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Gero > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Early warning signs of cancer

A 
Change in bowel or bladder
sore doesn't heal
unusual bleeding
skin thickening
indigestion
nagging cough or hoarseness
painless enlarged lymph nodes
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2
Q

What are the benefits of doing a Comprehensive Geriatric Assessment?

A

improves functioning
enhances survival
decreases hospitalization

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3
Q

most important determinant of cancer

A

age

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4
Q

On what scale is cancer staged?

A

TNM system

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5
Q

What factors are used in the TNM system?

A

tumor size, location, degree of invasion

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6
Q

What are the first symptoms of lung cancer?

A

pleural pain
cough
hemoptysis
dyspnea

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7
Q

The patient with lung cancer with mediastinal involvement will present with what symptoms?

A

heart failure
arrhythmia
pleural effusion

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8
Q

Which organ cancer is considered clinically silent?

A

Lung cancer

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9
Q

Which type of lung cancer is the worst and most aggressive?

A

Small cell

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10
Q

Which type of lung cancer is the most treatable?

A

squamous

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11
Q

Clinical presentation of liver cancer

A

hepatomegaly
RUG and or epi pain
weight loss

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12
Q

Lab abnormalities seen in liver cancer

A

LFTs
hypercalcemia
hyperlipidemia
hypoglycemia

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13
Q

Clinical presentation of pancreatic cancer

A 
jaundice
vague abd or back pain
n/v
wt loss
generalized weakness
labile blood sugars
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14
Q

Tumor markers present in pacreatitis

A

CA 19-9

CEA

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15
Q

Surgery for pancreatic cancer

A

Whipple

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16
Q

Clinical manifestations of stomach cancer

A 
***vague***
anemia
weakness
fatigue
dizziness
epigastric fullness
constipation
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17
Q

DX of stomach cancer

A

endoscopy

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18
Q

Characteristics of nociceptive pain

A

responds to analgesics

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19
Q

neuropathic pain characteristics

A

burning, tingling, nerve pain

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20
Q

Which aging related change can cause orthostatic hypotension in the older adult?

A

decrease in baroreceptors

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21
Q

What are the first line medications for CHF?

A

ace inhibitors and diuretics

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22
Q

Which type of CHF medication will have poor short term outcomes but better long term outcomes?

A

beta blockers

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23
Q

What is the max dosage for dig?

A

0.125

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24
Q

Sodium limits for pt with CHF

A

2-3g/day

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25
Q

Bronchitis and emphysema is characterized by

A

airway inflammation and hypertrophy and firbrosis

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26
Q

Clinical manifestations of emphysema

A 
dyspnea
increased a:p diameter
hypoxia
wt loss due to energy use
crackles
wheezes
clubbing
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27
Q

Pt with emphysema are called…

A

pink puffers

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28
Q

Pt’s with emphysema are most comfortable in what position?

A

tripod

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29
Q

Chronic bronchitis clinical manifestation

A 
productive cough
frequent resp infex
dyspnea on exertion
hypoxia
hypercapnea
polycythemia and cyanosis
crackles
tackycardia
pedal edema
wt gain
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30
Q

Chronic bronchitis is called..

A

blue bloater

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31
Q

Which atypical symptoms of pneumonia are commonly seen in the older adult?

A

confusion, dehydration, failure to thrive

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32
Q

Which antibiotic is the best choice to treat community acquired pneumonia?

A

Clarithromycin (macrolides)

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33
Q

Clinical manifestations of TB

A

low fever
non productive cough
chills
atypical pneumonia

34
Q

DX of TB

A

chest xray

35
Q

TX of TB

A

INH and Rifampin x4mo

36
Q

What is the treatment regimen for TB

A

4 meds x2 months

37
Q

If TB is resistant, what is the tx regimen?

A

4 meds x 18-20 mo

38
Q

Which sleep scale will show what interrupts the pt sleep?

A

Pittsburgh Sleep Quality Index

39
Q

TX for sleep disorders

A

biofeedback

40
Q

Andropause

A

dec in testosterone

41
Q

somatopause

A

decrease in growth factor

42
Q

Characteristics of metabolic disorder

A

BP > 129/84
Triglycerides >149
HDL 99

43
Q

Mild hypoglycemia tx

A

15g of carb 4oz juice

44
Q

Moderate hypoglycemia tx

A

15g carb repeated

45
Q

Severe hypoglycemia tx

A

glucagon, IV glucose

46
Q

DX of hyperthyroidism

A

TSH

47
Q

Iodine induced hyperthyroidism is secondary to

A

amiodorone

48
Q

Geriatric hyperthyroidism presentation

A

tachycardia, fatigue, tremors, nervousness

49
Q

Subclinical hypothyroidism labs

A

TSH elevated

T4 norm

50
Q

Hypothyroidism sx in the older adult

A

fatigue, cold intolerance, wt gain, muscle cramps, paresthesias, confusion

51
Q

Common complication related to hypothyroidism tx

A

angina

52
Q

Grading scale for Gero version of MAST for alcoholism

A

0-3 normal
5-9 80% chance alcoholism
>10 100% chance

53
Q

Alcohol withdrawal symptoms begin within

A

48-72 hours after last drink

54
Q

Caffeine withdrawal symptoms begin within

A

12-24 hours after last

55
Q

Which model is used when a pt is ready to change their substance use?

A

5 A’s

56
Q

What are the 5 A’s

A 
Ask about substance use
Advise to quit
Assess willingness to change
Assist in quit attempt
Arrange follow up
57
Q

When a pt is reluctant to change, which model is used?

A 
Relevance
Risks of behavior to health
Rewards of quitting
Roadblocks to quitting
Repitition
58
Q

PT

A

11-12.5 sec

59
Q

INR

A

2-3

60
Q

Which lab value is to evaluate the effectiveness of warfarin?

A

PT

INR

61
Q

Which lab value is to evaluate the effectiveness of heparin?

A

PTT

62
Q

PTT

A

60-70 sec

63
Q

Platelet count

A

150-400

64
Q

Which drugs are Protein bound?

A

Furosemide
Dilantin
Warfarin

65
Q

What are the limits when administering neuroleptic drugs?

A

No more than twice a day in 7 da period

66
Q

At what grade level should drug education be written

A

5th

67
Q

On the geriatric depression scale what score is suggestive of depression

A

> 5

68
Q

Which score on the GDS is always indicative of depression

A

> =10

69
Q

Which drug class is the safest for depression tx

A

Ssri

70
Q

Which four basic features distinguish between delirium and dementia

A

Acute onset
In attention
Disorganized thinking
Altered level of consciousness

71
Q

The nurse knows that which medication prevents reabsorption of serotonin

A

Zoloft

72
Q

Normal hemoglobin

A

12-13

73
Q

Micro cystic anemia is caused by which deficiency

A

Iron

74
Q

DX of iron deficiency anemia

A

Serum ferritin

75
Q

Tx of iron deficiency anemia

A

325 mg ferrous sulfate

76
Q

Macrocyclic anemia is also called

A

B12 deficiency anemia

77
Q

DX for macrocyclic anemia

A

Schilling test: parietal cells to check intrinsic factor

78
Q

Macrocyclic anemia sx

A

Beefy red tongue
Abd pain
Paresthesia

79
Q

Which toxic chemicals can cause hemolytic anemia

A

Lead
Copper
Arsenic

80
Q

When transfusing blood, what gauge is used?

A

18

Gero (3 decks)

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