elderly test 1 Flashcards
3 classifications of theories about odler adult hood and what they mean
1) biological: looking at length of life ans viability of organs
2) psychological: behavioural capacities like learning, perception, memory
3) sociological: life satisfcation, adjustment to role changes
3 physical changes that occur
1) dendritic loss
2) bone density loss
3) muscle loss
5 sensory changes
1) sight
2) smell
3) taste
4) hearing
5) tactile
what happens to sleep patterns
they become shorter
why is sleep important
essential for restorative processes like tissue regeneration and immune enhancement
define explicit memory
deliberate, like studying for a test and deliberately remembering info
define implicit memory
unconscious, like remembering your time tables
define semantic memory
general knowledge like word meanings
define episodic memory
tied to particular events
define autobiographical memory
“kodak moments” relate to significant events
define the wear and tear theory
introduced by dr august weismann, cells eventually officially die off after years of wear and tear
define programmed senescence
after a particular role of cell is complete, it dies
define cross linking theory
accumulation of cross-linking proteins damages cells, slowing down bodily processes, results in aging
3 examples of collagen cross linking
wrinkling of skin, hardening of arteries, tightening of tendons
define brain plasticity
the brains ability to change with learning
4 factors that complicate diagnosis for older adults
1) age related changes
2) chronic medical conditions
3) use of multiple meds
4) cognitive impairment
3 key considerations when determining what meds are appropriate
1) a thorough assessment
2) med history
3) nurses knowledge of pharmacokinetics and pharmacodynamics
4) review of current meds
5) dosage
6) individ. treatment plan to educate
define pharmacokinetics
movement of drug through the body
- absorption, distribution, metabolism, excretion
define pharmacodynamics
effects the drug has on the body
pharmacokinetics: absorption in older adults and result
- delayed gastric emptying
- reduced intestinal mobility
- increased pH
= drugs in body longer
pharmacokinetics: distribution in older adults and result
- decreased muscle mass
- increased fat - prolonged action
- decreased total body water
= drugs have more impact - use lower doses
pharmacokinetics: metabolism in older adults and result
- decreased liver size
- decreased hepatic flow
- decreased enzymes
pharmacokinetics: excretion in older adults and result
- decreased renal capacity
= potential for toxicity = use less drugs and shorter lasting drugs
2 pharmacodynamic sensitivities that develop (the type of drugs)
- sedating medications
- centrally acting medications (that lower blood pressure)
6 medications that have anticholinergic properties
- antidepressants
- cold medication
- neuroleptic medications
- GI medications
- allergy medications
- insomnia medications
6 side effects that anticholinergics cause and therefore should be avoided with elderly to avoid anticholinergic syndrome
- urinary retention
- constipation
- tachycardia
- blurred vision
- confusion
- diminished cognitive function
4 medications that increase serotonin
- SSRI
- St. johns wart
- antibiotics
- ginseng
7 side effects from medications that promote serotonin and therefore should be closely monitored with elderly
- restlessness
- tremors
- tachycardia
- confusion
- high blood pressure
- muscular rigidity
- diarrhea
5 strategies for safer med use in elderly population
1) avoid / reduce polypharmacy
2) encourage alternative strategies
3) promote that meds arent the only answer to wellness
4) encourage pharmacist as a resource
5) educate client about meds/interactions
how many meds or more creates polypharmacy
5 or more
define BEERS criteria for prescribing meds to elderly (5)
1) potentially inappropriate meds
2) potentially inappropriate meds to avoid due to conditions
3) meds to be used with caution
4) med combos that may be harmful
5) list of meds to be avoided/dosed carefully for those with renal impairments
2 presentations of psychosis in older adults
1) chronic/recurring in people with schizophrenia or other illnesses
2) who develop symptoms with old age
define lewybody dementia
abnormal protein called alpha-synuclein in brain. causes issues with movement, behaviour, mood, thinking
early onset schizo vs late onset vs very late onset time frames
EO: before 40 yrs , LO: 40-60 yrs, VLO: over 60 years
6 diagnosis that regard psychosis in elderly
- schizophrenia spectrum disorder
- delusional disorder
- delirium
- substance use/abuse
- polypharmacy
- charles bonnet syndrome
delusional disorder is more common in:
middle to old age
delirium may have 2 symptoms
1) hallucinations
2) paranoid delusions
4 assessment focuses for psychosis
1) rule out physical/medical triggers (infection, poly, substances)
2) involve family/caregivers
3) is onset sudden
4) obtain thorough history (previous episodes, hospitalizations)
does anxiety in older adults present differently than in younger people
yes
5 triggers for anxiety in older person
1) dementia
2) comorbid conditions
3) anxiety disorder
4) drugs and diet
5) response to health, social, environmental, personal stressors late in life
9 treatments for later life anxiety
1) CBT
2) relaxation therapy
3) supportive training
4) pschoed. strategies
5) alternative strategies
6) pharmacological treatment (short term)
7) SSRI
8) anxiolytics
9) independant interventions
is late life depression worse than early onset
yes
is depression less likely to be fatal in the elderly
no, it is more fatal
4 etiology for elderly depression
1) hormonal changes
2) life events
3) vascular changes
4) physiologic changes in brain
screening tools for elderly depression
1) PHQ 2: initial screening.
2) PHQ 9: self assessment
3) Cornel scale
who is at the most risk for suicide
elderly men
what is the first and foremost depression treatment for elderly
environmental and behavioural strategies
