Our main job as nurses is to assess. A full head-to-toe assessment must be done to
each patient on our progressive care unit then a focused assessment dependent
on 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 must
focus on in geriatric patients include eyesight changes or eye diseases and
whether or not they wear corrective lenses; Decreased hearing and if they have
any hearing aids; Missing teeth or presence of dental appliances and whether
they fit or not; Signs of decreased nutrition intake or decreased nutrition
intake by the patient due to not feeling hungry; GI issues such as constipation
or diarrhea and if the patient has incontinent episodes; Evaluation of the skin
is necessary to assess for bruising, turgor, lesions, and keratosis; Musculoskeletal
issues such as limited ROM, joint tenderness, fractures, and osteoporosis.
Tremors and signs of stroke are also commonly assessed. Physical examinations
vary accordingly of course (Elsway & Higgins).
In geriatric patients, we must assess the functional status
of activities of daily living (ADL). Common ADL questions include questions
about using the telephone, ability to walk and how far, shop for groceries,
preparing meals, house chores, yard work, laundry, money management and paying
their bills. Important questions we must always ask our patients are how they take
their medications, how much, when, what they take, and the reason why they take
certain medications. Polypharmacy is a huge issue among geriatric patients
because they tend to keep old medications previously prescribed that they did
not finish because they were feeling better (Elsway & Higgins, 2010).
According to the National Institutes of Health the functional
assessment is just as important as the comprehensive physical geriatric
assessment. Other factors that are important to assess in geriatric patients
are physical activity health, history of mental health or are they now
depressed, socioeconomic status, financial status, and environmental
characteristics. We must ask who the patient lives with and whether or not they
have adequate support or care. If they come from home we must assess family
support systems and if they come from a facility its important to assess the
type of services they provide to the patient and if they are receiving adequate
care there (NIH, 2017).
Abuse screening must ALWAYS be conducted wherever our
geriatric patients may be coming from. There are different types and levels of
abuse, these include: physical harm, sexual abuse, emotional abuse, neglect, and
financial abuse. Abuse happens because of cognitive and physical deficits of
the geriatric populations and caregiver role stress (Friese, 2010). Here in the
state of New Mexico, healthcare professionals must assess for and report this.
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