Safety-highlights-for-the-elderlyyy.pptx

Safety highlights for the elderly adult

1. Safety highlights for the elderly 1

2. A. PREVENT FALLS Raise the siderails when in bed Bed must be placed in low position when not giving direct client care Handrails in bathroom and halls Uncluttered rooms and floors Adequate, nonglare and floors Nightlight at the bathroom and halls Provide “call bell” such as dinner bell

3. CARDIAC ARREST First cause of death of elderlies Heart disease involving the coronary arteries DISEASES COMMON IN THE AGED Common disease of the elderly involving the coronary disease: Angina pectoris Myocardial infarction Hypertension

4. 1. Angina pectoris -chest pain resulting from myocardial ischemia (lack of blood supply usually caused by a thrombus (blood clot) TYPES ATHEROSCLEROSIS – hardening of the arteries because of the fatty plaque deposits in the intima of the arteries ARTERIOSCLEROSIS – calcium deposits in the media of the artery. It occurs when the blood vessels that carry oxygen and nutrients from the heart to the rest of the arteries become thick and stiff and it sometimes restricting blood flow to the organs and tissues. RISK FACTORS MODIFIABLE – Hypertension, hyperlipidemia, smoking, obesity, diabetes, stress, sedentary lifestyle Non-modifiable – age, sex, family history (prone to male) 4

5. 1. Angina pectoris SIGN AND SYMPTOMS: Chest pain that radiate to the neck, shoulder down to the aspect of left arm -short duration and usually relieved by rest and nitroglycerin MANAGEMENT Have patient rest in a very comfortable position Give anti-anginal drugs as ordered Teach client to identify own pain pattern and to recognize change pain 5

6. 2. MYOCARDIAL INFARCTION SIGN AND SYMPTOMS Intense chest pain, squeezing vise like tightness Burning, crushing and persistent pain Fatigue Nausea and vomiting Shortness of breath Cool extremities Anxiety and perspiration The most deadly one Blockage of more coronary arteries causing an area of necrosis in the myocardium.

7. 2. MYOCARDIAL INFARCTION MANAGEMENT 1 . Immediate hospital care is advisable 2. Assess characteristics of pain 3. Check vital signs 4. Monitor response of drug therapy 5. Provide care in calm, stay with client until discomfort is relieve 6. Limit visitors 7. Give analgesics and other drugs as ordered 8. Provide assistance in the activities of daily living 9. Give health teaching like decrease level of activity, reduce calorie intake if the client is obese, restrict sodium and restrict cholesterol, fat and saturated fat

8. HYPERTENSION TYPES Primary or essential or idiopathic hypertension – with unknown cause Secondary hypertension – with identifiable primary disease PREDISPOSING FACTORS Stress Family history Obesity A chronic elevation of systolic arterial blood pressure in which the systolic blood pressure is consistently over 140/90 mmHg for men and 160/95 mmHg or higher 8

9. HYPERTENSION Symptoms : Blood pressure elevated on at least three different occasions headache Blurring of vision Epistaxis (nose bleeding), tinnitus and flushed face Personality change: forgetful, irritable and confused 9

10. HYPERTENSION MANAGEMENT Monitor blood pressure Modify lifestyle to reduce stress Modify diet- reduce calories, sodium intake restricted and potassium increased if needed Exercise regularly in a planned program Avoid smoking Administer antihypertensive drugs as ordered Notify physician if condition worsen. 10

11. GENERAL CARE/ MANAGEMENT FOR CARDIAC DISEASE To prevent the disease instruct the patient to have a regular exercise, avoid being obese and avoid fatty and salty foods. Avoid large meals and rest period is given after each meal Give drugs as prescribed by doctor Constipation should be avoided Proper position on bed 11

12. B. PERIPHERAL VASCULAR DISEASE 12 SIGN AND SYMPTOMS Pain (leg muscle) Color changes (bluish or reddish in color) Skin temperature changes Changes in the size of the part (edema) (too much fluid trapped in the body tissues) Presence of trophic changes (dryness and thickening of nails, dry, thin, scaling skin are evidences of poor circulation THROMBOPHLEBITIS – occurrence of a clot on a venous channel with accompanying inflammation VARICOSE VEINS – due to valvular defects in the veins RISK FACTORS – prolonged standing or sitting (w/ cross leg), heredity and obesity SIGN AND SYMPTOMS – veins are large and tortuous, dull pain, chronic leg fatigue

13. B. PERIPHERAL VASCULAR DISEASE 13 CARE/MANAGEMENT Prevent complication and teach the patient : Care of the foot is a must Avoid use of tobacco Alcohol may be given in moderate amount Moderate exercise Obesity is avoided Diet high in protein, mineral and vitamins Use of support stockings Leg exercise is applicable 2. For thrombophlebitis – rest the affected areas, moist heat elevate the extremities 3. For varicosities – elevation of limbs, use of elastic stockings or bandage

14. c. NEUROLOGIC DISEASE DEMENTIA – impairment of intellectual function accompanied with memory loss and personality changes. ALZHEIMER’S DSE – chronic progressive degenerative illness for which no cure or treatment has yet been found. MANIFESTATIONS Physical health usually not affected Intellectual impairment – does not recognize staff or family Behavior - paranoid, delusions, wandering behavior, diminish hygiene and grooming Motor responses - motor ability declines Bowel and bladder function 14

15. c. NEUROLOGIC DISEASE DEGREE OF DEMENTIA MILD MODERATE SEVERE Characteristics of mild dementia Confusion Loss of memory Loss attention span Disorientation carelessness 15

16. c. NEUROLOGIC DISEASE Characteristics of moderate dementia More memory loss Complete disorientation Speech problem Incontinence Inability to use simple object like comb, spoon or fork Characteristics of severe dementia Bedridden or helpless Loss the power of speech No more focus Seizures 16

17. CARE AND MANAGEMENT Provide a safe environment to prevent falls, unsafe wandering Check client frequently specially at night Use restraints only when no other choice and only with physician order Assist with ambulation if needed Never leave anything at the bedside that could harm client Raise side rails up and bed in low position 2. Monitor medications and its effect 17

18. CARE AND MANAGEMENT 3. Use clear, verbal communication techniques Short words, simple sentences, verbs and nouns Speak in clear, low pitched voice Call client by name and identify yourself Speak slowly, clearly; wait for response Ask only one question at a time, use yes/no questions and avoid questions that require choices Repeat, do not rephrase 18

19. CARE AND MANAGEMENT 4. Use non – verbal communication Approach in a calm, friendly manner Label items using pictures Use gestures, move slowly Stand directly in front of client, maintain eye contact Move or walk with client, do not try to stop Listen actively, show interest Chart all phrases & non-verbal techniques used and use those that works 19

20. CARE AND MANAGEMENT 5. Monitor activities of daily living Orient to environment and activity on a “here and now” basis frequently Provide consistent routine with activities Remind how to self care activities, limit fluids when bedtime Avoid activities that tax the memory Give tasks that distract and occupy such as listening to music, coloring, watching TV 20

21. CARE AND MANAGEMENT 6. Maintain the client’s physical activity within limits of safety Walk outside if grounds are wander protected Dance Exercises with simple command, walking if able and ROM if bedridden Active games Balance activities 7. Avoid isolating the client, provide mental stimulation such as television or soft music Simple hobbies One to one contact Reality orientation Play word or number games 21

22. CARE AND MANAGEMENT 8. Provide high-calorie diet to clients who are hyperactive; provide finger foods if necessary 9. Encourage clients to stay awake during day so they can sleep at night 10. Avoid overstimulation at bedtime, schedule test and activities for morning and afternoon 11. Use consistent staff to provide care, changes is frightening; encourage self care, give cues, put families in touch with support groups. 22

23. PARKINSON’S DISEASE A progressive disorder with degeneration of the nerve cells Usually associated with arteriosclerosis, encephalitis and drug positioning 23 MANIFESTATION: Faint tremor, mainly of the upper limbs, “pill-rolling,” resting tremor Muscle rigidity, cogwheel type Mask-like appearance of the face with decreased blinking of the eyes Slowed monotonous speech Drooling of saliva and difficulty of swallowing Characteristics shuffling gaits – tends to walk on toes, taking small steps then increasing rate of motion Trunk slanted forward, arms are rigid at sides and do not swing Difficulty rising from sitting position Emotional lability, depression Cramped, small hand writing Autonomic symptoms – excessive sweating, seborrhea, lacrimation, constipation, decreased sexual capacity

24. CARE AND MANAGEMENT Administer medications as ordered. Avoid multiple vitamins containing vit B6 (pyridoxine) Provide safe environment Provide measures to increase mobility like ROM, EXERCISE, WARM BATHS, ASSISTIVE DEVICES Encourage independence in self care activities, do not rush clients Improve communication abilities, instruct clients to read, to listen to own voice or have speech therapy if needed. Avoid constipation and ,maintain adequate bowel elimination Maintain adequate nutrition, cut food into bite size, allow sufficient time for meals, use warming tray Provide psychological support to client, depression is common due to changes in the body image and self concept Explain importance of daily exercise Provide activities/methods to limit postural deformities, raise feet while walking, keep neck and head erect, firm mattress with a small pillow 24

25. CEREBRO-VASCULAR ACCIDENT The destruction of brain cells caused by a reduction in cerebral blood flow and oxygen caused either a thrombus or hemorrhage also called stroke RISK FACTOR Hypertension, diabetis mellitus, arteriosclerosis, cardiac dse Life-style; obesity. Smoking. Stress, use of oral contraceptives 25

26. CEREBRO-VASCULAR ACCIDENT MANIFESTATIONS On and off headache later becoming persistent Recurrent lightheadedness Severe dizziness Syncope or fainting Fall or drop attack with no loss consciousness Blurring of vision Temporary loss of sensation and disorientation Serious impairment of memory Nose bleeding Vomiting, seizures, confusion, fever, hypertension 26

27. CEREBRO-VASCULAR ACCIDENT CARE/MANAGEMENT Provide means of communication. Ask help from speech therapist as needed Oral hygiene Adequate nutrition. Give small frequent feeding Avoid constipation. Provide adequate fluids Prevention of contractures by passive exercise and observe proper positioning Monitor patient’s neurological status, don’t stimulate coughing Decrease environmental stimuli Assist physical therapist as needed Promote optimum skin integrity ; turn client and apply lotion every 2 hours during acute stage and those that develop hemiplegia Support paralyzed arm on pillow or use of sling while out of bed tp prevent subluxation of shoulder 27

28. CEREBRO-VASCULAR ACCIDENT Elevate extremities to prevent dependent edema(swelling caused by too much fluid trapped in the body tissue Prevent hazards by keeping side rails up at all times, institute safety measures and inspect body parts frequently for signs of injuiry 28

29. CEREBRO-VASCULAR ACCIDENT 29

30. CEREBRO-VASCULAR ACCIDENT 30

31. CEREBRO-VASCULAR ACCIDENT 31

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