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):
- 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
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
Defining Characteristics
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:
- 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.
Nursing Interventions and Rationale
In this section are the nursing interventions and rationale (or scientific explanation) for the nursing diagnosis Impaired Gas Exchange for Geriatric Nursing Care Plans or Gerontological Nursing Care Plans.
| Nursing Interventions | Rationale |
|---|---|
| Nursing Assessment | |
| Monitor and record the following during admission and routinely thereafter: respiratory rate, depth, and pattern; breath sounds, cough, sputum, and mental status. | Provides baseline data for subsequent assessments of the patient’s respiratory system. |
| Assess subtle changes in patient’s behavior or mental status e.g., anxiety, disorientation, hostility, and restlessness. Check oxygen levels using pulse oximetry (higher than 92%) or reviewing ABG values (optimally Pao2 80%-95% or higher). | These changes in the sensorium can indicate decreasing oxygen levels. To comprehensively monitor pulse oximetry, the hemoglobin (Hgb) must be determined. Patients with low hemoglobin levels can 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. |
| Auscultate the lungs for adventitious sounds. | When people get older, lungs elasticity decreases. The lower portion of the lung is not sufficiently aerated resulting in the occurrence of crackles (usually heard in individuals 75 years of age and above). This sign alone does not imply the presence of a 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. |
| Therapeutic Interventions | |
| Encourage breathing and coughing exercises. Instruct patient in use of incentive spirometry if applicable. | These measures provide alveolar expansion and remove the secretions from the bronchial tree, resulting to optimal gas exchange. |
| Encourage increased fluid intake (greater than 2.5 liters daily) unless contraindicated by a renal or cardiac condition. | Adequate hydration promotes mobilization of secretions. |
| Treat hyperthermia immediately, reduce pain, lessen pacing activity, and decrease anxiety. | These measures decrease the demand for increased oxygen consumption. |
| Teach the patient in the use of support devices such as nasal cannulas or oxygen masks. | Knowledge about these equipment promotes adherence to the treatment. |
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:
- 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.