate health disparities, and improve access to care.

Define "Health promotion activities."

activities in which an individual is able to proactively engage in to advance or improve
his or her health.

Define "primary prevention activities."

those designed to completely prevent a disease from occurring, such as immunization
against pneumonia or influenza.

Who should receive the pneumonia vaccine and describe the schedule.

All adults 65 years of age or older should receive a dose of PCV13 followed by a dose of PPSV23 at
least 1 year later.

When should an older adult receive the herpes zoster vaccine?

Once after age 60 even if the older adult has had a prior episode of herpes zoster.

Who should receive the tetanus vaccine and describe the schedule.

every 10 years Tdap recommended for older adults who have contact with
infants younger than 12 months of age.

Describe "secondary prevention."

efforts are directed toward early detection and management of disease, such as the use of
colonoscopy to detect small, cancerous polyps. Health Screening is a form of secondary prevention.

Describe "tertiary prevention."

efforts are used to manage clinical diseases to prevent them from progressing or to avoid
complications of disease, as is done when beta-blockers are used to help remodel the heart in congestive heart failure.

Healthy People 2020 and the USPSTF suggest the following focus areas for nurses to promote health and prevent disability in the elderly client (7):

● Physical activity
● Nutrition
● Tobacco use
● Health screening
● Injury prevention
● Preventive medications and immunizations
● Caregiver support

Describe "functional decline."

A decreased ability to independently perform activities of independent living or IADLs. Attributable
in part to physical activity.

What are the benefits of moderate physical activity (10)?

● Decreasing overall mortality
● Decreasing coronary heart disease (CHD), the leading cause of death in the United States
● Decreasing colon cancer
● Decreasing the incidence and improving the management of diabetes mellitus
● Decreasing the incidence and improving the management of hypertension
● Decreasing obesity
● Improving depression
● Improving quality of life
● Improving functional status
● Decreasing falls and injury

General dietary guidelines for older adults include (U.S. Department of Agriculture, 2010) (8):

● Limit alcohol to one drink per day for women, two daily for men.
● Limit fat and cholesterol.
● Maintain a balanced caloric intake.
● Ensure adequate daily calcium, especially for women.
● Older adults should consume foods fortified with vitamins, such as fortified cereals or supplements.
● Older adults who have minimal exposure to sunlight or who have dark skin need supplemental vitamin D. Daily
vitamin D intake should be 800 to 1000 IU and can be derived from fortified foods or supplements
● Include adequate whole grains, fruits, and vegetables.
● Drink adequate water.

List the 5 A's of tobacco use:

● Ask about smoking status at each healthcare visit.
● Advise client to quit smoking.
● Assess client's willingness to quit smoking at this time.
● Assist client to quit using counseling and pharmacotherapy.
● Arrange for follow-up within 1 week of scheduled quit date.

Describe "tobacco cessation counseling."

Level A recommendation: The USPSTF found good evidence that screening, brief
behavioral counseling, and pharmacotherapy are effective in helping clients quit smoking and remain smoke-free after 1
year. There are good data to support that smoking cessation lowers the risk for heart disease, stroke, and lung disease.

Describe "CAGE."

The CAGE questionnaire is a self-report
screening instrument that is easy and quick to administer (Ewing, 1984). It asks four yes/no questions and requires
approximately 1 minute to complete. CAGE is a mnemonic for the following four key screening questions:

● Cut down: Refers to attempts by the client to cut down on drinking
● Annoyance: Related to suggestions by friends or family to cut down on drinking
● Guilt: Relates to client guilt about drinking
● Eye opener: Relates to the need for a drink in the morning to get going

What is the leading cause of unintentional injury death in older adults in this country?

Falls

List intrinsic conditions that increase fall risk (6).

1. Postural instability
2. Decreased muscle strength
3. Gait disturbances
4. Decreased proprioception
5. Visual or cognitive impairment
6. Polypharmacy

List environmental conditions that increase fall risk (6).

1. Slippery surfaces
2. Stairs
3. Irregular surfaces
4. Poor lighting
5. Incorrect footwear
6. Obstacles in the pathway

List interventions aimed at reducing the risk of falls (6).

1. Home safety evaluation with appropriate modifications
2. Discontinuation of high-risk medications
3. Management of postural hypotension
4. Vitamin D supplementation
5. Assessment and treatment of foot problems
6. Exercise

What is the Level C recommendation for fall prevention?

The USPSTF does not recommend comprehensive risk assessment and management
of these risks to prevent falls in all community-dwelling adults aged 65 years or older because the likelihood of
benefit is small. This assessment and fall-risk plan should be provided for those with a history of falls, comorbid
illnesses that place the patient at risk for falls, poor performance on the Get Up and Go test, and use of
ambulatory devices.

What is the level B recommendation for fall prevention?

The USPSTF recommends exercise or physical therapy and vitamin D supplementation
to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls.

Which medications account for many ED visits, especially for those over the age of 80?

Insulin, warfarin, oral hypoglycemic meds, oral antiplatelet meds all account for many ED
visits, particularly for those over age 80

The Framingham heart study findings list the following as risk factors for coronary heart disease (10):

● Age 50 or older for men and 60 or older for women
● Hypertension
● Smoking
● Obesity
● Family history of premature CHD
● Diabetes (considered to be a CHD risk-equivalent, i.e., carries the same risk of a coronary event as known
CHD)
● Sedentary lifestyle
● Abnormal lipid levels
● Homocystine
● Lipoprotein A

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