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AE 3 > Elder Mistreatment + Cancer > Flashcards

Elder Mistreatment + Cancer Flashcards

1
Q

Situational Theory

A

Result of caregiver strain/stress

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2
Q

Psychopathology Theory

A

Stems from perpetrator’s own psychological issues

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3
Q

Exchange Theory

A

Related to victim-perpetrator long term relationship and dependency

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4
Q

Social Learning Theory

A

How abuse was learned

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5
Q

Political Economy Theory

A

Focuses on challenges faced by older adults in society

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6
Q

Challenges with Dementia + Elder Mistreatment (2)

A
  • patients are not able to provide a detailed history

- lack of objective assessment and policies on elder mistreatment screening and management

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7
Q

Risk Factors for Elder Mistreatment (7)

A
  • functional impairment
  • low SES
  • lack of support
  • dependency
  • cognitive impairment
  • social isolation
  • hx of childhood trauma or abuse, substance abuse, depression, other mental health disorders
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8
Q

Perpetrator characteristics

A
  • family member most of the time
  • long history of conflict with the victim
  • living with victim for awhile
  • recent financial stress or job loss
  • caregiver strain/stress
  • dependency on victim
  • lack of support
  • low SES, poor housing
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9
Q

Elder Mistreatment Screening (2)

A
  • Elder Assessment Instrument (EAI)

- Hwalek Sengstock Elder Abuse Screening Test (HS_EAST)

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10
Q

EAI - Elder Adult Instrument

A
  • inpatient and outpatient
  • general appearance
  • evidence of dehydration
  • physical and psychological indicators
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11
Q

HS_EAST

A
  • self report on older history

- if positive, get a comprehensive history and physical assessment should be completed to validate possible mistreatment

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12
Q

poor oral hygiene is associated with increased incidence of _______

A

pneumonias

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13
Q

many medications cause dry mouth and _______ risk of _____ ______

A

increasing risk of dental caries

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14
Q

DM glucose control is ____ in the presence of periodontal disease

A

worsens in the presence of periodontal disease

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15
Q

Denture Cleaning

A
  • don’t wear overnight
  • good hygiene
  • brush with liquid hand soap, dishwashing liquid, denture cleansing paste
  • avoid regular toothpaste
  • soak overnight in a cup of water or denture cleaner
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16
Q

Denture Care

A
  • make sure they fit
  • avoid sugary snacks and drinks
  • avoid alcohol and tobacco
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17
Q

What meds dry your mouth?

A

Anticholinergics

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18
Q

Salivary stimulant

A

Pilocarpine

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19
Q

Frailty is 3 or more of the following

A
  • unplanned weight loss
  • weakness
  • poor endurance and energy
  • slowness
  • low activity
20
Q

Cascade Iatrogenesis

A

Initial medical interventions tat triggers a series of complicating events

21
Q

Risk Factors for Cascade Iatrogenesis

A
  • older
  • more functional impairment
  • higher acuity
22
Q

Examples of Airborne

A

TB, measles, chickenpox

23
Q

Examples of Droplet

A

PIMM - pertussis, influenza, mumps, meningitis

24
Q

Examples of Contact

A

MRSA, pediculosis, scabies, RSV, C. diff

25
MRSA treatment
- Vancomycin, Linezolid - take full length of vancomycin treatment - showers instead of bath - wash cloths in hot water and dryer - sleep in a separate bed from others
26
The best way to decrease incidence of MRSA
Health Teaching - avoid large crowds - hand hygiene - avoid contaminated surfaces - avoid close contact with people with infectious wounds
27
VRE
Vancomycin - Resistant Enterococcus | = normal bacteria that live in intestinal tract --> important for digestion
28
Teletherapy
- don't move nodes | - radiation of specific area
29
Brachytherapy
- radioactive seeds implanted | - avoid pregnant women, kids, and careful body fluids
30
Side Effects of Radiation
- local skin changes - discoloration, redness, peeling - altered taste - fatigue - inflammatory responses that causes tissue fibrosis and scarring - secondary cancers
31
Radiation Therapy teaching
- do not move markings - good sunscreen - prescribed lotion - soft cotton clothing - gentle soap and water to cleanse - avoid direct skin exposure - xerostomia care - BONE more vulnerable to fracture
32
Cells that affect Chemo
- skin - hair - intestinal tissues - spermatocytes - blood-forming cells (immunosuppresion)
33
Extravasation
Key: PREVENTION - check the IV site before administering - flush - check for blood return - run medication slowly - PPE!
34
Side Effects of Chemo
- severe N/V (PRE MEDICATE) - mucositis - alopecia - changes in cognitive function - peripheral neuropathy - neutropenic precaution
35
Neutropenic precautions
- keep door closed - avoid fresh flowers, fresh fruit, raw foods - PPE - hand hygiene - CBC and temps - IV abx if really immunosuppressed
36
Oncologic Emergencies
- Sepsis | - DIC
37
Meds for DIC
- anticoagulants - cryoprecipitated clotting factors - hand hygiene - PPE
38
Hypercalcemia
Occurs with bone metastasis - fatigue - loss of appetite - N/V - constipation - polyuria - dehydration - severe muscle weakness - loss of deep tendon reflexes - paralytic ileus - kidney stones
39
Hypercalcemia treatment
- hydration - NS IV - Dialysis to get rid of calcium - Diuretics to get rid of calcium
40
Superior Vena Cava syndrome
superior vena cava compressed or obstructed by tumor growth - Stoke's sign (edema of face, arms, hands) - dyspena - erythema - epistaxis
41
Superior Vena Cava syndrome treatment
- high dose radiation - metal stent - diuretics to help with edema - airway is priority!
42
Tumor Lysis syndrome
complication of chemo - hyperkalemia - tall tented t waves - flat p waves - bradycardia - uric acid stones - GI hypermotility
43
Tumor Lysis syndrome treatment
- check electrolytes - daily ECG - daily potassium - insulin (with glucose!) to help bring potassium into the cell - K Xalate (frequent bowel mvmt) - Allopurinol - calcium gluconate - check kidney function
44
Spinal Cord Compression
Tumors that radiate to spine - paralysis - weakness
45
Spinal Cord Compression Tx
- palliative (support brace) - removal of lesion - high dose radiation - steroids

AE 3 (8 decks)

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