Concurrent Illness Flashcards
Atypical presentation
Signs and symptoms of a disease are different or absent from what would be expected
Common in elderly and can make identifying the underlying cause challenging
Esp in 85 year old and have cognitive impairment
The older patient
Many factors differentiate older person from other patient
The older adults commonly has more chronic acute episodes that need management
Factors effecting elderly
Commorbidities
Atypical presention
Geriatric syndromes
Frailty
Geriatric syndromes
Describes a syndrome with high prevalence in older adults
Gs will have a significant negative effect and are commonly associated with a poorer quality of life
Types of geriatric syndromes
Falls Frailty Malnutrition Incontinence Pressure wound Delirium
Common health problems of old age
Musculoskeletal skeletal conditions Heart disease Visual and hearing deterioration Diabetes Cancer Hypo/hyperthermia
Care ppanning for elderly includes
Health promotion Knowledge of risks Prevention of disease Management of chronic disease Patients values Andrew wishes
Health assessment
Assessment
Information
Assessment
First step of the nursing process Collect verify Organize Interpret Document
Information can be
Subjective
Objective
Cognition as a vital sign
Cannot answer question Overly sleepy Disorganised thinking Easily distracted Agitated
Airway
Upper airway changes with calcification of cartilage Alveoli larger and have thinner walls Difficult to hyperextend Foreign objects- teeth Diminished gag reflex
Breathing
Chest wall stiffness
Alterations in lung volumes and airflow
Long exposure to resp hazard
Circulation
General colour
Feel quality of pulses
Listen for heart failure
Remember alterations of baroflex mechanism means there is bluntening of compensation
Disability (neuro)
Know your patient and what their level of normal
Don’t presume they are old they are confused
Pupil response
Do they have a hearing or vision deficit
Exposure
Expose patient and have a look for bruises, marks, chest wall deformity, tubes, paradoxical movement
But be quick , keepcolder patient warm
Examples of specific assessment
Mna - mini nutritional assessment Braden ax Abbey pain scale Mmse - mini mental state exam Geriatric depression scale Cam - detects delirium
Plan
Involves goal setting with patient
Relates to nmba standards 5
Involve other professionals
Beware if the myths about elderly people
Some staff may assume that a change in cognition in elder is normal
Managing illness treatment does not focus on addressing tge problem but the symptoms
Good discharge planning for acute facilities is essential to maintain wellness
Focus on the whole person
Successful planning
Personal relationships develops around mutual trust
Establish rapport, introduce yourself, explain purpose
Be aware of the prior history
Gain understanding of yours patients wishes
Facilitating person- centredness
Be attentive and open with older person
Be non-judgemental
Make a concerted effort to understand their perspective, priorities and issues
Clarify what is understood and get agreement on the plan forward
