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
- Disturbed Sleep Pattern
- Adult Failure to Thrive
- Risk for Aspiration
- Risk for Deficient Fluid Volume
- Risk for Injury
- Risk for Infection
- Risk for Impaired Skin Integrity
Risk for Deficient Fluid Volume
- Risk for Deficient Fluid Volume
Here are the risk factors for the nursing diagnosis Risk for Deficient Fluid Volume:
- Inability to take fluids due to illness or placement of fluids
- Use of osmotic medications during diagnostic procedures
- 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.
The commonly used expected outcomes or patient goals for Risk for Deficient Fluid Volume nursing diagnosis:
- The patient’s mental status, vital signs, and urine specific, 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.
Nursing Interventions and Rationale
The following are sample nursing interventions and rationale (or scientific explanation) for the Risk for Deficient Fluid Volume that you can use for your nursing care plan for geriatric nursing or gerontological nursing care plans:
|Assess and record the amount, color, and frequency of any fluid output, including urine, diarrhea, emesis (vomit), or other drainages.||This assessment allows comparison of intake to output amounts. Dark colored urine signals concentration and hence dehydration.|
|Assess and record skin turgor. Check hydration status by gently pinching a fold of skin over the forehead, clavicle, sternum or abdomen.||Skin that is prone to tenting usually signals dehydration. A furrowed tongue signifies severe dehydration.|
|Monitor fluid intake. Encourage fluid intake of 2-3 liters per day unless contraindicated. Indicate intake goals for the day, evening, and night shifts.||These measures help to ensure proper and adequate hydration. Restrictions may apply to patients suffering from cardiopulmonary and renal disorders.|
|Assess level of consciousness including orientation, ability to obey commands, and behavior.||Inability to obey commands, decrease in orientation, and disorderly behavior can indicate dehydration.|
|Weigh the patient daily at the same time of day (usually prior to breakfast) using the same scale and clothing.||Utilizing comparable measurements guarantees more valid comparisons. Wide variations in weight (e.g., 2.5 kg [5lb] or greater) can indicate increased or decreased hydration status.|
|Assess the patient’s ability to take and drink fluids by himself or herself. Put fluids within easy reach. Utilize cups with lids to lessen concern over spilling.||These measures eliminate barriers to adequate fluid intake.|
|Monitor intake & output especially for a patient receiving tube feedings or contrast medium. Check for evidence of third spacing of fluids, including increasing peripheral edema, especially sacral; output significantly less than intake (1:2); and decrease urine output (less than 30 ml/hr).||These agents act osmotically to pull fluid into the interstitial tissue.|
|If the patient is on IV infusion, evaluate cardiac and respiratory status for signs of fluid overload. Assess the apical pulse and auscultate the lungs during vital signs monitoring.||A fluid overload could lead to heart failure or pulmonary edema. Increasing heart rate (HR), crackles, and bronchial wheezes can be indicative of heart failure or pulmonary edema.|
|In dehydrated patients, anticipate a rise in serum sodium, blood urea nitrogen, and serum creatinine levels.||Increase in these laboratory values is usually common with dehydration.|
|Ensure easy access to the toilet, urinal, commode, or bedpan at least every two (2) hours when the patient is awake and every four (4) hours at night. Answer the call light immediately.||The duration between acknowledgment of the need to void and urination declines with age.|
|Whenever in the room, give the patient fluids. Offer a variety of liquids the patient prefers, but limit caffeine since it acts as a diuretic.||Aging individuals have a reduced sense of thirst and need encouragement to drink.|
Recommended nursing diagnosis and nursing care plan books and resources.
- 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.
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]