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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.
Gerontology nursing or geriatric nursing specializes in the care of older or elderly adults. Geriatric nursing addresses the physiological, developmental, psychological, socio-economic, 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 field but is best given through a collaborative effort 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.
Nursing Care Plans
Here are 11 nursing care plans (NCP) and nursing diagnosis for geriatric nursing or nursing care of the elderly (older adult):
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- Risk for Falls
- Impaired Gas Exchange
- Hypothermia
- Disturbed Sleep Pattern
- Constipation
- Adult Failure to Thrive
- Risk for Aspiration
- Risk for Deficient Fluid Volume
- Risk for Injury
- Risk for Infection
- Risk for Impaired Skin Integrity
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Risk for Infection
Nursing Diagnosis
Risk Factors
Here are the risk factors for the nursing diagnosis Risk For Infection:
- Age-related changes in immune and integumentary systems and/or suppressed inflammatory response occurring with long-term medication use (e.g., steroids, analgesics, anti-inflammatory agents), slowed ciliary response, or poor nutrition
Defining 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
The commonly used expected outcomes or patient goals for Risk for Infection nursing diagnosis:
- 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.
Nursing Interventions and Rationale
The following are sample nursing interventions and rationale (or scientific explanation) for the Risk for Infection that you can use for geriatric nursing or gerontological nursing care plans:
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| Nursing Interventions | Rationale |
|---|---|
| Nursing Assessment | |
| Monitor baseline vital signs, including the level of consciousness and orientation. In addition, watch out for heart rate greater than 100 bpm and respiratory rate higher than 24 breaths per minute. Auscultate lung fields for adventitious sounds. Be aware, however, that crackles (rales) may be a normal finding when heard in the lung bases. | Acute changes in mental status is an indicative sign of infection in older individuals. Other signs of infection include increased heart rate and respiratory rate. Adventitious breath sounds may or may not be present until the late stages of the illness. |
| Assess the patient’s skin for tears, breaks, redness, or ulcers. Record condition of the patient’s skin on admission and as an ongoing assessment. | Skin that is not intact is prone to infection. |
| Assess the patient’s temperature, using a low-range thermometer if possible. | 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 environment and may not be kept at the 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. |
| Therapeutic Interventions | |
| Obtain temperature readings rectally if the oral reading does not match the clinical picture (i.e., skin is very warm, the patient is restless, mentation is depressed) or if the temperature reads 36.11°C (97°F) or higher. | If the oral reading shows inaccuracy, rectal readings may help guarantee the patient’s core temperature is correctly determined. |
| Avoid the use of a tympanic thermometer if possible. | Reliability of the electronic tympanic thermometer may be inconsistent because of improper use. |
| Assess the quality and color of the patient’s urine. Document changes when noted, and report findings to the health care provider. Also be alert to urinary incontinence, which can signal urinary tract infection (UTI). | Urinary tract infection, as evidenced by cloudy, foul-smelling urine without painful urination and urinary incontinence, is the most common infection in older adults. |
| Limit urinary catheters insertion when possible. | Urinary catheter poses a higher risk of infection. |
| Anticipate blood cultures, urinalysis, and urine culture. | Cultures can identify the microorganisms (bacteria, fungi, or fungi) that is causing the infection. |
| Anticipate the request for white blood cell count. | An older patient with WBC count higher than 11,000/mm3 can be a late sign of infection since their immune system is slower to respond compared to the young individuals. |
| If an infection is proven, expect the initiation of IV fluid therapy. | Fluid therapy will improve hydration at the same time compensate losses caused by fever and liquefy the secretions for less forceful expectoration. |
| Anticipate a chest x-ray examination as ordered if the patient’s lung sounds are not clear. | This is requested by the physician to rule out pneumonia. |
| Anticipate the need for a broad-spectrum antibiotic regimen, antipyretic, and oxygen inhalation if an infection is proven. | These actions will eradicate infection, reduce fever, and improves oxygenation to the brain. Fever raises cardiac workload as the body reacts to the infection. Due to a decreased physiologic reserve, older individuals may have a greater risk of heart failure or pulmonary edema as a result of prolonged tachycardia. |
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Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More care plans related to basic nursing concepts:
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- Cancer (Oncology Nursing) | 13 Care Plans
- End-of-Life Care (Hospice Care or Palliative) | 4 Care Plans
- Geriatric Nursing (Older Adult) | 11 Care Plans
- Prolonged Bed Rest | 8 Care Plans
- Surgery (Perioperative Client) | 13 Care Plans
- Systemic Lupus Erythematosus | 4 Care Plans
- Total Parenteral Nutrition | 4 Care Plans
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]
I’m an LPN for 30 years of med surg, rehab, surg, geriatric care, addiction, and psych care. I love my career of caring for people. I want to join a team that wants to continue to improve nurse care. Please keep me a part of your network. I also like to be called Penny.
very interesting..
It is very useful lesson for improving geriatric patient health care provision.
I like it to have more.
Or the whole course, if possible.
I utilize your web page/info on all of my care plans, thank you
I am an LVN Case Manager for mostly geriatric and disabled members in managed care.