Geriatric Nursing Care Plans - 11 Nursing Diagnosis For The Elderly

9/29/2020 Geriatric Nursing Care Plans: 11 Nursing Diagnosis for the Elderly
11 Geriatric Nursing Care Plans (Older

Adult)
Nursing care plans and diagnosis for the older adult
By Paul Martin, BSN, R.N. - Last Updated on April 10, 2019
Nursing care plans and nursing diagnosis for elderly patients (geriatric nursing)
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In this nursing care plan guide are 11 nursing diagnosis for the care of the elderly (older adult)
or geriatric nursing or also known as gerontological nursing. Learn about the assessment,
care plan goals, and nursing interventions for gerontology nursing in this post.
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Gerontology nursing or geriatric nursing specializes in the care of older or elderly adults.
ACCEPT
Geriatric nursing addresses the physiological, developmental, psychological, socio-economic,
https://nurseslabs.com/geriatric-nursing-care-plans/ 1/34
cultural and spiritual needs of an aging individual.
Since aging is a normal and fundamental part of life. Providing nursing care for elderly clients
should not only be isolated to one eld but is best given through a collaborative e ort which
includes their family, community, and other health care team. Through this, nurses may be
able to use the expertise and resources of each team to improve and maintain the quality of
life of the elderly.
Geriatric nursing care planning centers on the aging process, promotion, restoration, and
optimization of health and functions; increased safety; prevention of illness and injury;
facilitation of healing.
Here are 11 nursing care plans (NCP) and nursing diagnosis for geriatric nursing or
nursing care of the elderly (older adult):
1. Risk for Falls
2. Impaired Gas Exchange
3. Hypothermia
4. Disturbed Sleep Pattern
5. Constipation
6. Adult Failure to Thrive
7. Risk for Aspiration
8. Risk for De cient Fluid Volume
9. Risk for Injury
10. Risk for Infection
11. Risk for Impaired Skin Integrity
1. Risk for Falls
Nursing Diagnosis
Risk for Falls
Risk Factors
Common risk factors for the nursing diagnosis risk for falls:
ACCEPT
Age (especially ≥ 65 years)
Impaired physical mobility
Loss of muscle strength
Altered sensory perception
Presence of illness (Alzheimer’s disease, dementia, osteoporosis)
Urinary incontinence
Use of medications
Disorientation
Dizziness
Lack of knowledge of environmental hazards secondary to confusion
Improper use of aids (e.g., canes, walkers, wheelchair, crutches)
De ning Characteristics
Not applicable for risk diagnosis. A risk diagnosis is not evidenced by signs and symptoms,
as the problem has not occurred and nursing interventions are directed at prevention.
Desired Outcomes
Expected outcomes or patient goals for risk for falls nursing diagnosis:
Patient will be free from falls.
Patient and caregiver will implement measures to increase safety and prevent falls in the
home.
Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scienti c
explanation for the nursing diagnosis risk for falls:
Nursing Interventions Rationale

Nursing Assessment
These factors will help in determining

interventions necessary for the patient. Risk
Identify factors that increase the level of fall
factors include age, presence of an illness,
risk
sensory and motor de cits, medication use,
and inappropriate use of mobility aids.
Assess the patient’s environment for factors A patient who is not familiar with the
ACCEPT
associated with an increased risk for fall. placement of furniture in an area or who
has inadequate lighting in the house

increases the risk for falls.
Therapeutic Interventions
Healthcare providers need to recognize

Secure a wristband identi cation to warn
patients at high risk for falls to implement
healthcare providers to implement fall
measures to promote patient safety and
precaution on the patient.
prevent falls.
Provides easy access to assistive devices
Place assistive devices and commonly use and personal care items. Items such as call
items within reach. bell, telephone, and water should be kept
close to avoid frequent reaching.
Hospital facility should have clear policies
Review hospital protocols regarding
and procedures during transfers that will
transferring a patient.
ensure the patient’s safety.
Keep the patient’s bed in the lowest position Keeping the bed closer to the oor prevents
at all times. injury and risk of falls.
This is to prevent an unstable patient from
Answer call light as soon as possible.
ambulating without any assistance.
Raising the side rails reduces the risk of
Use side rails on bed as needed
patients falling out of bed during transport.
Advise the patient to wear shoes or slippers Wearing non-slip footwear help prevents
with non-slip soles when walking. slips and falls.
The patient should be familiarized with the
Orient the patient to the surroundings.
bed, location of the bathroom, furniture,
Avoid re-arranging the furniture in the
and other environmental hazards that can
room.
cause older patients to trip or fall.
Ensure the patient’s room is well-lit.
Providing lighting in key places can reduce
Consider the use of a bedside lamp that is
fall risk and avoid obstacles during mobility.
turned on at night.
Encourage the family and other signi cant Prevents the patient from accidentally
others to stay with the patient at all times. falling or pulling out tubes.
Hazard can be lessened if the patient
Ensure the patient’s eyesight is regularly
utilizes appropriate aids to improve visual
checked and explain the importance of
and auditory orientation to the
wearing eyeglasses if needed. Make sure
environment. Visually impaired patients are
glasses and hearing aids are always worn.
at high risk for falls.
Instruct the patient how to ambulate at Help relieve anxiety at home and eventually
home, including using safety measures such decreases the risk of falls during
as handrails in the bathroom. ambulation.
Encourage the patient to engage in a Exercises can improve muscle strength,
program of regular exercise and gait balance, coordination and reaction time.
training. PhysicalACCEPT
conditioning reduces the incidence
of falls and avoids injury that is sustained

when a fall happens.
A review of the patient’s prescribed
medications will recognize side e ects and
drug interactions that may enhance fall
Collaborate with other health care team to
injury risk. The more medications a patient
assess and review patient’s medications that
takes, the greater the risk for side e ects
can contribute to the risk for falls. Identify
and interactions such as orthostatic
the peak e ects of the medications that can
hypotension, dizziness, confusion, urinary
alter the consciousness of the patient.
incontinence, and altered gait and balance.
Polypharmacy in older adults is a signi cant
risk factor for falls.
The use of gait belts provides a more secure
Evaluate the need for physical and means to safely assist patients when
occupational therapy to assist patient with transferring from bed to chair. Assistive aids
gait techniques and provide the patient with such as wheelchairs, canes, and walkers
assistive devices for transfer and allow the patient to have stability and
ambulation. Initiate a home safety balance during ambulation. High toilet seats
evaluation as needed. can facilitate safe transfer on and o the
toilet.
2. Impaired Gas Exchange

Nursing Diagnosis
Impaired Gas Exchange
Related Factors
The following are the common related factors for the Impaired Gas Exchange nursing
diagnosis:
Reduced oxygenation with decreased functional lung tissue
The following are the common subjective and objective data or nursing assessment cues
(signs and symptoms) that could serve as your “as evidenced by” for this care plan:
ACCEPT
Dyspnea
Irritability; restlessness
Lethargy
Tachycardia
Decreased mental acuity
Abnormal ABGs
Desired Outcomes
Below are the commonly used expected outcomes or patient goals for Impaired Gas
Exchange nursing diagnosis:
Patient’s respiratory pattern and mental status will be normal for the client.
Patient’s pulse oximetry or arterial blood gas results will be within the patient’s normal
limits.

In this section are the nursing interventions and rationale (or scienti c explanation) for the
nursing diagnosis Impaired Gas Exchange for Geriatric Nursing Care Plans or Gerontological
Nursing Care Plans.
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Nursing Assessment
Monitor and record the following during
Provides baseline data for subsequent
admission and routinely thereafter:
assessments of the patient’s respiratory
respiratory rate, depth, and pattern; breath
system.
sounds, cough, sputum, and mental status.
Assess subtle changes in patient’s behavior These changes in the sensorium can
or mental status e.g., anxiety, disorientation, indicate decreasing oxygen levels. To
hostility, and restlessness. Check oxygen comprehensively monitor pulse oximetry,
levels using pulse oximetry (higher than the hemoglobin (Hgb) must be determined.
92%) or reviewing ABG values (optimally Patients with low hemoglobin levels can
ACCEPT
Pao2 80%-95% or higher). have a higher pulse oximetry level and still
exhibit acute confusion or restlessness. This

happens as a result of diminished
hemoglobin to deliver oxygen through the
body.
When people get older, lungs elasticity
decreases. The lower portion of the lung is
not su ciently aerated resulting in the
occurrence of crackles (usually heard in
individuals 75 years of age and above). This
Auscultate the lungs for adventitious sign alone does not imply the presence of a
sounds. disease condition. Crackles (rales) that do
not clear with coughing in an individual with
no additional symptoms such as increased
temperature, increasing anxiety, changes in
sensorium, increasing respiratory depth are
considered benign.
These measures provide alveolar expansion
Encourage breathing and coughing
and remove the secretions from the
exercises. Instruct patient in use of incentive
bronchial tree, resulting to optimal gas
spirometry if applicable.
exchange.
Encourage increased uid intake (greater
Adequate hydration promotes mobilization
than 2.5 liters daily) unless contraindicated
of secretions.
by a renal or cardiac condition.
Treat hyperthermia immediately, reduce
These measures decrease the demand for
pain, lessen pacing activity, and decrease
increased oxygen consumption.
anxiety.
Teach the patient in the use of support
Knowledge about these equipment
devices such as nasal cannulas or oxygen
promotes adherence to the treatment.
masks.
3. Hypothermia
Nursing Diagnosis
Hypothermia
Related Factors
The following are the common related factors for the Hypothermia nursing diagnosis for
geriatric nursing or gerontological nursing:
Age-related changes in thermoregulation and environmental

ACCEPT exposure
Reduction in body temperature below the normal range
Shivering
Cool skin
Pallor
Tachycardia
Desired Outcomes
Below are the commonly used expected outcomes or patient goals for Hypothermia nursing
diagnosis for geriatric nursing or gerontological nursing:
The patient’s temperature and mental status will remain within the patient’s normal limits,
or they return to the patient’s normal limits at a rate of 1°F/hr, after interventions.

In this section are the nursing interventions and rationale (or scienti c explanation) for the
nursing diagnosis Hypothermia for the nursing care plan for the elderly (geriatric nursing):

Nursing Assessment
This assessment will indicate the presence
Monitor temperature through the use of a
of hypothermia. The normal temperature of
low-range thermometer if available.
an older adult is 35.5°C (96°F).
Monitor oral temperature by placing the tip Oral temperature provides the most
of the thermometer far back in the patient’s accurate reading of a patient’s core
mouth. temperature.
Note: For an older adult, refrain from taking
Elderly persons have poor peripheral
an axillary temperature. If unable to
circulation and decrease subcutaneous fat
measure the temperature orally, measure
in the axillary area contributing to the
temporal or tympanic temperature but note
formation of pocket airs that may make
that improper use of these thermometers
assessment inaccurate.
can produce inaccurate results.
Increasing disorientation, altered
Assess and record the mental status of the
sensorium, or atypical behavior may
patient.
indicate hypothermia.
ACCEPT
Watch out with the use of sedatives, muscle These pharmacologic therapies can
relaxants, and hypnotics (including decrease shivering, hence put patients at

anesthetics). risk for environmental hypothermia.
Furthermore, elderly people are at risk for
environmental hypothermia at ambient
temperatures of 22.22°-23.89°C (72°-75° F)
Make sure to give blankets to patients This measure will keep the patient warm
undergoing testing or x-ray examination. thus it will help avoid hypothermia.
Increasing the room temperature to at least
23.89°C (77.5°F) is one method to reverse
Initiate slow rewarming if the patient is
mild hypothermia. Additional measures
mildly hypothermic.
include the use of warm blankets, head
covers, and warm circulating air blankets.
This method is done to reverse moderate to
Warm the patient internally by providing severe hypothermia. Other methods include
warm oral or IV uids if the patient’s warmed saline gastric or rectal irrigations or
temperature drops below 35°C (95°F). introduction of warmed humidi ed air into
the airway.
Irregular HR, dysrhythmias, and very warm
extremities caused by vasodilation in the
Watch out for signs of excessive rapid
periphery, which causes heat loss from the
rewarming.
core are some of the signs of excessive
rapid rewarming.
Once the patient’s temperature fails to
increase by 1°F/hr using these methods,
anticipate laboratory request for WBC count Causes aside from environmental factors
for possible sepsis, glucose level for may be responsible for the hypothermia.
hypoglycemia, and thyroid test for
hypothyroidism.
Administer antibiotics as prescribed for Treating the underlying condition will help
sepsis, glucose for hypoglycemia, or thyroid the patient’s temperature to return to
therapy. normal.
4. Disturbed Sleep Pattern
Nursing Diagnosis
Disturbed Sleep Pattern
Related Factors
The following are the common related factors for Disturbed Sleep Pattern nursing diagnosis:
Unfamiliar surroundings and hospital routines/interruptions

ACCEPT
Here are the common subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this care plan:
Verbal complains of di culty falling asleep
Decreased ability to function
Dissatisfaction with sleep
Desired Outcomes
The commonly used expected outcomes or patient goals for Disturbed Sleep Pattern nursing
diagnosis:
Within 24 hours of interventions, the patient will reports attainment of adequate rest. The
mental status will remain intact for the patient.

The following are the nursing interventions and rationale (or scienti c explanation) for the
nursing diagnosis Disturbed Sleep Pattern for geriatric nursing or gerontological nursing care
plans:

Nursing Assessment
Assess and record the patient’s sleeping Elderly people usually sleep less than they
pattern, gathering information from the did when they were younger and often
patient’s signi cant others or caregiver. awaken more frequently during at night.
Persons with a low level of activity and who
Gather inquiries regarding activity level and
take naps frequently sleep only 4 to 5 hours
nap.
per night.
If the patient complains of being tired after
activities or displays behaviors such as
irritability, yelling, or shouting, encourage
napping after lunch or early in the
Monitor the patient’s activity level.
afternoon. Otherwise, discourage daytime
napping, especially in the later afternoon,
because it can interfere with nighttime
sleep.
Identify the patient’s typical nighttime Emulating the typical nighttime rituals may
routine and try to follow it. promote sleep.
Therapeutic
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Try to arrange activities together such as This lessens the frequency of interruptions
ACCEPT
doing vital signs, taking medication, and and promotes rest and sleep.
toileting.
The e ect of stimulants includes increase
Refrain the patient from drinking
alertness, insomnia and frequent nighttime
ca einated co ee, cola, and tea after 6 pm.
awakenings to urinate.
Exposure to bright lights, unnecessary
Provide a calm and quiet environment and noises, snoring roommates, and loud talking
lessen interruptions during sleep hours. can result in sleep deprivation. Use of white
noise sound generators may facilitate sleep.
Administer pain medications as ordered,
These interventions promote comfort thus
provide back rub, and pleasant conversation
enhance the sleep.
at sleep time.
5. Constipation
Nursing Diagnosis
Constipation
Related Factors
Here are the common related factors for Disturbed Sleep Pattern that can be used for the
“related to” of the nursing diagnostic statement.
Changes in diet, decreased activity, and psychosocial factors
Changes in bowel pattern; unable to pass stool
Atypical presentation in older adults (changes in mentation, urinary incontinence,

unexplained falls)
Straining with defecation
Desired Outcomes
The commonly used expected outcomes or patient goals for Constipation nursing diagnosis:
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The patient will state that his or her bowel habit has returned to normal within 3 to 4 days
of this diagnosis.
Patient’s stool will appear soft, and the patient will not strain in passing tools.

The following are sample nursing interventions and rationale (or scienti c explanation) for
Constipation that you can use for our geriatric nursing or gerontological nursing care plans:

Nursing Assessment
During admission, assess and record the
patient’s normal bowel elimination pattern
(frequency, time of day, associated habits, This assessment sets a baseline and
and previous measures to manage identi es the normal bowel elimination
constipation). Discuss with the patient’s pattern of the patient.
signi cant others or caregiver if the patient
cannot provide this information.
Quantify the amount of roughage to the Excessive roughage taken too rapidly can
severity of constipation. cause gas, bloating and diarrhea.
Assess hydration status for signs of
dehydration. Maintain diet, uid, activity, The use of osmotic medications can result in
and continuation of routines. If there is an dehydration. Fluid volume de cit can result
absence of bowel movement within 3 days, in hard stools, which are more di cult to
start with mild laxatives to attempt to pass.
reattain the normal bowel pattern.
Inform the patient
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during hospitalization may increase the risk preventively than it is when present or
ACCEPT
of constipation. Allow the patient to use prolonged.
e ective nonpharmacologic management

practiced at home as this problem is
observed or prophylactically as needed.
Educate the patient about the connection
Increase consumption of uids can make
between uid intake and constipation.
the stool soft and lessens the risk of
Encourage uid intake (2500 ml/day) unless
constipation. Patients with renal, cardiac, or
contraindicated. Assess and record bowel
hepatic diseases may have a uid
movements (amount, date, time,
restriction.
consistency).
Having a roughage (raw fruits and
Instruct the patient to include roughage in
vegetables, whole grains, legumes, nuts,
every meal when possible. For patients with
fruits with skin) in the diet adds bulk in the
low tolerance to raw foods, encourage
stool, therefore, minimizes episodes of
intake of bran via cereals, bread, and mu n.
constipation.
Educate the patient about the connection
between activity level and constipation.
Regular exercise stimulates peristaltic
Support optimal activity for all patients.
movement thus it can reduce or prevent
Institute and build an activity program to
constipation.
foster participation; include devices
necessary to enable independence.
Encourage the patient to use his or her Scheduling interventions that correspond
gastrocolic or duodenocolic re ex to with the bowel habits of the patient are
promote colonic emptying, if the usual more likely to increase bowel movements.
bowel movement happens in the early Taking warm liquids in the morning, for
morning. If the patient’s bowel movement example, also promotes peristalsis. Digital
occurs in the evening, ambulate the patient stimulation of the inner anal sphincter can
just before the right time. trigger a bowel movement.
Try to use the patient’s previously e ective
measures. Follow the maxim “start low, go Aggressive measures done may lead to
slow” (i.e., apply the lowest level of rebound constipation and can hinder with
nonnatural intervention and progress gently subsequent bowel movements.
to a more powerful intervention).
When giving pharmacologic therapy to the Older persons tend to focus on the loss of
patient, administer the more benign, oral habit as an indicator of constipation rather
methods rstThe following hierarchy of than on the number of stools. Do not
laxatives is recommended: intervene pharmacologically until the older
adult has not had a stool for three days.
ACCEPT
Bulk-forming additives such as bra,

methylcellulose, psyllium
Mild laxatives (apple or prune juice, Milk

of Magnesia)
Stool softeners (docusate calcium,

docusate sodium)
Potent laxatives or cathartics (senna,

bisacodyl, cascara sagrada)
Medicated suppositories (glycerin,

bisacodyl)
Enema (tap water, saline, sodium

phosphate/biphosphate)
Laxatives are administered to facilitate

Administer laxatives as ordered after
barium removal. This will prevent rebound
diagnostic imaging of the gastrointestinal
constipation due to severe disruption of
tract with the aid of barium.
bowel habit during the preparation.
6. Adult Failure to Thrive

Nursing Diagnosis
Adult failure to thrive
Related Factors
The following are the common related factors for Adult Failure to Thrive nursing diagnosis:
Loss of independence, loss of functional ability, cognitive impairment, impaired immune

function, malnutrition, depression, and the impact of a chronic disease
Inadequate nutritional intake-eating less than the requirements
Weight loss
Di culty in performing self-care activities
Desired Outcomes ACCEPT
The commonly used expected outcomes or patient goals for Adult Failure to Thrive nursing
diagnosis:
The patient will exhibit or verbalizes improvement in at least one of the following:
increased functional ability, sense of hopefulness, weight gain, increased appetite, peaceful
death.

The following are sample nursing interventions and rationale (or scienti c explanation) for
Adult Failure to Thrive that you can use for your nursing care plan for the elderly (geriatric
nursing):

Nursing Assessment
Conduct a comprehensive physical
A thorough system assessment provides a
assessment. Evaluate the condition of
baseline for succeeding comparison.
chronic disease.
A study of laboratory information
Examine laboratory and other studies such
determines nutrients and electrolytes
as CBC with di erential, albumin, pre-
imbalances important for basic body
albumin levels, thyroid-stimulating hormone
function, protein status and thyroid
(TSH), and basic metabolic panel (BMP).
function, and presence/absence of infection.
Taking a patient’s history that concentrates
on the timing of the change in behaviors
and appetite, medications, and a reduction
Gather essential information about the
in activities of daily living (ADLs) and
patient’s history; involve the caregiver as
instrumental activities of daily living (IADLs)
needed. Assess critical factors such as the
will help determine contributing factors to
death of a spouse or family member.
the drop in function. Examples of these
factors include depression, dementia, pain
and decreased sense of taste or smell.
Allow the patient to vent feelings of fear, Supporting the patient and acknowledging
anger, despair, frustration, and concerns that these feelings are normal often help
about hospitalization and health. lessen feelings of despair.
Explain age-related changes to the patient When an individual normally ages, their
and signi cant others. physiologic reserve declines and a ects
multiple systems. Failure to thrive can occur
from the interaction of three components:
physical frailty, disability or decline in
functional
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neuropsychiatric
ACCEPT function.
Frailty is de ned by a state of increased

vulnerability caused by a diminished
physiologic reserve a ecting multiple
systems.
Disability is de ned as di culty or

decrease in performing ADLs.
Neuropsychiatric impairment is a
complex phenomenon that can occur
from life circumstances leading to
depression, physiologic disruption
leading to delirium, or neurologic
changes resulting in cognitive
impairment.
Collaborate with other health care provider as needed.

They can help address issues such as
Speech therapists and dieticians swallowing or inadequate food and uid
intake.
They can help assess physical
strengths/limitations and the potential for
Physical and occupational therapist
improvement with a program or assistive
tools.
They can help assess support networks and

Social Services
readiness for end-of-life possibility.
7. Risk for Aspiration

Nursing Diagnosis
Risk for Aspiration
Risk Factors
Here are the common risk factors for Risk For Aspiration nursing diagnosis:
Impaired cough and gag re exes or ine ective esophageal sphincter
ACCEPT
Desired Outcomes
The commonly used expected outcomes or patient goals for Risk for Aspiration nursing
diagnosis:
The patient will swallow independently without choking.
The patient’s airway will be patent and lungs are clear upon auscultation both before and
after meals.

The following are sample nursing interventions and rationale (or scienti c explanation) for the
Risk for Aspiration that you can use for your nursing care plan for geriatric nursing or
gerontological nursing care plans:

Nursing Assessment
Evaluate the patient’s swallowing re ex by
putting your thumb and index nger on
Ability to swallow and an intact gag re ex
both sides of the laryngeal prominence and
are important to avoid aspiration and
instruct the patient to swallow. Assess gag
choking before the patient puts foods/ uids
re ex by gently touching one side and then
in the mouth.
the other palatal arch with a tongue blade.
Record these ndings.
Monitor food intake. Record patient’s food
consumption (including amount and
consistency), where the patient puts food in
This information can be useful for some
the mouth, how the patient manipulates or
caregivers during the succeding feedings.
chews prior swallowing, and the duration of
time before the patient swallows the food
bolus.
This evaluation will help assess the patient’s
swallowing ability without choking.
Monitor the patient during swallowing.
De ciencies may require aspiration
precautions.
Choking or coughing can happen within a
Monitor the patient for choking or coughing few minutes following food or uid
before, during, or after swallowing. placement in the mouth and indicates
aspiration of material into the airway.
Wet sounding speech may signal a
Check for a wet or gurgling sound upon
pulmonary aspiration and can indicate
speaking after the patient swallow.
restricted or absent gag and swallow re ex.
Assess the patient for breath sound These are indicative of silent aspiration. For
abnormalities (e.g., crackles [rales], rhonchi, example, elder patients are at higher risk for
ACCEPT
wheezes), shortness of breath, dyspnea,
cyanosis, increasing temperature, and silent aspiration since their sphincter fails to
deteriorating level of consciousness). close completely between swallows.
Watch out for food retention on the sides of
This can signal a poor tongue movement.
the mouth.
Check for drooling of saliva or food or These are signs of a restricted jaw, lip, or
inability to close the lips when using a straw. tongue movement.
This noninvasive procedure is used to
determine whether patients are aspirating,
consistency of foods and liquid most likely
to be aspirated, and aspiration cause. Using
Anticipate a video uoroscopic swallowing
four consistencies of barium, the radiologist
exam (VFSE) or modi ed barium swallow
and speech therapist check for the presence
exam (MBS) to evaluate the patient’s gag
of decreased or impaired tongue function,
and swallow re exes
reduced peristalsis in the pharynx, delayed
or absent swallow re ex, and restricted
ability to close the epiglottis that guards the
airway.
Thickening agents are added to the uid to
increase its viscosity and improve swallow
Based on the results of the swallowing
safety. Likewise, mechanical soft, pureed, or
video, uoroscopy, thickened uids may be
liquid diets may be ordered to permit
prescribed.
patients to take in food with low risk for
aspiration.
Anticipate the need for a speech therapist as This collaboration will address the problem
indicated. of gag and swallow re exes.
Tilt the head forward 45° during swallowing
for patients with impaired swallowing re ex. This head position will help prevent
Note: Tilt the head toward the una ected inadvertent aspiration by closing o the
side for patients with hemiplegia. airway.
Encourage adequate rest periods prior Low energy or exhaustion raises the risk of
meals. aspiration.
This position lessens the possibility of
Put the patient in an upright position with
choking and aspirating by closing o the
the chin tilting down slightly during eating or
airway and promoting a gravitational ow of
drinking, and place pillows on the side to
foods and uids into the stomach and
maintain the upright position.
through the pylorus.
Make sure that the patient’s denture t
Chewing well decreases the risk of choking.
properly and stay in place.
Instruct patients
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optimal
A patient with dementia tends to forget to
swallow with every bite. Watch out for ACCEPT
chew and swallow.
retained food between sides of the mouth.
Allow su cient time for the patient to nish Usually, patients with swallowing problems
eating and drinking. need twice as much time for eating and
drinking as those whose swallowing is
intact.
Allow someone to stay with the patient Promotes safety in case of choking or
during meals or uid intake. aspiration.
Encourage breathing and coughing exercise
These measures facilitate lung expansion
every 2 hours while awake and every 4
and help avoid infection.
hours during the night.
Suction equipment should be readily
Have the suction machine available in case
available at the bedside especially for
of aspiration.
patients with high risk for aspiration.
If aspiration occurs, do the following measures:
Assess indications of a complete airway

obstruction based on the American Heart
Association (AHA) guidelines such as Complete airway obstruction requires
signs and symptoms of poor air immediate intervention.
exchange, cyanosis, inability to speak or
breathe.
Assess for any alterations in the

This assessment helps determine that a
breathing pattern and respiratory rate
change in the patient’s condition has
every 1-2 hours following a suspected
occurred.
aspiration.
Encourage a patient with partial airway

This measures will relieve and clear the
obstruction to forcefully cough as
airway.
possible.
Suction the airway using a large-bore

catheter (e.g., Yankauer or tonsil suction
Suctioning will remove the obstruction.
tip) for unconscious or nonresponsive
patients with partial airway obstruction.
For either a complete or partial

aspiration, notify the health care provider X-ray ndings and result will con rm if food
and get a request for chest x-ray or uids obstruct the airway.
examination.
ACCEPT
NPO will lessen the risk to the patient.
Institute nothing by mouth (NPO) status

until a diagnosis is established.
Anticipate the use of antimicrobial A possibility of the occurrence of aspiration

agents. pneumonia.
8. Risk for De cient Fluid Volume

Nursing Diagnosis
Risk for De cient Fluid Volume
Risk Factors
Here are the risk factors for the nursing diagnosis Risk for De cient Fluid Volume:
Inability to take uids due to illness or placement of uids
Use of osmotic medications during diagnostic procedures
Desired Outcomes
The commonly used expected outcomes or patient goals for Risk for De cient Fluid Volume
nursing diagnosis:
The patient’s mental status, vital signs, and urine speci c, color, consistency, and
concentration will remain within normal limits for the patient.
The patient’s mucous membranes will remain moist, and there is no “tenting” of skin.

Risk for De cient Fluid Volume that you can use for your nursing care plan for geriatric
nursing or gerontological nursing care plans:

Nursing
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Assess and record the amount, color, and This assessment

ACCEPT allows comparison of
frequency of any uid output, including intake to output amounts. Dark colored
urine, diarrhea, emesis (vomit), or other urine signals concentration and hence
drainages. dehydration.
Assess and record skin turgor. Check
Skin that is prone to tenting usually signals
hydration status by gently pinching a fold of
dehydration. A furrowed tongue signi es
skin over the forehead, clavicle, sternum or
severe dehydration.
abdomen.
Monitor uid intake. Encourage uid intake These measures help to ensure proper and
of 2-3 liters per day unless contraindicated. adequate hydration. Restrictions may apply
Indicate intake goals for the day, evening, to patients su ering from cardiopulmonary
and night shifts. and renal disorders.
Assess level of consciousness including Inability to obey commands, decrease in
orientation, ability to obey commands, and orientation, and disorderly behavior can
behavior. indicate dehydration.
Utilizing comparable measurements
Weigh the patient daily at the same time of guarantees more valid comparisons. Wide
day (usually prior to breakfast) using the variations in weight (e.g., 2.5 kg [5lb] or
same scale and clothing. greater) can indicate increased or decreased
hydration status.
Assess the patient’s ability to take and drink
uids by himself or herself. Put uids within These measures eliminate barriers to
easy reach. Utilize cups with lids to lessen adequate uid intake.
concern over spilling.
Monitor intake & output especially for a
patient receiving tube feedings or contrast
medium. Check for evidence of third spacing
These agents act osmotically to pull uid
of uids, including increasing peripheral
into the interstitial tissue.
edema, especially sacral; output signi cantly
less than intake (1:2); and decrease urine
output (less than 30 ml/hr).
If the patient is on IV infusion, evaluate A uid overload could lead to heart failure
cardiac and respiratory status for signs of or pulmonary edema. Increasing heart rate
uid overload. Assess the apical pulse and (HR), crackles, and bronchial wheezes can
auscultate the lungs during vital signs be indicative of heart failure or pulmonary
monitoring. edema.
In dehydrated patients, anticipate a rise in
Increase in these laboratory values is
serum sodium, blood urea nitrogen, and
usually common with dehydration.
serum creatinine levels.
Ensure easy access to the toilet, urinal, The duration between acknowledgment of
commode, oruses
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hours when the patient is awake and every age.
ACCEPT
four (4) hours at night. Answer the call light

immediately.
Whenever in the room, give the patient
uids. O er a variety of liquids the patient Aging individuals have a reduced sense of
prefers, but limit ca eine since it acts as a thirst and need encouragement to drink.
diuretic.
9. Risk for Injury

Nursing Diagnosis
Risk for Injury
Risk Factors
Here are the risk factors for the nursing diagnosis Risk for Injury for geriatric nursing care
plans:
Age-related diminished physiologic reserve, cardiac function, or renal function.
Reduced brain oxygenation happening with disease condition and decreased functional
tissue
Impaired sensory/perceptual reception occurring with poor vision or hearing
Desired Outcomes
The commonly used expected outcomes or patient goals for Risk for Injury nursing diagnosis:
The patient’s mentation will return to normal for the patient within 3 days of therapy.
The patient will be free from injury or harm as a result of mental status.

Risk for Injury that you can use for your nursing care plan for the elderly (geriatric nursing):

Nursing Assessment
Monitor baseline level of consciousness A component
ACCEPT
of the Mini-Mental Status
(LOC) and neurologic status of the patient Examination, this assessment tool provides
upon admission. Evaluate mental status and a baseline for succeeding evaluation of a
preconfusion functional abilities from the patient’s confusion. A three-step task is
caregiver or signi cant others. Ask the complex and is a gross indicator of brain
patient to complete a three-step task. For function. Because it requires attention, it
example, “Put your right hand on your chest, can also test for delirium.
wave with your left hand, and then raise
your eyebrows”
Delirium is a serious problem for
hospitalized older individuals and usually
goes not identi ed. The CAM tool
(Waszynski, 2007) can be administered in a
Utilize the confusion assessment method short period of time. CAM is a simple
(CAM) to determine the presence or absence standardized tool that can be used by
of delirium/confusion. bedside clinicians and has been validated in
settings from medical-surgical areas to
intensive care units. If your agency does not
already employ this tool, there are several
online sources that describe it in detail.
Acute confusion is caused by physical and
psychosocial conditions and not by age
alone. For example, oximetry or arterial
blood gas (ABG) values may reveal low
oxygenation levels, serum glucose or
ngerstick glucose may reveal high or low
glucose level, and electrolytes and complete
Determine the cause of acute confusion. blood count (CBC) will ascertain imbalances
and/or presence of elevated white blood cell
(WBC) count as a determinant of infection.
Hydration status may be evaluated by
pinching over the sternum or clavicle for
turgor (tenting occurs with uid volume
de cit) and observing for dry mucous
membranes and a furrowed tongue.
Test short-term memory by showing the
patient how to use the call light, having the
patient return the demonstration, and then
waiting at least 5 minutes before having the Inability to retain information beyond 5
patient demonstrate the use of the call light minutes signi es poor short-term memory.
again. Record the patient’s actions in
behavioral terms. Describe the “confused”
behavior.
Assess the apical
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physician of a newly discovered episode of abnormalities

ACCEPTmay cause poor brain
an irregular pulse. If the patient is hooked oxygenation, which can result to confusion.
on a cardiac monitor or telemetry, check for
dysrhythmias; inform the physician
accordingly.
Monitor the patient’s pain using a rating
scale of 0-10. If pain scale is not possible,
assess for nonverbal cues such as frowning,
grimacing, rapid blinking, clenched sts, and Acute confusion can be a sign of pain.
dgeting. Ask for some assistance from the
signi cant other or caregiver to help in
identifying pain behaviors.
If the pain is the cause of the confusion, the
Treat the patient for pain, as indicated, and
patient’s behavior should change
monitor behaviors.
accordingly.
The output should equal intake.
Monitor intake and output every 8 hours.
Dehydration can lead to acute confusion.
Renal function plays an essential role in
uid balance and is the main mechanism of
drug clearance. Blood urea nitrogen (BUN)
and serum creatinine are in uenced by
Assess kidney function by reviewing the
hydration status and in older individuals
patient’s creatine clearance result.
shows only part of the picture. Hence, to
fully understand and assess renal function
in older patients, creatine clearance must be
examined.
Review current medications, including over- High levels of some medications, such as
the-counter (OTC) drugs, with the digoxin, anticholinergic agents, and drug
pharmacist. interaction can cause acute confusion.
If the patient has short-term memory
problems, toilet or o er the urinal or
bedpan every 2 hours while awake and A patient with a short-term memory
every 4 hours during the night. Establish a problem cannot be assumed to use the call
toileting schedule and post it on the patient light.
care plan and, inconspicuously, at the
bedside.
Keep the patient’s urinal and other routinely A confused patient may wait until it is too
used items within easy reach for the patient. late to ask help with toileting.
Have the patient wear glasses and hearing
Glasses and hearing aids are likely to aid
aid, or keep them close to the bedside and
reduced sensory confusion.
within easy reach for patient use.
Encourage the patient’s signi cant other to Familiar objects may facilitate orientation
ACCEPT
bring items familiar to the patient, including while also producing comfort.
a blanket, bedspread, and pictures of family

and pets.
Check on the patient at least every 30
minutes and every time you pass the room.
A confused patient requires additional
Place the patient close to the nurses’ station
safety precautions.
if possible. Provide an environment that is
nonstimulating and safe.
Attempt to reorient the patient to his or her
environment as needed. Keep a clock with
large numerals and a huge print calendar at Reorientation may lessen confusion.
the bedside; verbally remind the patient of
the date and day as needed.
Patients who are confused about the place
Provide music but not TV. and time usually think the action seen on TV
is occurring in the room.
Tell the patient in simple terms what is
occurring. For example, “I will take your
Complex sentences may be hard to
blood pressure on your left arm,” “This food
understand.
given to you is healthy,” “I’ll help you walk
towards the prayer room.”
If the patient exhibits hostile behavior or
misperceives your role (e.g., the nurse Patients who are acutely confused have a
becomes a janitor, police), leave the room. poor short-term memory and may not
Come back in 15 minutes. Introduce retain the previous encounter or that you
yourself to the patient as if it is your rst were involved in that encounter.
time meeting. Start conversation anew.
If the patient becomes aggressive, hostile, or
argumentative while you are trying to
reorient, stop this approach. Do not This approach avoids the escalation of
question with the patient or the patient’s anger in a confused person.
understanding of the environment. State, “I
get why you may seem to think about that.”
Arguing can cause a cognitively impaired
If the patient has a permanent or severe
person to become hostile and combative.
cognitive de cit, check on her or him at least
Note: Individuals with severe cognitive (e.g.,
every 30 minutes and reorient to baseline
Alzheimer’s disease or dementia) also can
mental status as indicated; however, do not
experience acute confusional states (i.e.,
question with the patient about his or her
delirium) and can be returned to their
understanding of reality.
baseline mental state.
If the patient tries to leave the hospital, walk Distraction is a proven measure of reversing
with him or her and attempt distraction. Ask a behavior in a patient who is confused.
the patient to tell you about the destination.
ACCEPT
For example, “That seems to be an
interesting place! Can you describe it.” Keep

your tone friendly and conversational.
Resume walking with the patient away from
doors and exit around the unit. After a few
minutes, attempt to lead the patient back to
the room. O er snacks and nap.
Have the patient’s signi cant other talks

with the patient by phone or come in and sit
These interventions by the signi cant other
with the patient if the patient’s behavior
may help promote the patient’s safety.
requires checking more regularly than every
30 minutes.
If the patient tries to climb out of bed, o er
a urinal or bedpan or assist to the The patient may need to use the toilet.
commode.
This action facilitates extra supervision to
Alternatively, if the patient is not on bedrest,
promote a patient’s safety while also
place him or her in a chair or wheelchair at
supporting stimulation and limiting
the nurses’ station.
isolation.
Bargain with the patient. Attempt to This is a delaying approach to mitigate
establish an agreement to stay for a xed anger. Due to a poor memory and attention
period, such as until the health care span, the patient may forget he or she
provider, meal, or signi cant other comes. wanted to leave.
If the patient is attempting to pull out tubes,
hide them. Put a stockinette mesh dressing
over intravenous (IV) lines. Secure feeding
Remember: Out of sight, out of mind.
tubes to the side of the patient’s face using
paper tape, and drape the tube behind the
patient’s ear.
Use medications being prescribed carefully Follow the maxim “start low and go slow”
for managing behavior. with medications because older patients can
respond to a small amount of drugs.
Neuroleptics, such as haloperidol, can be
used e ectively in calming patients with
dementia or psychiatric illness
(contraindicated for individuals with
parkinsonism). However, if the patient is
experiencing acute confusion or delirium,
short-acting
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ACCEPT
anxiety and fear. Anxiety or fear usually
promotes destructive or dangerous

behaviors in acutely confused older
patients.
Neuroleptics can cause akathisia, an
adverse drug reaction characterized by
increased restlessness.
Use restraints with caution and according to Patients tend to become more agitated
hospital policy. when wrist and arm restraints are applied.
Some interventions may become irritating
stimuli. For example, if the patient is now
drinking, terminate the IV line; If the patient
Evaluate the continued need for certain
is eating, remove the feeding tube; if the
interventions.
patient has an indwelling urethral catheter,
remove the catheter and start a bladder
training.
10. Risk for Infection

Nursing Diagnosis
Risk for Infection
Risk Factors
Here are the risk factors for the nursing diagnosis Risk For Infection:
ADVERTISEMENTS
Age-related changes in immune and integumentary systems and/or suppressed

in ammatory response occurring with long-term medication use (e.g., steroids, analgesics,
anti-in ammatory agents), slowed ciliary response, or poor nutrition
Desired Outcomes
TheThis
commonly used
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experience. By for Infection
continued usednursing
diagnosis: ACCEPT
The patient will remain free of infection as evidenced by orientation to person, place, and
behavior within the patient’s normal limits; respiratory rate and breathing pattern within
the patient’s normal limits; urine that is clear, has straw-yellow color and of characteristic
odor; core temperature and heart rate within the patient’s normal limits; sputum that is
clear to whitish in color, and skin that is intact and of normal color and temperature for the
patient.

Risk for Infection that you can use for geriatric nursing or gerontological nursing care plans:

Nursing Assessment
Monitor baseline vital signs, including the
level of consciousness and orientation. In Acute changes in mental status is an
addition, watch out for heart rate greater indicative sign of infection in older
than 100 bpm and respiratory rate higher individuals. Other signs of infection include
than 24 breaths per minute. Auscultate lung increased heart rate and respiratory rate.
elds for adventitious sounds. Be aware, Adventitious breath sounds may or may not
however, that crackles (rales) may be a be present until the late stages of the
normal nding when heard in the lung illness.
bases.
Assess the patient’s skin for tears, breaks,
redness, or ulcers. Record condition of the
Skin that is not intact is prone to infection.
patient’s skin on admission and as an
ongoing assessment.
Older adults may run lower temperature
due to decreasing metabolism in individuals
with a sedentary lifestyle. They also are
drawn to lose heat easily to the
Assess the patient’s temperature, using a
environment and may not be kept at the
low-range thermometer if possible.
correct temperature. A temperature of
35.5°C (96°F) may be normal, whereas a
temperature of 36.67°-37.22°C (98°-99°F)
may be regarded as febrile.
Obtain temperature readings rectally if the
oral reading does not match the clinical If the oral reading shows inaccuracy, rectal
picture (i.e., skin is very warm, the patient is readings may help guarantee the patient’s
restless, mentation is depressed) or if the core temperature is correctly determined.
temperature reads
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Avoid the use of a tympanic thermometer if Reliability of the electronic tympanic
ACCEPT
possible. thermometer may be inconsistent because

of improper use.
Assess the quality and color of the patient’s
Urinary tract infection, as evidenced by
urine. Document changes when noted, and
cloudy, foul-smelling urine without painful
report ndings to the health care provider.
urination and urinary incontinence, is the
Also be alert to urinary incontinence, which
most common infection in older adults.
can signal urinary tract infection (UTI).
Limit urinary catheters insertion when Urinary catheter poses a higher risk of
possible. infection.
Cultures can identify the microorganisms
Anticipate blood cultures, urinalysis, and
(bacteria, fungi, or fungi) that is causing the
urine culture.
infection.
An older patient with WBC count higher
than 11,000/mm3 can be a late sign of
Anticipate the request for white blood cell
infection since their immune system is
count.
slower to respond compared to the young
individuals.
Fluid therapy will improve hydration at the
If an infection is proven, expect the initiation same time compensate losses caused by
of IV uid therapy. fever and liquefy the secretions for less
forceful expectoration.
Anticipate a chest x-ray examination as
This is requested by the physician to rule
ordered if the patient’s lung sounds are not
out pneumonia.
clear.
These actions will eradicate infection,
reduce fever, and improves oxygenation to
the brain. Fever raises cardiac workload as
Anticipate the need for a broad-spectrum
the body reacts to the infection. Due to a
antibiotic regimen, antipyretic, and oxygen
decreased physiologic reserve, older
inhalation if an infection is proven.
individuals may have a greater risk of heart
failure or pulmonary edema as a result of
prolonged tachycardia.
11. Risk for Impaired Skin Integrity

Nursing Diagnosis
Risk for Impaired Skin Integrity
Risk Factors
Here are the risk factors for the nursing diagnosis Risk for Impaired Skin Integrity:
ACCEPT
Reduced subcutaneous fat and decreased peripherally capillary network in the

integumentary system
Desired Outcomes
The commonly used expected outcomes or patient goals for Risk for Impaired Skin Integrity
nursing diagnosis:
The patient’s skin will remain nonerythremic and intact.

Risk for Impaired Skin Integrity that you can use for your geriatric nursing care plan:
Nursing Assessment
Assess the patient’s skin upon admission This assessment provides a baseline for
and regularly thereafter. succeeding assessments of skin integrity.
Skin that rests over the sacrum, scapulae,
heels, spine, hips, pelvis, greater trochanter,
Monitor skin over bony prominences for knees, ankles, costal margins, occiput, and
erythema. ischial tuberosities is at higher risk for skin
breakdown due to excessive external
pressures.
Observe skin for any areas of redness, Redness or breaks in skin integrity require
changes in the texture or any breaks in the aggressive skin care measures to avoid
skin surface. additional breakdown and infection.
Use a lift sheet or roll the patient during Sliding, pulling, or dragging across sheets
repositioning. can result in shear injury.
Provide a turning schedule at least every Turning shu es site of pressure and
two (2) hours. pressure relief.
Utilize waterbed, airbed, air- uidized
mattress, alternating pressure mattress, or These mattresses promote comfort and
other pressure-sensitive mattresses for protect skin from injury produced by
older individuals who are unable to get out prolonged pressure.
of bed or on bedrest.
ACCEPT
Pad bony prominences with pillows or pads, This measure keeps alternative positions
even when the patient is up in a wheelchair and pads the bony prominences, hence
or sits for long periods. protecting overlying skin. The ischial
tuberosities are prone to breakdown when
a patient is in the seated position. Gel pads
for the chair or wheelchair sears help in
disperse pressure.
Lotions provide moisture and can make skin
Use lotions generously on dry skin. smooth and supple. Lanolin-containing
lotions are particularly helpful.
Assist the patient out of bed as frequently as
possible. Amply utilize mechanical lifting
devices to assist during patient’s transfers. If These measures promote blood ow which
getting out of the bed is impossible, provide can prevent skin breakdown.
support with position changes every 2
hours.
Establish and provide a turning schedule on Schedule raises awareness of the nurses
the patient care plan and at the bedside. and signi cant others of turning schedule.
Discourage placing tubes under the patient’s

head or limbs. Place a pad or pillow Too much pressure from tubes can result in
between the patient and the tube for decubitus ulcer.
cushion support.
Hot water can burn older adults, who have
Use tepid water (32.2°-40.5°C [90°-105°F]) diminished pain sensitivity and reduced
and super-fatted, nonperfumed soaps. sensation to temperature. Super-fatted
soaps prevent skin dryness.
Complete baths dry out the skin of an older
Clean the patient’s face, axillae, and genital
adult and preferably performed every other
areas daily.
day instead.
Record the percentage of food intake with
meals. Allow the signi cant other to provide
foods the patient likes. Recommend A diet that is high in protein and ascorbic
nutritious snacks as indicated. Collaborate acid protects the skin from breakdown.
with a dietician as needed for nutritional
advice.
Limit the use of plastic protective pads Pad and diapers trap heat and moisture and
under the patient. When used, place at least can result in the breakdown of the skin
one layer of cloth between the patient and (macerated associated skin damage).
the plastic pad to absorb moisture. For
patients with incontinence, observe the pad
at least every two (2) hours. Avoid use of
adult diapers unless the patient is
ACCEPT
ambulatory, going for a diagnostic test, or is

up in a chair.
References and Sources

Here are the references and sources for this Geriatric Nursing Care Plan:
Boltz, M., Capezuti, E., Fulmer, T. T., & Zwicker, D. (Eds.). (2016). Evidence-based geriatric
nursing protocols for best practice. Springer Publishing Company.[Link]
Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and

collaborative problems. Lippincott Williams & Wilkins. [Link]
Gilje, F., Lacey, L., & Moore, C. (2007). Gerontology and geriatric issues and trends in US
nursing programs: a national survey. Journal of Professional Nursing, 23(1), 21-29. [Link]
Mauk, K. L. (Ed.). (2010). Gerontological nursing: Competencies for care. Jones & Bartlett
Publishers. [Link]
Wold, G. H. (2013). Basic Geriatric Nursing-E-Book. Elsevier Health Sciences. [Link]
ACCEPT
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Paul Martin, BSN, R.N.

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-
surgical nurse for ve years, he handled di erent kinds of patients and learned how to provide individualized care to
them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve
their goals. He is currently working as a nursing instructor and have a particular interest in nursing management,
emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his
clinical knowledge and skills to students and nurses helping them become the best version of themselves and
ultimately make an impact in uplifting the nursing profession.
About Nurseslabs 
Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with
knowledge for the progression and empowerment of their nursing careers. Since we started in 2010, Nurseslabs has become one of
the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. Our ultimate goal is to help address the
nursing shortage by inspiring aspiring nurses that a career in nursing is an excellent choice, guiding students to become RNs, and for
the working nurse – helping them achieve success in their careers!
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9/29/2020 Geriatric Nursing Care Plans: 11 Nursing Diagnosis for the Elderly

11 Geriatric Nursing Care Plans (Older

cultural and spiritual needs of an aging individual.

1. Risk for Falls

2. Impaired Gas Exchange

4. Disturbed Sleep Pattern

6. Adult Failure to Thrive

7. Risk for Aspiration

8. Risk for De cient Fluid Volume

9. Risk for Injury

10. Risk for Infection

11. Risk for Impaired Skin Integrity

1. Risk for Falls

Age (especially ≥ 65 years)

Impaired physical mobility

Altered sensory perception

Presence of illness (Alzheimer’s disease, dementia, osteoporosis)

Lack of knowledge of environmental hazards secondary to confusion

Improper use of aids (e.g., canes, walkers, wheelchair, crutches)

Patient will be free from falls.

Nursing Interventions and Rationale

Nursing Interventions Rationale

These factors will help in determining

has inadequate lighting in the house

Healthcare providers need to recognize

of falls and avoids injury that is sustained

2. Impaired Gas Exchange

Reduced oxygenation with decreased functional lung tissue

Decreased mental acuity

Nursing Interventions and Rationale

Nursing Interventions Rationale

exhibit acute confusion or restlessness. This

Age-related changes in thermoregulation and environmental

Reduction in body temperature below the normal range

Nursing Interventions and Rationale

Nursing Interventions Rationale

relaxants, and hypnotics (including decrease shivering, hence put patients at

4. Disturbed Sleep Pattern

Unfamiliar surroundings and hospital routines/interruptions

Verbal complains of di culty falling asleep

Decreased ability to function

Dissatisfaction with sleep

Nursing Interventions and Rationale

Nursing Interventions Rationale

Changes in diet, decreased activity, and psychosocial factors

Changes in bowel pattern; unable to pass stool

Atypical presentation in older adults (changes in mentation, urinary incontinence,

Straining with defecation

Nursing Interventions and Rationale

Nursing Interventions Rationale

e ective nonpharmacologic management

Bulk-forming additives such as bra,

Mild laxatives (apple or prune juice, Milk

Stool softeners (docusate calcium,

Potent laxatives or cathartics (senna,

Medicated suppositories (glycerin,

Enema (tap water, saline, sodium

Laxatives are administered to facilitate

6. Adult Failure to Thrive

Loss of independence, loss of functional ability, cognitive impairment, impaired immune

Inadequate nutritional intake-eating less than the requirements

Di culty in performing self-care activities

Nursing Interventions and Rationale