ch 7 - health assessment Flashcards
special considerations for older adult assessment (6)
- listen patiently
- allow for pauses
- ask questions that are not often asked
- observe for minute details
- utilize all resources available
- recognize normal v abnormal aging changes
what is included in a health history (6)
- demographic info
- past medical history
- current meds and supplements
- social history
- functional history
- review of systems
factors that may affect the collection of info for health history for older adult (6)
- visual/auditory acuity
- manual dexterity
- language and health fluency
- adequacy of translation of materials
- availability of trained interpreter
- cognitive ability and reading level
what systems are included in review of systems before physical exam (11)
- constitutional
- senses
- respiratory
- cardiac
- vascular
- urinary
- sexual
- musculoskeletal
- neurological
- GI
- integumentary
special considerations when assessing older adult: height and weight (2)
monitor for changes in weight:
- weight gain (especially if pt has HF)
- weight loss (malnutrition, dentures, dementia)
special considerations when assessing older adult: temperature
-even low grade temp can indicate serious illness
special considerations when assessing older adult: blood pressure
-take postural bp (look for HTN and orthostatic hypoTN)
special considerations when assessing older adult: skin
-check for skin cancer
special considerations when assessing older adult: ears (2)
- increased hair can make visualization of ear canal/tympanic membrane difficult
- may not be able to straighten out ear canal entirely
special considerations when assessing older adult: hearing (3)
- cerumen impaction is common. remove before assessing hearing and tympanic membrane
- presbycusis is common
- evaluate hearing function
special considerations when assessing older adult: eyes (2)
- small pupils common
- gray ring around iris is normal
special considerations when assessing older adult: vision (3)
- test visual acuity
- need for more light to read is common
- decreased color discrimination
special considerations when assessing older adult: mouth (3)
- excessive dryness common
- periodontal disease common
- decreased taste and thirst
special considerations when assessing older adult: neck
-carotid arteries may appear enlarged but just because of loss of subq fat
special considerations when assessing older adult: chest/pulmonary (2)
- kyphosis/barrel chest can alter location of lobes
- higher risk aspiration pneumonia
special considerations when assessing older adult: heart (2)
- listen for murmurs and extra heart sounds (S4 can be common)
- observe for edema (especially lower legs)
special considerations when assessing older adult: extremities (2)
- edema is common
- DP and PT pulses may be hard to palpate
special considerations when assessing older adult: abdomen/GI (2)
- auscultation of bowel sounds may be difficult because of increased fat
- hemorrhoids are common
special considerations when assessing older adult: musculoskeletal (3)
- ROM (for osteoarthritis)
- observe gait
- observe for heberdens nodules
special considerations when assessing older adult: neurological (3)
- diminished/absent achilles reflex is common
- slowed reflexes are normal
- slight memory loss common
special considerations when assessing older adult: GI (4)
FEMALE: -decreased size sexual organs -sparse hair MALE: -decreased size sexual organs -thin and graying hair
what are common areas of concern in older adults (geriatric syndromes) (6)
- falls and gait abnormalities
- frailty
- delirium
- urinary incontinence
- sleep disorders
- pressure ulcers
Evaluation of person’s ability to carry out basic tasks
for self-care and tasks needed to support
independent living
functional assessment