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EMT > Chapter 35 > Flashcards

Chapter 35 Flashcards

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1
Q

Geriatric patients are predisposed to problems not seen during youth.
… are common.
More likely to occur when bones are weakened by … or …
Sedentary behavior can lead to … and …

A

hip fractures; osteoporosis; infection; pneumonia; blood clots

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2
Q

Age-related changes can predispose an older adult to respiratory illness.
Airway musculature becomes …
Alveoli in the lung tissue become … and the elasticity …
The body’s chemoreceptors … with age.

A

weakened; enlarged; decreases; slow

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3
Q

Pneumonia:
Inflammation/infection of the lung from bacterial, viral, or fungal causes
Leading cause of death from … in Americans older than 65 years
… associated with aging increases the risk of contracting pneumonia.

A

infection; Immune suppression

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4
Q

The heart …with age.
… declines.
… contributes to systolic hypertension.

A

hypertrophies; Cardiac output; Arteriosclerosis

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5
Q

Geriatric patients are at risk for ….: Accumulation of fat and cholesterol in the arteries

A

atherosclerosis

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6
Q

Increased risk for formation of an … : Severe blood loss can occur.
Blood vessels and heart valves become … and degenerate.
Changes in the electrical conduction system of the heart lead to abnormal …/…

A

aneurysm; stiff; heart rates/rhythms

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7
Q

…:
Loss of proper function of the veins in the legs
Can lead to deep vein thrombosis or pulmonary embolism

A

Venous stasis

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8
Q

heart failure:
the signs and symptoms will differ with right- or left-sided failure
… heart failure occurs when the fluid backs up into the body

A

right-sided

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9
Q

With … heart failure, fluid backs up into the lungs.
Causes pulmonary edema and shortness of breath

…: Sudden attack of respiratory distress
Patient is awakened from sleep

A

left-sided; Paroxysmal nocturnal dyspnea

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10
Q

stroke:
Leading cause of death in older people
Preventable risk factors: …, …, …, …, lack of …Uncontrollable factors: age, race, gender

A

smoking; diabetes; hypertension; obesity; exercise;

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11
Q

stroke contd:
…strokes are less common and more likely to be fatal–> Broken blood vessel causes bleeding into the brain.
… strokes occur when a blood clot blocks the flow of blood to a portion of the brain.
If the symptoms occurred within the past few hours, the patient will be a candidate for stroke center therapy.
Transient ischemic attack (TIA) can present with the same signs and symptoms as a stroke.

A

Hemorrhagic; Ischemic

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12
Q 
changes in the nervous system: 
Most common findings
Changes in …
Changes in … 
… responses to questions
Brain decreases in … 
Performance of most of the ... declines
A 
thinking
memory
slower
weight
sense organs
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13
Q 
Vision
Decreased ..., .., and ability to accommodate to …
…
Decreased … 
Inability to see … (presbyopia)
…, ...degeneration, ...detachment
A 
visual acuity; depth perception; light
cataracts
tear
up close
glaucoma; macular; retinal
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14
Q 
Hearing
Hearing ... sounds becomes difficult.
Problems with ….make falls more likely
...is gradual hearing loss
Heredity and long-term exposure to loud noises are the main factors
A

high-frequency
balance
presbycusis

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15
Q 
Taste
Decrease in the number of … 
Patients may lose interest in eating
Touch
Decreased sense of touch and … 
Decreased sensation of … and … 
May be injured and not know it
A

taste buds; pain perception; hot and cold

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16
Q 
Dementia: Chronic, generally irreversible condition that causes a progressive loss of:
… abilities
… skills
… skills
Potential causes
A

cognitive
psychomotor
social

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17
Q 
dementia contd: 
Patients may:
Have short- and long-term ….
Have a decreased ….
Be unable to perform ...
Show a decreased ability to ...
Appear ...or …
Have impaired …
Be unable to ...
A 
memory loss
attention span
daily routines
communicate
confused; angry
judgment 
vocalize pain
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18
Q

…: Sudden change in mental status, consciousness, or cognitive processes
Marked by the inability to focus, think logically, and maintain attention
Affects 15% to 50% of hospitalized people aged 70 years or older

A

delirium

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19
Q

delirium is generally the result of a reversible … or … causes

A

physical ailment; metabolic

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20
Q

syncope: Assume this is a life-threatening problem until proven otherwise.
Often caused by an interruption of … to the brain

A

blood flow

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21
Q

neuropathy:
Disorder of the nerves of the … nervous system
Function and structure are impaired
Symptoms depend on which nerves are affected and where they are ….:
Motor, sensory, or autonomic

A

peripheral; located

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22
Q 
changes in the GI system: 
Reduction in the volume of …
...loss
... are reduced.
… slows.
Diseases in the bowel
Impaired ... function
GI bleeding can occur in the upper or lower GI tract.
Can result from inflammation, infection, or obstruction
A 
saliva
dental
gastric secretions
gastric motility
liver
23
Q 
Specific GI problems in older patients include:
...
...in the upper and lower GI system
… disease
… disease
… obstruction
A 
Diverticulitis
bleeding
peptic ulcer
gallbladder
bowel
24
Q

Ask patients about NSAID and alcohol use.

… can help determine if a patient is hypovolemic.

A

Orthostatic vital signs

25
Q

acute abdomen-nongi complaints:
Extremely difficult to assess
Most serious threat from abdominal complaints is …
… is one of the most rapidly fatal conditions.

A

blood loss; Abdominal aortic aneurysm (AAA)

26
Q

Changes in the kidneys:
Reduction in … function
Reduction in …
… degeneration

A

renal; renal blood flow; tubule

27
Q 
Changes in the genitourinary system 
Decreased … 
Decline in ... control
Decline in ...
Increase in … voiding
Benign ...
A 
bladder capacity
sphincter muscle 
voiding senses
nocturnal 
prostatic hypertrophy
28
Q

….: Is not a normal part of aging
Can lead to skin irritation, skin breakdown, and urinary tract infections

…:
Bladder and urinary tract infections can cause inflammation.
In severe cases, patients may experience renal failure.

A

incontinence; urinary retention

29
Q 
changes in endocrine system: 
Reduction in ...hormones (thyroxine)
Signs and symptoms:
… heart rate
… 
… skin and hair
… 
…
A 
thyroid 
slower
fatigue
drier
cold intolerance
weight gain
30
Q

changes in endocrine system:

… (HHNS) is a type 2 diabetic complication in older people.

A

Hyperosmolar hyperglycemic nonketotic syndrome

31
Q

Infections are commonly seen in older people because of their increased risk.
Less able to …
May present with anorexia, fatigue, weight loss, or changes in mental status
…and …s are common in patients who are bedridden.
Signs and symptoms may be decreased or minimized

A

fight infections;

pneumonia; UTIs

32
Q 
Decrease in ...:
More common in postmenopausal women
Bones become more ….and tend to break more easily.
Joints lose their ...
Decrease in the amount of ...
A

bone mass; brittle; flexibility; muscle mass

33
Q

Changes in physical abilities:
Strength declines.
Ligaments and cartilage of the joints lose their …
… of the supporting structures of the body

Osteoporosis:
Decrease in …
Reduces bone strength and increases susceptibility to …

A

elasticity; atrophy; bone mass; fracture

34
Q

Osteoarthritis
Progressive disease of the joints that destroys …
Promotes the formation of … in joints
Leads to joint stiffness
Affects joints in the hands, knees, hips, and spine

A

cartilage; bone spurs

35
Q

Proteins that make the skin …decline.
Layer of fat under the skin becomes thinner.
… of the skin declines.
… becomes more common.
Skin tears more easily.
Sweat glands do not respond as readily to heat.

A

pliable; Elasticity; Bruising

36
Q

Pressure ulcers
The pressure from the weight of the body cuts off the … to the area of skin.
With no blood flow, a sore develops.
Pad … and under …

A

blood flow; voids; bony prominences

37
Q

Older people are more susceptible to toxicity because of:
Decreased … function
Altered gastrointestinal … Decreased … in liver
Decreased liver function makes it harder to .. the blood and eliminate medications and alcohol.

A

kidney; absorption; vascular flow; detoxify

38
Q

…: use of multiple prescription medications by one patient
Negative effects can include overdosing and negative medication interaction.
Medication noncompliance occurs due to:
Financial challenges
Inability to open containers
Impaired cognitive, vision, and hearing ability

A

Polypharmacy

39
Q

Depression is not part of normal aging, but rather a medical disease.
Treatable with medication and therapy
If unrecognized or untreated, it is associated with a higher suicide rate in the … population than in any other age group.
Risk factors

A

geriatric

40
Q

… have the highest suicide rate of any age group in the United States.
Older people choose much more lethal means than younger victims.
Common predisposing events and conditions
If a patient is displaying signs of depression, it is appropriate to ask if he or she is considering suicide.

A

Older men

41
Q

the …: created to help you remember what is different about older patients
G: … patient
E: … assessment–> can help give clues to the patient’s condition and the cause of the emergency
M: … assessment–> obtain thorough med history
S: … assessment–> older people may have less of a social network and need assistance with daily living

A

GEMS diamond; geriatric; environmental; medical; social

42
Q

Circulation
Poor … is a serious issue.
… heart rate and irregular … are common.
Vascular changes and circulatory compromise might make it difficult to …

A

peripheral perfusion; Lower; rhythms; feel a pulse

43
Q

Vital signs
The heart rate may be lower due to medications such as ….
Weaker and irregular pulses are common.
Circulatory compromise may make it difficult to feel a … pulse, so consider other pulse points.

A

beta-blockers; radial

44
Q

Vital signs (cont’d)
Blood pressure tends to be ….
Capillary refill is not a good assessment.
The respiratory rate should be in … range.
Be sure to auscultate breath sounds.
Carefully assess pulse oximetry data.

A

higher; normal;

45
Q 
trauma: 
Normal changes associated with aging create risk and complicate assessment.
Slower ...mechanisms
Limited physiologic reserves
Normal effects of aging on the body
Existing medical issues
A

homeostatic compensatory;

46
Q 
Older people have a higher risk of ... because of altered mental status, inattention, and compromised neurologic status.
Risk of mortality is increased when:
Preexisting medical conditions exist
The immune system is weakened
Fluid replacement is complicated by ...
A

burns; renal compromise

47
Q

Higher mortality from penetrating trauma
Penetrating trauma can easily cause serious internal bleeding.
… are the leading cause of fatal and nonfatal injuries in older adults.
Nearly half of fatal falls result in …

A

Falls; traumatic brain injury.

48
Q

Osteoporosis predisposes older patients to … and … fractures.
… of the spine are more likely.

A

hip; pelvic; compression fractures

49
Q

Brain tissue shrinks with age
Increased risk of …
… are among the deadliest of all head injuries.
Serious head injuries are often missed because the mechanism may seem relatively minor.
Other factors predispose an older patient to a serious head injury

A

closed head injuries; Acute subdural hematomas

50
Q

Internal temperature regulation is slowed.
Half of all deaths from hypothermia occur in ….
Death rates from hyperthermia are more than …in older people.

A

older people; doubled

51
Q

Circulation
Drinking alcohol and … medications can make bleeding control difficult.
Older patients can more easily go into shock.
Patients who were hypertensive prior to injury may have a… when they are actually in shock.

A

anticoagulant; normal BP

52
Q

Broken bones are common and should be splinted.
Do not force a patient with… or …into a “normal” position.
In hip and pelvic fractures, avoid log rolling.
Provide blankets and heat to prevent hypothermia.
Provide psychological support.

A

joint flexion; kyphosis

53
Q

Falls can be caused by
Medical condition
…
Medication …
It is important to find out why the fall occurred.
Look for clues from the patient, bystanders, and environment.

A

Cardiac rhythm disturbance; interaction

54
Q

Inflicted bruises are usually found on the … and …, …, …, …, and … Pressure bruises caused by the human hand may be identified by oval grab marks, pinch marks, or handprints.
Human bites are typically inflicted on the upper extremities and can cause … and …
Regard injuries to the genitals or rectum with no reported trauma as evidence of sexual abuse in any patient.

A

buttocks; lower back; genitals; inner thighs; face; ears; lacerations; infection

EMT (45 decks)

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