Our main job as nurses is to assess. A full head-to-toe assessment must be done toeach patient on our progressive care unit then a focused assessment dependenton the issue the patient presents with. The geriatric assessment differs because the older adult population,have more illnesses in general.
Most common physical assessment areas that we nurses mustfocus on in geriatric patients include eyesight changes or eye diseases andwhether or not they wear corrective lenses; Decreased hearing and if they haveany hearing aids; Missing teeth or presence of dental appliances and whetherthey fit or not; Signs of decreased nutrition intake or decreased nutritionintake by the patient due to not feeling hungry; GI issues such as constipationor diarrhea and if the patient has incontinent episodes; Evaluation of the skinis necessary to assess for bruising, turgor, lesions, and keratosis; Musculoskeletalissues such as limited ROM, joint tenderness, fractures, and osteoporosis.Tremors and signs of stroke are also commonly assessed. Physical examinationsvary accordingly of course (Elsway & Higgins).
In geriatric patients, we must assess the functional statusof activities of daily living (ADL). Common ADL questions include questionsabout using the telephone, ability to walk and how far, shop for groceries,preparing meals, house chores, yard work, laundry, money management and payingtheir bills. Important questions we must always ask our patients are how they taketheir medications, how much, when, what they take, and the reason why they takecertain medications. Polypharmacy is a huge issue among geriatric patientsbecause they tend to keep old medications previously prescribed that they didnot finish because they were feeling better (Elsway & Higgins, 2010).
According to the National Institutes of Health the functionalassessment is just as important as the comprehensive physical geriatricassessment. Other factors that are important to assess in geriatric patientsare physical activity health, history of mental health or are they nowdepressed, socioeconomic status, financial status, and environmentalcharacteristics. We must ask who the patient lives with and whether or not theyhave adequate support or care. If they come from home we must assess familysupport systems and if they come from a facility its important to assess thetype of services they provide to the patient and if they are receiving adequatecare there (NIH, 2017).
Abuse screening must ALWAYS be conducted wherever ourgeriatric patients may be coming from. There are different types and levels ofabuse, these include: physical harm, sexual abuse, emotional abuse, neglect, andfinancial abuse. Abuse happens because of cognitive and physical deficits ofthe geriatric populations and caregiver role stress (Friese, 2010). Here in thestate of New Mexico, healthcare professionals must assess for and report this.
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