Age and Complex Health Examinations Flashcards

1
Q

Stroke Assessment

A

Airway: open?
Breathing: brief resp exam and O2 stats
Circulation: brief CV exam, BP, carotid bruits, irregular pulse
Disability: GCS, blood glucose, temperature
Exposure and everything else: neuro/ cranial nerve exam, bamford classification, stroke severity (NIHSS), gait, speech and swallowing assessment

Investigations:

  • CT brain
  • ECG
  • Bloods - clotting, hypoglycaemia, infection, hypercholesterolaemia
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2
Q

Comprehensive Geriatric Assessment

A

Physical Health

  • PMH and comorbidities
  • Medication list and review
  • Nutritional status
  • Skin integrity
  • Falls screening
  • Urinary and faecal incontinence

Mental health conditions

  • Cognitive assessment + delirium assessment
  • Mood and anxiety
  • Fears

Social circumstances

  • Care packages
  • Statutory care and eligibility
  • Finances

Functional abilities

  • mobility and transfers
  • ADLs

Environment

  • Housing
  • Equipment and adaptations
  • Telecare
  • Transport
  • Accessibility
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3
Q

Nutritional Assessment

A

Feed/ shop/ cook themselves?
Change in weight/ appetite?
Problems with dentition/ swallowing
Usual dietary intake?

MUST - Malnutrition Universal Screening Toll
- BMI (<20 = 1, <18.5 = 2)
- Weight loss (5-10% = 1, >10% = 2 in last 3-6 months)
- Acutely unwell/ no nutrition >5 days (2)
Risk
- 0 low risk
- 1 medium risk - observe
- 2+ high risk - treat

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4
Q

Delirium Assessment

A

PINCH ME

  • Pain
  • Infection
  • Nutrition
  • Constipation
  • Hydration
  • Medication
  • Environment
CAM
1. acute onset and fluctuating 
\+
2. Inattention 
\+
3. Disorganised thinking
OR
4. Altered level of consciousness 
4AT
1. Alertness 
- 0: normal 
- 4: hypo/ hyper
2. AMT4 (age, DoB, birthplace/ current location, current year)
- 0: no mistakes
- 1: 1 mistake 
- 2: 2+ mistakes 
3. Attention (months backwards)
- 0: 7+
- 1: <7 or does not attempt 
- 2: untestable 
4. Acute and fluctuating 
- 0: no 
-4: yes
Overall
- 0: unlikely 
- 1-3: possible cognitive impairment
- 4+: possible delirium +/- cognitive impairment
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