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50 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Geriatrics
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The assessment and treatment of someone 65 years or older.
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42.5
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bereavement
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Sadness over the loss of friend(s) and/or loved one(s).
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42.5
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Geriatrics cardiovascular system
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The system undergoes decreasing efficiency which is not necessarily cause by aging. The heart hypertrophies (enlarges) with age, probably in response to chronically increased afterload imposed by stiffening blood vessels. Cardiac output declines mostly due to decreasing stroke volume. The number of pacemaker cells and sinoatrial node decreases drastically as person ages, which often leads to bradycardia.
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42.6
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arteriosclerosis
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The stiffening of vessel walls. Contributes to systolic HTN placing an extra burden of the heart.
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42.6
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What causes the cardiovascular decline in geriatrics?
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Sedentary lifestyle, disabilities or psychological factors leading to limited physical activity.
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Notes
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Geriatric Respiratory system
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Respiratory capacity decreases, largely due to the decrease elasticity of the lungs and the size and strength of the respiratory muscles. Vital capacity decreases and residual volume increases. Although the total amout of air in the lungs does not change with age, the proportion of that air usefully used in gas exchange progressively declines. Air flow deteriorates with age largely due to airway size and resistance.
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42.7
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Geriatrics reaction to hypoxemia and hypercarbia
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Elderly have a slower reaction due to a dulled respiratory drive because of a decrease in the sensitivity to changes in the arterial blood gases or CNS response to such changes.
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42.7
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Geriatrics musculoskeletal effects on respiratory system
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Musculoskeletal changes like kyphosis may affect pulmonary function by limiting lung volume and maximal inspiratory pressure.
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42.7
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Geriatrics lung defense
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Cough and gag reflex decrease with age thus increasing the risk of aspiration. Further more ciliary mechanisms that normally help remove bronchial secretions are slowed.
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42.7
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vital capacity
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The amount of air that can be exhaled following a maximal inhalation.
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42.7
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residual volume
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The amount of air left in the lungs at the end of maximal exhalation.
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42.7
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Geriatric changes in the renal system
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Decrease in weight due to loss of functioning nephron units, and renal blood flow decreases as much as 50%. Typically the kidney can still handle routine demands, it may not be able to handle unusual challenges as when being sick. Excrete sodium slower because of lower glomerular filtration rate.
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42.7
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Hyperkalemia in geriatrics
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Due to slower/lower glomerular filtration rate the geriatric pt may have difficulty handling potassium. Hyperkalmemia may become serious over even lethal due to acidotic state or if the potassium load is increase from any source.
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42.8
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Notes on incontinence
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Not a normal part of aging, typically cause by emotional issues. Can lead to irritation, rash, and UTIs. Elderly are more prone to incontinence partily due to bladder capacity decreasing.
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42.8
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Two major types of incontinence
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Stress and urge.
Stress incontinence occurs during activities such as coughing, laughing, lifting, etc. Urge is trigger by fluid, running water, or even thinking of going. |
42.8
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Causes of urinary retention
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UTI, in men enlarge prostates, acute or chronic renal failure among many other other reasons.
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42.8
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Geriatric changes in digestive system
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Taste buds decrease, and Olfactory receptors may decrease appetite due to loss in enjoyment of eating food. Saliva in mouth decrease. Dental loss is not a normal part of aging but is common. Gastric secretions decrease, often slowing gastric motility. Liver system that detoxify drugs notely decreases with age.
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42.8
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Geriatric changes in musculoskeletal system
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Widespread decrease in bone mass, especially in postmenopausal women. Heights decreases as narrowing of the inter vertebral disks and compression fractures of the vertebrae. Arthritis is common limiting mobility of joints. Muscle mass decreases.
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42.8
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Geriatric changes in nervous system
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Common findings are slower response and/or requesting questions repeated. Brain decreases in weight and size which does not interfere with mental capabilities. Vision problems are common especially over 65 years old. Chance of hearing loss increase. Proprioception (body position) decrease with age, further increasing fall risk.
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42.9
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cateracts
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Vision problem resulting from hardening of the lens over time. Causes blurred vision, double vision, spots, or "ghost" images. Surgical repair is often use to treatment.
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42.9
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Glaucoma
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Narrowing of sight cause by increasing intraocular pressure severe enough to damage optic nerve, treatment consist of oral or eyedrop medications.
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42.9
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Geriatrics changes in integumentary system
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Wrinkling and loss of resiliency of the skin is the most visible sign of aging. Wrinkles occur because skin is thinner, drier, less elastic, and more fragile. Elastin and collagen decrease, oil from sebaceous and sweat glands also decrease. Hair follicles may produce less or stop, along with less melanin.
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42.9
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Homeostatic
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The process by which the body maintains a constant internal environment. Most principles work by feedback principle much like the house thermostat.
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42.9-10
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MIs in geriatrics
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Chest pain is common although in the geriatric pt it may be decrease in intensity, atypical, or absent. Often pt may c/o dyspnea and/or fatigue.
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42.10
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Major risk factor for MIs
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Tobacco use, HTN, diabetes, obesity, psychosocial factors, physical activity, and alcohol consumption.
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42.10
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Preventive strategies to preventing MIs
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Cease tobacco use, healthy diet, good control of blood glucose, exercise, weight control, HTN control. Physician may order ASA daily.
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42.10
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What is the most common cause of hospitalization in pt's over 65?
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Heart failure
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42.10
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Arrhythmias in older pts are generally a result of:
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Age-related changes in the heart, existing cardiac condition/disease, adverse drug effects, or a combination of these factors.
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42.10
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What is the most common arrhythmia seen in geriatric pts?
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Atrial fibrillation which increase risk of CVA and heart failure.
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42.11
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Why take BP in both arms for chest pain?
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To differentiate against ischemia and aneurysm or aortic dissection (tears in artery). A systolic change of 15mm Hg or higher suggestive of dissection or aneurysm.
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42.11
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Symptoms of hyperglycemia
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Fatigue, poor wound healing, blurred vision, and frequent infection. Three Ps Polyuria (urination), Polydipsia (thirst), Polyphagia (hunger).
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42.12
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s/s of hypothyroidism
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May match those that are normal with aging, cold intolerance, constipation, dry skin, weakness, and bradycardia.
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42.12
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thyrotoxicosis
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Acute onset of hyperthyrodism, s/s tachycardia tachycardia, tremors, anxiety, hyperactive reflexes. Often cause by A-Fib in geriatric pts.
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Common s/s of hyperthyroid
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Weakness, lethargy, depression.
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42.12
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Osteoporosis
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Decrease in bone mass leading to reduction in bone strength and greater susceptibility to fractures. Influence by numerous factors including genetics, smoking, level of activity, diet, alcohol, hormonal factors, and body weight.
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42.13
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Delirium
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Also known as acute brain syndrome or acute confusional state and is a symptom not a disease. Acute onset of confusion or disorientation.
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42.13
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Dementia
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A disease that produces irreversible brain failure leading to confusion and disorientation.
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42.13
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Parkinson's disease
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Age related neurological disorder that has two or more of the following symptoms: resting tremors of an extremity, slowness of movement (bradykinesia), rigidity or stiffness of extremities or trunk, and poor balance.
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42.14
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Adipose affect on drugs
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Prolongs half-life
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42.15
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Trauma in the elderly
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Temperature regulation is slowed in elderly thus they get colder or hotter easier. A top 10 cause of death.
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42.15
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Notes on falls
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Was the cause extrinsic (external) cause such as tripping on a loose rug, ice, etc? or Was the fall cause by and intrinsic (internal) cause such as dizziness, syncopal, etc (medical)? Pt may denie intrinsic cause.
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42.15
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GEMS
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Acronym used in the assessment and treatment of the geriatric pts.
G-Geriatric:Thinking of aging and the possibility of atypical presentations. E-Environmental:Hot, cold, clean, hazards? M-Medical assessment:Often requires further detail history. S-Social assessment-Daily activity, social network, etc. |
42.18
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Spondylosis
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Immobility and consolidation of vertebral joints.
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workbook
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List 4 injuries the geriatric pt is more susceptible to:
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1) Subdural Hematoma
2) Compression of the cervical spine 3) Rib Fx 4) Hip Fx |
workbook
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S/S of Meniere's disease
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A progressive disorder of the inner ear that often effects hearing and balance. Causes vertigo, tinnitus, and pressure in the ear. Often only effects one ear.
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Causes for increased risk of PE in the elderly
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Decrease mobility
Also due to a higher incidence of disease associated with PE such as CA, Heart attack, cardiac arrhythmias, and clotting disorders. |
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Side effects of beta blockers and calcium channel blockers in the elderly
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Decrease BP
Decrease pulse |
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Possible side effects of diuretics use in the elderly
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Dehydration, cardiac dysrhythmias, electrolyte imbalance, tachycardia, ALOC, hypovolemic shock.
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presbycusis
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Age related hearing loss, particularly of high frequencies.
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Leading cause of accidental death among elderly
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After falls, motor vehicle accidents are the second leading cause of accidental death among elderly people.
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42.16
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