Gerontological Nursing Certification (GERO-BC) cheat sheet

Programmed aging theories (telomere shortening, Hayflick limit) contrast with stochastic theories (free radical, somatic mutation); no single theory fully explains aging.

Adults 65 and older make up roughly one in six Americans, and the 85-plus group is the fastest-growing age segment in many high-income countries.

Normal aging includes reduced renal clearance and lower muscle mass; serum creatinine can remain normal despite a substantially reduced glomerular filtration rate.

Autonomy, beneficence, nonmaleficence, and justice are core ethical principles; decisional capacity is task-specific and is not determined by age or diagnosis alone.

Nurses are mandated reporters of suspected elder mistreatment in every US state; mistreatment includes physical, sexual, emotional, and financial abuse, neglect, and abandonment.

OBRA 1987 nursing home reform established residents' rights, the MDS assessment, individualized care planning, and limits on physical and chemical restraints.

The Patient Self-Determination Act requires Medicare- and Medicaid-funded facilities to ask about advance directives and document them; living wills and durable power of attorney for health care are common types.

Ageism is associated with poorer preventive care, exclusion from research, and worse health outcomes; it is not a benign attitude.

HIPAA and state law govern privacy; guardianship or conservatorship is a court process, not a clinical decision made by the care team.

ADLs are basic self-care tasks (bathing, dressing, toileting, transferring, continence, feeding); IADLs are complex community skills (shopping, finances, medications, transportation, cooking, housekeeping).

The Katz ADL index rates independence in six basic activities; the Lawton IADL scale detects earlier decline in community-living skills such as finances and medication management.

The Mini-Cog combines three-item recall and clock drawing; a score of 0-2 suggests cognitive impairment and triggers fuller evaluation.

CAM-positive delirium requires acute onset or fluctuating course plus inattention, and either disorganized thinking or altered consciousness; hypoactive delirium is easily missed.

Depression is not normal aging; the Geriatric Depression Scale avoids somatic items, and PHQ-2/9 scores should be interpreted with medical comorbidity.

A Timed Up and Go of 12 seconds or more suggests increased fall risk; also assess orthostatic blood pressure, vision, footwear, home hazards, and medications.

Presbycusis is age-related high-frequency hearing loss; use face-to-face speech, reduce background noise, and do not mistake hearing loss for dementia.

Home safety assessment covers lighting, loose rugs, grab bars, stair rails, bathroom access, medication storage, and emergency communication.

Unintentional weight loss, poor dentition, dysphagia, and food insecurity are key nutrition findings; BMI alone can miss sarcopenia.

The Beers criteria list potentially inappropriate medications for older adults, including long-acting benzodiazepines, strong anticholinergics, and chronic NSAID use.

Polypharmacy is commonly defined as five or more medications and raises the risk of adverse drug events, interactions, and falls.

Start low and go slow; adjust for renal and hepatic function and avoid prescribing cascades in which a new drug treats an adverse effect of another.

Anticholinergic burden can cause confusion, constipation, urinary retention, dry mouth, and falls; review the regimen before adding another drug.

CBT-I, sleep hygiene, exercise, music, reminiscence, and multimodal pain care reduce reliance on sedatives and antipsychotics.

Restraints are a last resort requiring a time-limited order and monitoring; fall prevention includes orthostatic checks, toileting schedules, and environment modification.

Hospice eligibility generally requires a prognosis of six months or less if the disease follows its expected course; POLST translates goals into portable medical orders.

Medication reconciliation at every transition, teach-back, and timely follow-up reduce avoidable readmissions.

Multicomponent delirium prevention programs target orientation, sleep, mobility, hydration, vision and hearing, and bowel and bladder care.

USPSTF: colorectal cancer screening ages 45-75; mammography individualized ages 40-74; DEXA for women 65 and older; AAA ultrasound for men 65-75 who ever smoked.

Vaccines for older adults include annual influenza, current COVID-19, pneumococcal (PCV20 or PCV21), recombinant zoster at 50 and older, Tdap, and RSV for eligible adults.

About 150 minutes per week of moderate activity plus muscle strengthening twice weekly and balance training reduce falls and functional decline.

Motivational interviewing, action plans, problem-solving, and teach-back support self-management; health literacy affects recall and adherence.

Screen hearing, vision, depression, cognition, falls, incontinence, and advance care planning at Medicare wellness visits or annual visits.

Use the least restrictive setting that meets needs; PACE provides comprehensive capitated care for nursing-home-eligible adults to remain at home.

Food insecurity, transportation barriers, social isolation, and caregiver strain affect adherence; screen and refer to community resources.

The Medicare Annual Wellness Visit produces a personalized prevention plan and is not a head-to-toe physical examination.

PDSA tests small changes; root cause analysis examines system causes; quality measures include falls, pressure injuries, readmissions, antipsychotic use, and patient experience.

SBAR improves handoffs; huddles and care conferences align goals; clarify roles and respect each profession's scope of practice.

The RN retains assessment, teaching, and care planning; tasks delegated to unlicensed assistive personnel depend on state nurse practice act and documented competency.

Transformational leadership uses idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration and is linked to better team outcomes.

PICOT frames clinical questions; appraise evidence by design and risk of bias, then integrate patient values and available resources.

Culture change models such as the Eden Alternative and Pioneer Network emphasize resident choice, relationships, and home-like environments.

Nurses advocate for patient rights, informed consent, pain relief, and reporting of mistreatment; unresolved ethical conflicts warrant ethics consultation.

Certification, precepting, and continuing education support competence; professional scope is governed by the state nurse practice act.