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I & E > Chronic conditions > Flashcards

Chronic conditions Flashcards

1
Q

Substance abuse- Eti

A
  • Alcohol & psychoactive drugs most common
  • Approx 1.8-0.5% in older generations
  • Decreases with older age
  • Female, isolated hx of substance abuse or MH
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2
Q

Substance abuse- Sx

A
  • More difficult to ID
  • Isolation, current GI sx and depressed feelings mask use
  • Polypharmacy and decreased alcohol tolerance create issues
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3
Q

Substance abuse- Dx

A

65+ No more than 1 drink per day

- Substance/ alcohol abuse questionaires

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4
Q

Substance abuse- Tx

A
  • Motivational intervention
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5
Q

Hypothyroid- Eti

A
  • Autoimmune thyroiditis
  • Radioiodine tx
  • 1-17%
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6
Q

Hypothyroid- Sx

A
  • Fatigue and weakness
  • Constipation
  • Neuro: dementia, ataxia, delayed DTRs
  • ## May not have classic sx: wt gain, cold intolerance, cramps
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7
Q

Hypothyroid- Dx

A
  • High TSH, low free T4
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8
Q

Hypothyroid- Tx

A

Levothyroxine, may require smaller amount

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9
Q

Malnutrition- Eti

A
  • 17-65% geriatric pts suffer malnutrition
  • Protein most common
  • CA, GI issues, not hungry
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10
Q

Malnutrition- Sx

A
  • Impaired wound healing
  • 4-5% wt loss in 6-12 months
  • Reduced functional status
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11
Q

Malnutrition- Dx

A
  • Monitor wt, BMI

- >15% is severe malnutrition

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12
Q

Malnutrition- Tx

A
  • Tx underlying cause

- Use enhancers, nutritional counseling

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13
Q

Poor dentition- Eti

A
  • 1/3 >65 edentous
  • Average 11 missing teeth
  • Carries, periodontal disease, prolonged use
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14
Q

Poor dentition- Sx

A
  • Pain, infection in mouth
  • Dark lesions around teeth
  • Plaque build up
  • Malnutrition
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15
Q

Poor dentition- Tx

A

Refer to dentist for tooth repair, prosthesis

- Teach oral hygiene, fluoride use

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16
Q

Dizziness- Eti

A
  • 4-30% 65+
  • Increases 10% every 5 years older
  • Meds, alcohol, vertigo, hypotension, vestibular defecits
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17
Q

Dizziness- Sx

A
  • Hx of falls
  • Orthostatic hypotension
  • Lt headed & dysequilibrium
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18
Q

Dizziness- Dx

A
  • BP
  • Eye & ear exam
  • B12
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19
Q

Dizziness- Tx

A

Underlying cause

- Vestibular rehab

20
Q

Dismobility- Eti

A
  • Independant- 5-7.5% dépendent for standing, ambulating

- Institution: 80% dependent for standing & ambulating

21
Q

Dismobility- Sx

A

Inability to move that interferes with activities of daily living

22
Q

Dismobility- Dx

A
  • Fall questionnaire
  • Get up and go
  • Romberg
23
Q

Dismobility- Tx

A
  • Cane or walker
  • Proper footwear
  • Assistive devices
24
Q

Diabetes- Eti

A
  • 27% age >65
  • Increased risk of M&M
  • longer duration, higher rate of complications, more functional dependance
25
Q

Diabetes- Sx

A
  • DM 2 most common

- Decreased insulin production is predominant factor

26
Q

Diabetes- Dx

A
  • A1c > 6.5%
  • Fasting >126
  • 2 hr gtt > 200
27
Q

Diabetes- Tx

A
  • Reduced efficacy of metformin in older adults
  • Diet, exercise & wt loss
  • Ok to have higher A1c scores due to consequences of hypoglycemia 8%
28
Q

Arthritis- Eti

A
  • Most common joint disease

- Old age greatest risk factor

29
Q

Arthritis- Sx

A
  • Space narrowing on X-ray
  • Joint line tenderness and boney enlargement
  • Worse with activity, better with rest
  • Hands, knees, hips, and spine
  • Heberden & bouchard nodes
30
Q

Arthritis- Dx

A

Xray findings

31
Q

Arthritis- Tx

A
  • Higher level of NSAID toxicity in elders
  • Acetaminophen is first line
  • Multidisciplinary tx with exercise, wt loss
32
Q

Heart failure- Eti

A
  • Incidence & prevalence increases with age
  • 4 fold increase btwn 65-85
  • Men>W
  • Most common cause of hospitalization
33
Q

Heart failure- Sx

A
  • Altered sx: lethargy, anorexia, abd discomfort, GI disturbance
  • Exertional dyspnea
  • fatigue, orthopnea
34
Q

Heart failure- Dx

A
  • Echo, ECG & CXR
35
Q

Heart failure- Tx

A
  • Manage HTN

- ACE & Beta blockers

36
Q

Venous insufficiency- ETI

A
  • W>M

- Limited mobility, stroke, ankle orthoses

37
Q

Venous insufficiency- Sx

A
  • Pain, burning, aching and fatigue in legs
  • Pitting edema t fibrosis
  • Brawny, dry, or atrophic white scarring, ulcers
38
Q

Venous insufficiency- Dx

A

Clinical

39
Q

Venous insufficiency- Tx

A
  • Emollients
  • Compression and elevation
  • Sclerotherapy
40
Q

HTN- Eti

A

63-74% adults age 65-85

  • Increased arterial stiffness due to collagen replacing elastin
  • Endothelial dysfunction
  • Age related renal dysfunction- renal artery stenosis most common cause
  • Increased salt sensitivity
  • Higher risk of CV events
41
Q

HTN- Sx

A
  • Older = asymptomatic
  • Dizziness, palpitations, headache
  • Occipital morning headache
  • End organ damage
42
Q

HTN- Tx

A
  • Tx to target BP: 140/90 80
  • Takes 1 yr for tx to be effective
  • Thiazide diuretics, ACE & ARB
  • Beta blockers less effective
43
Q

Pressure ulcer- Eti

A
  • Dermal tissue damage
  • Acute hospital stay = highest risk, 60%
  • Fracture, incontinence, and low serum albumin
  • Non-blanchable erythema, lyphopenia, immobility, decreased body wt
44
Q

Pressure ulcer- Sx

A
  • Sacrum, heels & trochanters
  • 1: blanchable hyperemia
  • 2: ulcer through epidermis
  • 3: full thickness skin loss, damage to subq tissue
  • 4: extensive destruction, necrosis, muscle, bone exposure
45
Q

Pressure ulcer- Tx

A
  • Moist occlusive dressings

- Debridement of necrosis

46
Q

Sleep disorders- Eti

A

Common with neuro disorders- parkinson, dementia

- >65% institutionalized experience

47
Q

Insomnia

A
  • Daytime impairment due to sleep issue
  • > 1 month
  • Pain, dyspnea, reflux interfere with sleep
  • ## CBT to tx

I & E (11 decks)

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