Nursing study guide
Geriatric Nursing
Start with the person's goals and baseline, then protect function, cognition, safety, and independence.
Individual first
Chronologic age does not define function, cognition, values, living situation, or the patient's priorities.
Change matters
Small changes in mobility, intake, sleep, continence, attention, or medication use can signal acute illness.
Nursing lens
Prevent avoidable decline while treating the acute problem and planning a safe transition.
Baseline + goals
Compare today with usual function
A respectful assessment asks what matters as well as what is wrong.
Function
Mobility, transfers, bathing, dressing, toileting, eating, medications, transportation, finances, and household tasks.
Cognition + mood
Usual memory, attention, communication, sleep, mood, behavior, sensory aids, and decision support.
Context
Home setup, caregiver capacity, access, culture, finances, health literacy, advance-care planning, and patient goals.
Avoid ageism
Do not dismiss pain, fatigue, confusion, incontinence, falls, or depression as normal aging.
Acute change
Delirium is sudden and demands a cause
Delirium fluctuates and may be quiet; dementia is usually chronic and progressive.
Recognize
New inattention, altered alertness, disorganized thinking, perceptual change, or fluctuation from baseline can indicate delirium.
Find contributors
Assess oxygenation, infection, pain, hydration, elimination, glucose, medicines, withdrawal, sleep, sensory loss, and the environment.
Support
Treat the cause, orient calmly, promote mobility and sleep, provide glasses and hearing aids, and involve familiar support when appropriate.
Escalate
New confusion is an acute clinical change until evaluated; rapidly changing neurologic, respiratory, or circulatory findings require urgent response.
Medication safety
Reconcile the whole medication picture
Age-related physiologic change, multimorbidity, and polypharmacy can increase adverse effects.
Collect
Prescriptions, over-the-counter products, supplements, actual schedule, prescribers, pharmacies, adherence barriers, and recent changes.
Connect
New dizziness, confusion, falls, constipation, urinary symptoms, bleeding, renal change, or poor intake may be medication related.
Verify
Indication, dose, renal and hepatic considerations, duplication, interactions, monitoring, and whether each medicine is still needed.
Teach
Use a plain-language list, one consistent routine when possible, and teach-back with the patient and chosen support person.
Mobility + falls
A fall is a clinical event, not an inevitable part of aging
Screen, assess modifiable risks, intervene, and reassess.
Ask
Falls, near falls, fear of falling, dizziness, footwear, vision, toileting urgency, assistive devices, and circumstances.
Assess
Gait, strength, balance, orthostatic symptoms, cognition, feet, medications, environment, and injury.
Protect function
Use correctly fitted devices, safe footwear, supervised mobility, strength and balance plans, and environmental changes.
After a fall
Assess before moving when injury is possible, obtain help, follow policy, identify contributors, and revise the plan.
Essential nursing care
Prevent hospital-associated decline
Routine care is clinical care when reserve is limited.
| Need | Assessment | Nursing priorities |
|---|---|---|
| Hydration + nutrition | Intake, weight trend, mouth, swallowing, dentition, access, preferences | Offer appropriate choices, assistance, oral care, and ordered swallowing or nutrition support. |
| Skin | Mobility, moisture, perfusion, sensation, devices, nutrition | Reposition and offload according to risk; manage moisture; inspect beneath devices. |
| Elimination | Usual pattern, retention, constipation, urgency, medicines | Promote mobility, privacy, fluids when appropriate, and a cause-focused plan. |
| Sleep + senses | Routine, noise, pain, vision, hearing, aids | Cluster care when safe, reduce disruption, and keep glasses and hearing aids available. |
Communication + safety
Preserve autonomy while adding the right support
Capacity is decision-specific and should not be presumed absent because of age or diagnosis.
Communicate directly
Face the patient, reduce background noise, use plain language, allow time, and verify understanding.
Consent + support
Include the patient to the greatest extent possible and identify the authorized decision-maker only when needed.
Mistreatment
Recognize possible physical, emotional, sexual, or financial abuse, neglect, abandonment, and self-neglect; follow reporting law and policy.
Restraint risk
Use the least restrictive, cause-focused approach and follow policy; restraints can worsen injury, delirium, and functional loss.
Transitions
A safe handoff includes function and feasibility
The correct clinical plan can still fail if the patient cannot carry it out.
Reconcile
Medicines, equipment, wound or device care, diet, activity, appointments, symptoms, and who to call.
Confirm ability
Can the patient obtain, understand, afford, prepare, remember, and physically complete the plan?
Coordinate
Match nursing, therapy, pharmacy, social work, case management, primary care, specialists, and caregiver education to identified needs.
Teach back
Ask the patient or caregiver to explain and demonstrate key tasks before discharge.
Sources
Reference notes
Local policy, validated tools, and the individual plan guide bedside decisions.