COE Flashcards
define frailty
^vulnerability due to ageing.
decline in reserve and multi system function.
-> compromised ability to cope with stressors
cons of PEG feeding
bowel perforation wound infection peritonitis aspiration death Evidence that artificial nutrition in patients with advanced dementia neither prolongs nor improves quality of life
risk of death in first month for PEG fed individual
30%
DEFINE autonomy
The right for an individual to make his or her own choice
define justice
A concept that emphasizes fairness and equality among individuals
define non-maleficence
The principle that “above all, do no harm,” as stated in the Hippocratic Oath
define Beneficence
The principle of acting with the best interest of the other in mind.
define ‘basic care’ in terms of end of life decision making, and when it should be offered
oral food/fluid
must always be offered
define medical Tx, in terms of nutrition in end of life decision making, and when it should be offered
tube feeding/ parenteral fluids
must be offered if it will be of overall benefit to the patient
what is lasting power of attorney
legal document that lets a patient (the donor) appoint people (attorneys) to make decisions of their behalf (unable to make own decisions).
- health and welfare
- property and financial
what is the court of protection
makes decisions and appoints deputies to act on behalf of someone who is unable to make own decisions (already lost capacity to make LPA)
court appointed deputy
person must apply to the court of protection to be appointed to make decisions on behalf of someone who’s already lost capacity to make LPA
independent mental capacity advocate
safeguards a person who’s facing a big decision and lacks capacity, and has noone to represent their best interests
how does a older persons patient experience differ in hospital
more OT/PT input
longer stay
more complex discharge planning
Ix for pressure ulcers
CRP, ESR WCC Swabs Blood cultures X-ray for bone involvement
Mx of pressure ulcers
Antibiotics
Wound dressing
Pain relief
Debridement if grade 3/4
how do you assess nutritional status in geriatrics
MUST screening tool
Malnutrition Universal Screening Tool
ways to prevent pressure ulcers
barrier creams re-positioning mobile pressure distributing mattress regular skin assessment
things to consider before discharge of elderly pateint
PT
OT
carers?
comprehensive geriatric assessment
What drug is normally combined with L-dopa to prevent peripheral side-effects?
carbidopa
Name 3 complications of L-dopa therapy
postural hypotension
dyskinesia/chorea
confusion
hallucinations
what MMSE score supports dementia diagnosis?
<25
describe refeeding syndrome
prolonged starvation = low insulin and low cell phosphate
refeeding = ^insulin, ^cellular uptake of phosphate
-> hypophosphataemia
rhabdomyolysis, RBC+WCC dysfn, resp insuff, arrhythmias, cardiogenic shock, seizure, sudden death
Mx of refeeding syndrome
pabrinex to prevent
phosphate to treat
