Ch 20 notes Flashcards
how does quality of a patient’s report change with age?
older patients tend to overestimate their health when affected by increasing disease and disability
how do acute illnesses present differently in older adults
they are less likely to have a fever, and more likely to complain about shortness of breath, syncope, stroke, and acute confusion
geriatric conditions
a collection of symptoms and signs common in older adults not necessarily related to a specific disease (delirium, cognitive impairment, falls, dizziness, depression)
ETHIC(S)
Explanation, Treatment, Healers, Negotiate, Intervention, Collaborate, and Spirituality
areas to probe to determine a patient’s cultural identity in an interview
the individual’s cultural identity, cultural explanation of the individual’s illness, cultural factors related to the psychosocial environment and levels of function, and cultural elements in the clinician-patient relationship
activities of daily living
bathing, dressing, toileting, transferring, continence, feeding
instrumental activities of daily living
using the telephone, shopping, preparing food, housekeeping, laundry, transportation, taking medicine, managing money
What conditions are associated with flat or impoverished affect?
depression, Parkinson’s, and Alzheimer’s
what is the optimal BP for >80 yo
140-150/70-80
What is the BP change for orthostatic hypotension?
SBP drop of >20mmHg or DBP drop of >10mmHg
What does a RR >25 indicate?
a lower respiratory infection
What conditions are associated with undernutrition?
depression, alcoholism, cognitive impairment, malignancy, chronic organ failure, medication use, social isolation, poor dentition, and poverty
psuedoscars
white depigmented patches
actinic purpura
well demarcated vividly purple macules or patches
actinic lentigines
liver spots
basal cell carcinoma
a translucent nodule that spreads and leaves a depressed center with a firm elevated border
squamous cell carcinoma
a firm reddish appearing lesion often emerging in a sun exposed area
melanoma
a dark raised asymmetric lesion with irregular borders
what does an increased cup to disc ratio suggest
open angle glaucoma
what signs suggest COPD?
increased anteroposterior diameter, purse-lipped breathing, and dyspnea
get up and go test
the patient gets up from the chair, walks ten feet, turns, and returns to the chair
normal is <10 seconds, abnormal is >20 seconds
what do diminished or absent pulses suggest
arterial occlusion
