HLT1IPP Lecture Notes - Lecture 9: Donepezil, Galantamine, Cholinesterase

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9 Aug 2018

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More females than males robust evidence base suggests that higher levels of education in early life reduce the risk of dementia, while higher levels of high blood pressure in mid-life and diabetes in late life increase it (adi 2014). Dementia was the second leading cause of death in australia in 2013, accounting for almost 11,000 deaths (7. 4% of all deaths). For deaths associated with dementia, the median age at death was 88. Dementia is one of the leading contributors to burden of disease and disability, and people with dementia are frequent users of health and aged care services. Because of the degenerative nature of the condition, an individual"s need for assistance generally increases as the disease progresses. Ho(cid:449) does it differ fro(cid:373) alzhei(cid:373)er"s disease? a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning.

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PLEASE ANSWER ALL QUESTIONS..PLEASE NOT ONLY 1 QUESTION. THANK YOU

QUESTION 1. Chronic diseases generally have several underlying characteristics, including a.A long latency period between exposure to risk and disease outcomes b. Low degree of preventability c. High curve rate d.None of the above

QUESTION 2.Which of the following risk factors collectively explain a significant proportion (not incidence) of most chronic diseases. a.Tobacco, alcohol, diet b.Tobacco, alcohol, diet, physical activity c. Alcohol, physical activity d.Tobacco, diet, physical activity

QUESTION 3.Adherence to treatment is influenced by several interacting dimensions including a.Social and economic factors b. Healthcare system factors c.Condition-related factors d.Therapy-related factors e.Patient related factors f.All of the above

QUESTION 4. _________ is the leading cause of cancer in both developed and developing countries worlwide a.Radiation exposure b. Tobacco use c.Pesticide exposure d.Air pollution

QUESTION 5.This week's YouTube video on treating non-communicable diseases in Rwanda showed how a community health worker helps to treat heart disease, diabetes and _______ a.Cancer b.Asthma c.Hepatitis d.HIV/AIDS

QUESTION 6.Which of these are myths of chronic disease control a.Benefits of chronic disease control accrue not only to the individual but also to the population b.Economic growth improves all health conditions c. Chronic diseases are associated with low SES/poverty d.Chronic disease only occurs in the elderly e.a and c f.b and d

QUESTION 7 ___________ remains the leading cause of death among both men and women in low- and middle-income countries a.Cancer b.Cardiovascular disease c. Diabetes d.Obesity e.Respiratory disease

QUESTION 8.Chronic disease in adults accounts for approximately 60% of all deaths worldwide. True False

QUESTION 9.The WHO's Innovative Care for Chronic Conditions Framework includes a positive policy environment. True False

QUESTION 10.It is estimated that the overall number of cancer cases will rise by 50% in the next 20 years. True False

QUESTION 11.Comorbidity refers to simultaneous occurrence in a person of two or more disorders; comorbid conditions can increase the risk of adverse outcomes. True False

QUESTION 12.Emerging evidence supports starting promotion efforts during pregnancy and early childhood and continuing efforts throughout life lower exposures to major chronic disease risk factors. True False

QUESTION 13. Increased cumulative exposure to risk factors over the lifecourse combined with social and economic inequalities, leads to the levels of inequalities seen in later adult life. True False

QUESTION 14.The "compression of morbidity" model proposes that morbidity due to aging cannot be postponed or mitigated by disease prevention programs True False

QUESTION 15.There is few significant funding sources for chronic diseases in low-and middle-income countries. True False

QUESTION 16.To combat chronic diseases, modern, evidence-based interventions emphasize shared decision making and collaborative goal setting among providers and patients. True False

QUESTION 17.In the absence of legislative, financial and engineering approaches, health education programs often have a limited impact on preventing or reducing chronic diseases. True False

QUESTION 18. It is estimated that deaths from diet-related chronic disease in China will triple between 1995 and 2025. True False

QUESTION 19.The third highest percent of global DALY's is attributed to which risk factor? a.Alcohol use b.Tobacco use c.Unsafe sex d.Childhood underweight

QUESTION 20.In the 1990's which country experienced a substantial decline in male life expectancy as a result of dramatic socio-political changes a.China b.Russia c. India d.Canada

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Q37 Research indicates more than 90 % of the deaths occur in older adult 65 and older due to lack of appropriate immunizations on which annual vaccination should the nurse first instruct the patient?

A Pneumonia

B Varicella

C TDAP

D influenza

Q38 which strategies of care would be least likely to enhance the physical function of older adult choose? Choose 2 answers

A weight control

B hearing and vision screening

C smoking cessation

D illness management

E forcing them to attend all activities

Q39 what are common risk factors that contribute to functional decline in the older adult population?

A physical inactivity

B tobacco use

C low sodium dietary intake

D having small families

Q40 what principle is least related to promoting health and preventing certain disabilities in older adults?

A continue activities of daily life (ADLs)

B Maintain as active a lifestyle as possible and desired

C Monitor illnesses through annual health screening ( AHS)

D keep up on assistive and information technology and other tools

Q41 Which focusing on the psychosocial needs of older adults, authorVirginia satir recommends that Healthcare providers get back to the basic communication. whatare the five basic principles satir describes?

A invite

B follow through

C respect personal space

D maximize understanding

E Arrange environment

F maximize attention levels

G trust

H maximize communication

Q42 how do electronic health records facilitate better care coordination? Choose 2 answers

A saving time typing rather than writing

B increasing the accuracy of diagnosis and health outcomes

C preventing an increase in the number of medical errors

D improving communication among health providers

Q43 Rick a 91 year old male, hasa history of chronic otitis media and is experiencing mild hearing loss in hisright ear,what type of assistive technology would Rick use to improve communicative function?

A icon communication board

B behind the ear ( BTE) hearing aid

C Augmentive and alternative communication ( AAC)

D completely in the canal ( CIC) hearing aid

Q 44 An elderly patient has suffered a stroke and is currently in the process of transitioning out of the hospital and into an assisted living facility. The patient's primary diffulty after the stroke is dealing with dysarthria, whichhas limited the patient's ability to speak. whatcommunication technology would appropriately promote an optimal transition of care for the patient?

A an over the ear (OTE) hearing aid

B an augmentation and alternative communication ( AAC) device

C an assistive listening device ( ALD)

D an analog technology to amplify sound

Q45 what must the nurse inform the patient and family or caregivers about assistive devices? Choose 2 answers

A may lessen the importance of ongoing communication with healthcare providers.

B they may result in complete recovery from chronic illness

C they may limit complications of an illness or disability.

D they may enable independent performance and reduce risk of injury.

Q46 An 81 year old Patient has multiple chronic conditions including uncontrolled hypertension and peripheral artery disease and agrees to try assertive devices for monitoring blood pressure and improving circulation provided by a home health agency. Choose 2 answers

A allowing the patient enough time and opportunity for repetition

B only presenting the most relevant content to the patient.

C refraining from suggesting mnemonic devices to Aid the patients use of Technology

D having an outside educator provide several hours of detailed device instructions

Q47 A goal of the National Health Initiative healthy people 2010 is to increase the quality and extend the years of healthy life. What are two ways that this initiative can achieve its goal? Choose 2 answers

A by pressuring older adults who are lonely to move to nursing homes at younger ages

B By encouraging people to have more children so that the children can help their parents as they grow older

C by helping people overcome views of denial and foreboding as old age approaches

D by trying to spread the view that aging is natural and need not include illness and disease

Q48 match each government program with its description. Answer options may be used more than once or not at all

A provide health insurance for low-income families

B bases basic benefits on a workers average indexed monthly earnings in covered employment

C offers a payment system for long-term care ( LTC) foreligible older Americans and persons with disabilities

D is the health insurance program for those 65 or other people with disabilities

Q49 a senior is being cared for by her daughter. The daughter works a full-time job and is only able to care for her mother before she goes to work. On her lunch break, andafter she gets off work. thesenior expresses to a nurse that she gets lonely during the day and sometimes cannot perform tasks by herself.which community resource should the nurse recommend looking into?

A a local Health Clinic

B Day Care Services for Seniors

C a medication assistance program

D Meals on Wheels.

Q50 the Independence at home demonstration was created by the Affordable Care Act. Which statement is true regarding Primary Care teams participating in this initiative?

A the teams are led by a licensed administrator

B the teams must serve at least 500 Medicare beneficiaries.

C the teams be led by a physician.

D the teams can be lead by a nurse practitioner.

Q51 which important facts about Medicare should nurses know? Choose 2 answers

A Medicare requires income assessment in order to qualify for coverage

B Medicare cover assisted living services for Americans in extreme poverty.

C Medicare recipients range from those simply needing Wellness services to those who are profoundly Frail.

D Medicare covers certain disabled Americans who have not reached age eligibility.

Q52 what is a common preventable error that can occur during the transition of care for older adults?

A unhelpful Hospital staff B inaccurate medication reconciliation.

C disorganized dosing schedule

D lost nursing equipment.

Q53 how is communication further facilitated? Choose 2 answers

A through communication to between and among the patients family caregivers and health care providers

B through active engagement of patients and family caregivers with a focus on meeting the patients goals

C through reliance on use of text messages that are less disruptive to the patient and family.

D through Healthcare Providers conversing with the patient and allowing the patient speak with the family.

Q54 what are appropriate evaluation measures related to successful transitions of care? Choose 2 answers

A emotional and social domains of quality of life.

B all clinical indicators related to Chronic conditions.

C functional status

D exclusion of nursing sensitive measures.

Q55 a critical competency in geriatric nursing is the ability to assess family knowledge of the skills necessary in the care of older adults. What Broad caregiver competencies are included in this assessment?

A knowing the science behind the scenes of geriatrics

B allowing the active participation of the patient in all aspects of care.

C balancing the patient autonomy with safety

D knowing how to safely start an IV.

Q56 what Communications techniques promote safe transition of care in patients with aphasia?

A respond in the affirmative when a question is asked

B speak softer so as to never have a harsh tone

C give the patient time to speak

D use non-verbal gestures to communicate.

Q57 what roles of the nurse protect the patient from harm in a care transition?

A symptom manager,educator, collaborator, carecoordinator.

B medication manager screener educator listener

C liasson with Hospital decision maker collaborator coordinator

D decision maker Symptom Manager care coordinator.

Q58 which statements are true regarding health-related quality of life? Choose 2 answers

A cannot be measured in persons with chronic illness

B is measured by and object Observer, basedon the number of times an individual emits both verbal signs of happiness and well-being

C is measured by individuals perceived healthy days per month.

D can be measured by an instrument developed by the center of Disease Control (CDC)

Q59 several options are available as a care approaches to chronic illness care. Which method best describes palliative care?

A care that is only delivered by family or other personal caregivers

B end-of-life care that suspends active treatment

C a combination of active treatment and comfort measures

D a continued focus on here rather than comfort and quality of life.

Q60 A nurse caring for people at the end of their lives knows that Dysnea is relatively common and interferes with patients'comfort and rest. What is the evidence based intervention for shortness of breath?

A liquid morphine at starting dose of 10 mg every 4 hours and titrating dose upward until dyspnea is relieved.

B administer O2 at least 5 liters per minute

C 5 mg of liquid morphine every 4 hours,along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness.

D elevate the head of the bed no more than 20 degrees.

Q61 what do dying persons typically experience grief over?

A loss of bodily function and independence that occurs as illness becomes more prevalent

B loss ability to give and receive love

C loss of basic beliefs,values and faith.

D the feeling that nobody cares that the person is dying.

Q62 which of the following is often the biggest barrier to overcome in crucial conversations to death and dying?

A mistrust of healthcare providers

B lack of energy

C societal attitudes about death

D cost of care

Q63 The End of life Nursing Education consortium (ELNEC) is a resource targeted to nurse providing end of life care that supports evidence based care of dying patients and their families,as well as self care that lessens stress and anxiety and sustains nurse in providing excellent end of life care. Which of the following are self care principles? Choose 2 answers

A maintaining professional boundaries and relationships with patients and families, by tightly controlling feelings and empathy

B. Making good use of the expertise and support of the interprofessional care team

C. Diminishing attention on maintaining an active personal life since end-of-life care is a callings of sorts

D. Developing expertise in symptom management, which not only helps patients and their families, but increases satisfaction and lessens anxiety among professional caregivers

Q64. In addition to a living will, advanced directives may also include a durable power of attorney that encompasses health care related decision making. Which two of the following are accurate so statements regarding the legal instrument known as the durable power of attorney?

A. The alternative decision maker must be a close relative of a dying persons in order to understand his or her wishes.

B. It allows for an alternative decision maker in the event that the dying persons is incapacitated and no longer able to make health care decision

C. The living will remains a useful tool in providing direction to the alternate decision maker.

D. A durable power of attorney for health care decision also enables the alternative decision maker to also handle finances and other legal matters.

As the U.S. Surgeon General warns on each pack of cigarettes, smoking can be hazardous to your health. Researchers estimate that smoking kills 440,000 Americans a year10 times the fatalities from traffic accidents. Smoking is the overwhelming cause of lung cancer, which is the top cancer killer among women. Four of five people with lung cancer die within three years. Smoking is also the leading cause of heart disease, emphysema, and stroke.

Thus, smoking imposes major health and economic costs. Policymakers try to reduce these costs by discouraging smoking, especially among young people. About one in four U.S. high school students were smokers in 2005, the same rate as in 2003. Each day, about 3,000 U.S. teens under 18 become regular smokers. Worldwide, an estimated 100,000 teens become regular smokers each day.

One way to reduce youth smoking is to prohibit the sale of cigarettes to minors. A second way is to raise the price through higher cigarette taxes. The amount by which a given price hike reduces teen smoking depends on the price elasticity of demand. This elasticity is higher for teens than for adults. Why are teenagers more sensitive to price changes than adults?

First, recall that one factor affecting elasticity is the importance of the item in the consumer's budget. Because teen income is relatively low, the share spent on cigarettes usually exceeds the share spent by adult smokers.

Second, peer pressure shapes a young person's decision to smoke more than an adult's decision to continue smoking (if anything, adults face negative peer pressure for smoking). Thus, the effect of a higher price gets magnified among young smokers because that higher price also reduces smoking by peers. With fewer peers smoking, teens face less pressure to smoke.

And, third, young people not yet addicted to nicotine are more sensitive to price increases than are adult smokers, who are more likely to be already hooked.

The experience from other countries supports the effectiveness of higher cigarette taxes in reducing teen smoking. For example, a large tax increase on cigarettes in Canada cut youth smoking by two-thirds. Another way to reduce smoking is to change consumer tastes through health warnings on packages. In Canada, these warnings include photos showing how smoking can affect the brain, teeth, and gums, and a wilted cigarette depicts male impotence.

In Australia, labels show gangrenous limbs, underweight babies, cancerous mouths, and blind eyes. Belgium adds corpses to the picture.

In California, a combination of higher cigarette taxes and an ambitious awareness program contributed to a 5 per cent decline in lung cancer among women, even as it rose 13 per cent in the rest of the country. (As of 2007, state taxes varied from a low of 7 cents per pack in South Carolina to a high of $2.58 in New Jersey.)

More generally, the message about the dangers of smoking along with the higher cost of cigarettes has affected over time. Only about 20 per cent of American adults now smoke, down from more than half in the 1960s.

According to the U.S. Centers for Disease Control and Prevention, each pack of cigarettes sold in the United States costs society $7.18 in higher health care costs and lost worker productivity. The added cost exceeds $150 billion a year, which works out to be about $3,400 per smoker per year.

What is the best way to prevent and reduce smoking? Briefly discuss.

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HLT1IPP Lecture Notes - Lecture 9: Donepezil, Galantamine, Cholinesterase

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