EXAM 2 Flashcards
eyes + ears, endocrine, geropharm, pain, neurocognitive
dry macular degeneration
drusen deposits form r/t inflammation and sit on macula.
no cure
wet macular degeneration
abnormal vessels form, rupture, and bleed on the retina.
injection of proteins
macular degeneration signs
loss of fine vision
central vision acuity
macular degeneration risk factors
white females
infection
family history
injury
presbyopia
decreased focus on close objects
normal change w age
strabismus
weak eye muscles
myopia
near sighted
can see close
hyperopia
far sighted
can see far
ptosis
loss of eyelid tone
eye drooping
delirium
acute confusion
common w stimulation overload
yes, reorient
cataracts
cloudy lens
floaters
caused by pieces of vitreous that broke off
presbycusis
normal hearing loss w age
starts w high pitch and high frequency
conductive hearing loss
problem w transmission from external through middle ear
(cerumen impaction, otitis media)
sensorineural hearing loss
problem w nerves or inner ear
tinnitus
ringing of ears
otitis media
fluid in middle ear
otitis externa
fluid in external ear canal
swimmer’s ear
external ear
auricle, ear canal
middle ear
malleus incus, stapes, tympanic membrane
inner ear
cochlea (semicircular canals)
labyrinthitis
inflamed semicircular canals
dizziness + N/V
Meniere’s disease
chronic, flareups and remissions of severe vertigo and tinnitus
cerumen
ear wax
issues w q tip usage
increases cerumen production
chronic inflamed ear canal
fibers will clog ear canal
impaction of cerumen
open angle glaucoma
slow progression
loss of peripheral vision
closed angle glaucoma
acute complete blockage
fluid cannot drain
glaucoma
increased intraocular pressure on optic nerve
pharmacokinetics
what the body does to the drugs
pharmacodynamics
what the drug does to the body
drugs most likely to cause adverse drug events
antipsychotics
diuretics
anticoagulants
anticonvulsants
why are older people often dehydrated
decreased muscle mass (sarcopenia)
decreased thirst + water intake
diuretic drugs
nociceptive pain
nerves pick up signals about tissue damage
responsive to opioids
somatic or visceral
somatic pain
musculoskeletal pain
increases w movement
achy and sharp
visceral pain
deeper organ pain
diffused and often referred
neuropathic pain
nerve damage
use adjuvant meds
often have parastehsia
neuropathic pain
nerve damage
use adjuvant meds
often have paresthesia
painad scale
for nonverbal pt
based on…
breathing
- vocalization
facial expression
body language
consolability
pain is
subjective
causes of parkinson’s
environmental
genetic
lifestyle
parkinson’s pathophys
insufficient dopamine r/t 60-80% of substantia nigra dying off
average age of parkinson’s diagnosis
62 years
pugilistic parkinsonism
caused by repeated head trauma
parkinson’s motor signs
bradykinesia
festination
unilateral tremors
postural instability
stooped hunched posture
stiffness + rigidity
festination
shuffling gait with no arm movement
parkinson’s autonomic signs
orthostatic hypotension
constipation
increased urgency
parkinson’s cognitive changes
bradyphrenia
distracted attention
delayed working memory
difficulty organizing thoughts
other parkinson’s signs
loss of sense of smell
micrographia
masked face
decreased reflexes
depression
REM behavior disorder
paranoia
visual hallucinations
psychosis
to be diagnosed with parkinson’s, pt must experience
bradykinesia
tremor dominant parkinson
progresses at a slower rate
less likely to develop dementia
non tremor dominant parkinson
more widespread pathology
4x more likely to develop dementia
decreased liver function
increased drug effects
decreased renal function
decreased drug excretion (more toxicity)
increased gastric pH
slows effect of acid dependant drugs
increased gastric motility
decreased drug effect
decreased gastric motility
increased drug effect
increased body fat
increased drug affect of fat soluble drugs (extended storage)
Beer’s criteria
list of potentially inappropriate meds for older adults
include special guidelines for PIMs
palliative care
total care for patient and family unit
goal: relieve symptoms and provide best quality of life
hospice
terminal diagnosis or 6 month prognosis
a form of palliative care
dementia
chronic, progressive syndrome
general term for memory loss
2 groups of dementia symptoms
cognitive dysfunction
behavioral and psychological
Alzheimer’s
progressive, degenerative neuron loss
plaques and tangles
lewy body dementia
in parkinson patients
delirium
acute confusion
reversable
syndrome of disturbed consciousness
perception determines
behavior
perceptual field properties
fluidity
intensity
direction
stability
fluidity
person takes in what is occurring and is apart of the situation
intensity
awareness of factors in the environment
direction
gives meaning to field and what is perceived there
stability
some predictability and knowledge about how to function within the field
perceptual field during delirium
increased fluidity
increased intensity
decreased direction
decreased stability
hypoactive delirium symptoms
decreased alertness
lethargy
slowed movements
hyperactive delirium symptoms
agitation
combative
hallucinations
restlessness
pulling at lines
trying to escape
pharm nurse note for delirium
do not give benzos
suicide risk
older males dx w depression
SLAP
suicide risk assess
Specific plan
Lethal method
Availability of method
Proximity to help
delusions
false beliefs based on incorrect inference about external reality
nonbizarre delusions
situations that COULD occur
bizarre delusions
based on situations that are unreal, not understandable, and not based on real life
