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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
Q

MRSA treatment

A
  • 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
Q

The best way to decrease incidence of MRSA

A

Health Teaching

  • avoid large crowds
  • hand hygiene
  • avoid contaminated surfaces
  • avoid close contact with people with infectious wounds
27
Q

VRE

A

Vancomycin - Resistant Enterococcus

= normal bacteria that live in intestinal tract –> important for digestion

28
Q

Teletherapy

A
  • don’t move nodes

- radiation of specific area

29
Q

Brachytherapy

A
  • radioactive seeds implanted

- avoid pregnant women, kids, and careful body fluids

30
Q

Side Effects of Radiation

A
  • local skin changes - discoloration, redness, peeling
  • altered taste
  • fatigue
  • inflammatory responses that causes tissue fibrosis and scarring
  • secondary cancers
31
Q

Radiation Therapy teaching

A
  • 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
Q

Cells that affect Chemo

A
  • skin
  • hair
  • intestinal tissues
  • spermatocytes
  • blood-forming cells (immunosuppresion)
33
Q

Extravasation

A

Key: PREVENTION

  • check the IV site before administering
  • flush - check for blood return
  • run medication slowly
  • PPE!
34
Q

Side Effects of Chemo

A
  • severe N/V (PRE MEDICATE)
  • mucositis
  • alopecia
  • changes in cognitive function
  • peripheral neuropathy
  • neutropenic precaution
35
Q

Neutropenic precautions

A
  • keep door closed
  • avoid fresh flowers, fresh fruit, raw foods
  • PPE
  • hand hygiene
  • CBC and temps
  • IV abx if really immunosuppressed
36
Q

Oncologic Emergencies

A
  • Sepsis

- DIC

37
Q

Meds for DIC

A
  • anticoagulants
  • cryoprecipitated clotting factors
  • hand hygiene
  • PPE
38
Q

Hypercalcemia

A

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
Q

Hypercalcemia treatment

A
  • hydration
  • NS IV
  • Dialysis to get rid of calcium
  • Diuretics to get rid of calcium
40
Q

Superior Vena Cava syndrome

A

superior vena cava compressed or obstructed by tumor growth

  • Stoke’s sign (edema of face, arms, hands)
  • dyspena
  • erythema
  • epistaxis
41
Q

Superior Vena Cava syndrome treatment

A
  • high dose radiation
  • metal stent
  • diuretics to help with edema
  • airway is priority!
42
Q

Tumor Lysis syndrome

A

complication of chemo

  • hyperkalemia
  • tall tented t waves
  • flat p waves
  • bradycardia
  • uric acid stones
  • GI hypermotility
43
Q

Tumor Lysis syndrome treatment

A
  • 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
Q

Spinal Cord Compression

A

Tumors that radiate to spine

  • paralysis
  • weakness
45
Q

Spinal Cord Compression Tx

A
  • palliative (support brace)
  • removal of lesion
  • high dose radiation
  • steroids

AE 3 (8 decks)

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