1. What are the main components of the comprehensive geriatric assessment (CGA) and why is it important for older adults? (5 marks) - The CGA is a multidimensional, interdisciplinary diagnostic process that evaluates the medical, functional, psychological, and social aspects of older adults. It is important because it can identify the strengths and limitations of older adults, guide individualized care plans, prevent or delay functional decline, improve quality of life, and reduce hospitalization and institutionalization. (5 marks) 2. What are some common causes and risk factors of delirium in older adults? How can nurses prevent and manage delirium in this population? (10 marks) - Some common causes of delirium in older adults are infections, medications, dehydration, electrolyte imbalances, surgery, pain, sensory impairment, sleep deprivation, and environmental changes. Some risk factors are dementia, cognitive impairment, frailty, comorbidity, polypharmacy, and malnutrition. Nurses can prevent and manage delirium by identifying and treating the underlying cause, avoiding or minimizing the use of anticholinergic and sedative medications, ensuring adequate hydration and nutrition, maintaining normal sleep-wake cycles, providing orientation and reassurance, optimizing sensory input, and creating a safe and familiar environment. (10 marks) 3. What are the differences between pressure ulcers and diabetic foot ulcers in terms of etiology, pathophysiology, classification, and treatment? (15 marks) - Pressure ulcers are caused by prolonged pressure or shear forces on the skin and underlying tissues, especially over bony prominences. Diabetic foot ulcers are caused by neuropathy, ischemia, or infection in the feet of patients with diabetes mellitus. Pressure ulcers are classified according to the depth of tissue damage, from stage I (nonblanchable erythema) to stage IV (full-thickness tissue loss with exposed bone or muscle). Diabetic foot ulcers are classified according to the presence or absence of infection and ischemia, from grade 0 (pre-ulcerative lesion) to grade 5 (gangrene of the whole foot). Treatment of pressure ulcers involves relieving pressure and shear forces, debridement of necrotic tissue, wound dressing, infection control, nutrition support, and pain management. Treatment of diabetic foot ulcers involves glycemic control, debridement of necrotic tissue, wound dressing, infection control, revascularization if indicated, off-loading pressure from the ulcer site, and education on foot care. (15 marks)