Gero Final 2 Flashcards

Terms Definitions
fluidsaerationnutritioncommunicationactivity paineliminationsocialization
Herpes Zoster
dementia consciousness
Overstimulation “Tubes”Metabolic/fluid abnormalitiesPhysical restraintsPolypharmacyPostoperative statesSleep deprivationare potential causes of what?
Loss of appetite
AgeCommon aging changesMedicationsDependencyFunctional impairmentsInstitutionalizationThese are predisposing factors for what?
Multiple diseasesMultiple providersLegal implicationsPatient self-prescription & experimentationMedication collectingSearch for total therapyPatient/health care provider communicationall contribute to __________.
Functional abilityStrength/fatigueSleep and restNauseaAppetiteConstipationPain
QOL Physical dimension
Causes malnutrition in hospital
Tx Arthritis
Joint protectionRestNon-pharmacologic measuresMedication to reduce inflammationMedication to relieve pain
Two types sleep apnea
speak in ____ tones
fever, sweating, tachypnea, tachycardia, labile blood pressure
programmed theory
non-stochasticboilogical clock= aging
Monitor ____ for Heparin.
esyrelBusparEffexorMAO inhibitorsSt. John’s WortCocaineDextromorphanDemerolUltramDepakoteImitrexRemeronSSRIs are linked to _________ _________.
Serotonin syndrome
Signs of dehydration
Dry mucous membranesOliguria/anuriaHypotension (orthostasis)Tachycardia FeverAMSElectrolyte imbalances
Enhances sleep, rapidly reduces anxietyLacks significant potential for orthostatic or anticholinergic symptoms
Linear distribution of vesiclesClear fluidErythematous basesDermatomal distribution
WithdrawalVision-like experiencesRestlessnessDecreased socializationUnusual communicationOut of character statements, gestures, requests
Emotional/Spiritual Sx of Dying
Non-pharmacological interventions for constipation
FluidsFiberExerciseEnvironmental manipulationBowel Training Program
Arthritis c muscle pain
Polymyalgia rheumatica
Quality of life dimensions
PhysicalPsychologicalSocial Spiritual
________ osteoporosis is associated with aging.
which drugs commonly cause tinnitis?
Altered color discrimination and sensitivity to ______ is common.
___% over 65 are disabled.
Autonomic hyperactivityMental status changesNeuromuscular abnormalitiesare signs of _______ __________.
Serotonin Syndrome
End stage Alzheimer's medication (NMDA, glutamate agonist)
Leg elevation in this insufficiency relieves pain.
Obstructive sleep apnea is diagnosed in ___% elderly.
Influenza vaccine should be given annually, pneumococcal vaccine should be given once if given after age ___.
Signs: Rales, consolidation over involved area Usual signs: Productive cough, fever, Geriatric signs: tachycardia, confusion
Pneumococcal Pneumonia
Treatable aspects of coronary heart disease.
Financial burdenCaregiver burdenRoles and relationshipsAffection/sexual functionappearance
QOL Social Dimension
How do you Dx osteoporosis
DEXA scan
Anti-manic agents in combo c antidepressants.
Should older adults have caffeinated beverages as part of their fluid count?
What dietary substance can SSRIs interact with to cause overstimulation, jitteriness & insomnia.
This gait-disorder disease is caused by deficiency of Dopamine
Surgical Tx stress incontinence
Resuspend the bladder
vascular dementia results from...
mult small strokes
Namenda, AD treatment, late phase, works on glutamate metabolism
PT level >____ panic level.
30 s
Systolic pressures in elderly may increase due to arterial stiffening, but they should not exceed _____.
Systolic murmurs are _______; Diastolic murmurs are __________.
Common; Problems
Abnormal proliferation of blood vessels that damages the retina. Worst.
Macular degeneration
Inability to carry out a task
Regards death as a normal processNeither speeds up death nor delays itProvides relief from painProvides relief from other distressing symptomsIntegrates psychological and spiritual aspects of careOffers a support system to patients and their fam
Palliative Care
Discharge planning should be begun at ________.
Possible cause overflow incontinence
Neurological (eg diabetic damage)
Metastasis of non-melanomatous skin cancers.
Basal cell carcinoma
Your patient has stasis dermatitis. What do you tell them not to do?
Sleep apnea causes a diminished what?
O2 sat
Sudden weakness or numbness (one-sided)Dimness or loss of vision in one eyeSlurred speech, loss of speech, difficulty comprehendingDizziness, difficulty walking, loss of coordination, loss of balance, a fallSudden severe headacheDifficulty swallowingSudde
Signs of CVA
Male gender, obesity, enlarged tonsils/uvula, thick neck and upper airway tumors or cysts are risk factors for what?
Obstructive sleep apnea
Chronic coughInsomniaWeight lossNocturiaSyncopePlus, fatigue, shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, edema, weight gain. DeliriumFallsAnorexiaDecreased functional capacity
Atypical signs for heart failure
Side Fx pain meds
Sedation, constipation, dry mouth,
Signs of bowel obstruction.
Abdominal pain/ distention. Hyperactive BS above and hypoactive BS belowN/v (projectile)Small amts brown liquid from rectum
early stage of alzheimers
disoriented, a little lost
drugs that increase BUN
lasix, aspirin, corticosterouds, thiazides, abx
how many older adults fall each year?
Elderly can have impaired smell sensitivity r/t history of ____ and chronic nasal ______.
Smoking; allergies
_____ in elderly is abnormal, but decreased gastric motility and secretions is normal.
Low serum albumin causes higher levels of _____ drug.
Reduced muscle mass leads to reduced ___ whereas reduced renal excretion leads to increased ___.
Impaired ability to speak, write or name objects
Dowager's hump that decreases lung function. Think osteoporosis
Dorsal kyphosis
Physicians fail to recognize 32-67% of cases of delirium in hospitalized patients
Why is there more chronic depression in older adults?
Physical disability
Yearly regular Pap test beginning latest age 21. At age 30, change to every 2-3 years if had 3 normal Pap tests in a row stopping at age 65
Pap smear recommendations
Pain processed by a normal nervous system eg sprains, bone fractures, burns & bruises.
Nociceptive pain
____ of those who fall will fall repeatedly.
very common, starts in middle age. Non-crippling but slows down. Not a lot of inflammation; aches. Heberden’s nodules on most distal joint
Light-headedness or dizzinessDisturbances in gait and balanceLoss of appetite or unexplained weight lossInability to concentrate or shortened attention spanChanges in personalityChanges in grooming habitsUnusual patterns in urination or defecationVague di
Signs of Potential Coronary Heart Disease Exacerbation
There is less resilience for sleep in older adults after _______ disturbances.
sedation, dry mouth, constipation, paralytic ileus, weight gain, cognitive impairmentpotentiates antihypertensive drugs, causes priapism, postural hypotension & reflex tachycardiaWhat drug causes this and why?
TCAs - block NE
frontotemporal dementia characteristics
more rapid progression than AD behavioral disturbances (inhibitions are impaired)
ESR may be slightly _________ in older adults
s&s of hypernatremia
poor skin turgor, dry membranes, mental status changes
minimum data set
ongoing assessment that directs care plans
immunity theory
non-stochasticchange in t and b cells and responsivness
which murmurs are a problem? why?
diastolic indicate backflow
Katz index of ADL
assesses basic activities and dependency
18% of elderly have decreased vision even ___ _______.
With glasses
Theory of aging with random changes and accumulation of effects over time.
Stochastic theory
If you have “reason to believe” that abuse has occurred (or is occuring), you must report it to ________.
Erickson developmental task in elderly
Ego integrity v. Despair
shuffling, broadbased gait, new onset incontinence, confusion are Sx of what kind of dementia?
Normal pressure hydrocephalus
CrCl equation
((140-Age)x wt (kg))/ (72 x serum creatinine)
– dry, red. Area that’s been sun exposed. Pre-cancerous
Actinic keratosis
Ileus is an ________. The treatment is usually ________.
EMERGENCY; surgery
Routine screen (TC and HDL-C) in women >45 if at increased risk of CHD and all men >35
Dyslipidemia recommendation
Group at highest risk for suicide
White males >65 yrs
Result of an injury or malfunction in the peripheral or central nervous system. e.g. post herpetic neuralgia, peripheral neuropathy
Neuropathic pain
Severe major depressive episode very responsive to ECT.
Depression c melancholic features
s&s of hyponatremia
drop in BP, tachycardia, mental status change
what to do about 4th heart sound
report, not uncommon
Meds can interact with other ____, _____ and ______.
Meds, herbs, food
Ppl c macular degernation can see at the ______, but not in the _____.
sides; center
Top Causes of death of elderly (2004)
Heart DiseaseMalignant NeoplasmCerebrovascular DiseaseChronic Lower RespiratoryAlzheimer'sDMFlu/Pneumonia
Elderly lungs have loss of _____ ____ and stiffening of the chest wall.
Elastic recoil
#1 drug to NOT give a pt with DLBD
Nsg intervention to prevent pressure ulcer formation.
Always provide additional protection for skin (zinc cream, keep heels off bed, specialty mattress, frequent assessments)
Respond to the feelings the person is havingAsk about intent to harm self
Validation of feelings
Useful therapy for older adults c depression.
Reminiscence therapy; life review
Emergency shingles situation
lesions on the face – worry about scarring of eye and blindness.
This skin problem is a reactivation of dormant prior infection with varicella.
Shingles (Herpes zoster)
DRIP acronym for Transient (Acute) Incontinence
D (Delirium, depression, dementia, dehydration)R (Restricted mobility, retention)I (Infection, inflammation, impaction (fecal))P (Polyuria, pharmaceuticals)
interventions for bowel obstruction
good IV line (x2)NG to suctionpain meds
body structure changes of aging
less subq fattruncal obesityheight and bone mass loss
what is usually responsible for ED?
medical problems: diabetes, cardiac problems, meds
Apical pulse is at __ ICS and a little more to L than usual.
Sudden _____ and _____ of confusion in a patient are signs of delirium.
Onset & Worsening
Sleep assessment tool by Bysse et al. (1989() (Good assessment questions, complicated scoring )
Pittsburgh Sleep Quality Index
people ages 85 and up tend to be in __________ ___________ and use more _________
poorer healthservices
74% of people >65 rate their health as what?
Good or better.
What instrument do you use to assess fall risk? What components does this include?
Hendrich II Fall Risk ModelConfusion/disorientationDepression with symptomsAltered elimination Dizziness/vertigoMale genderAny administered antiepilepticsAny administered benzodiazepines
What affect may antipsychotics have on DLBD?
ACUTE deterioration due to epsand NMSNO Haldol, abilify
Adjusting to loss of spouse 5 stages
Reactionary (first few wks)Withdrawal (first few months)Recuperation (2nd 6 months)Exploration (2nd year)Integration (5th year)
What should you do if your pt has a BMI
Consider adding nutritional supplementation
What you can do to help families of dying patient
Kept me informedAsked how I was doingPut an arm around me when I criedBrought me foodKnew my nameCried with mePut a bed for me in the room (with the patient)Told me to hold the patient’s hand Held my handGot the chaplainLet me participate in care (of the patient)Stayed with me after their shift was over
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