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special pops > exam 2 > Flashcards

exam 2 Flashcards

1
Q

bathing

A

ADL

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2
Q

dressing

A

ADL

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3
Q

toileting

A

ADL

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4
Q

transferring

A

ADL

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5
Q

continence

A

ADL

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6
Q

feeding

A

ADL

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7
Q

grooming

A

ADL

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8
Q

walking

A

ADL

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9
Q

handling finances

A

IADL

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10
Q

use telephone

A

IADL

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11
Q

cook

A

IADL

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12
Q

laundry

A

IADL

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13
Q

manage medications

A

IADL

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14
Q

clean the house

A

IADL

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15
Q

absrption

A
  • decreased acidity
  • delayed GI transit
  • increased Tmax
  • AUC does NOT change
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16
Q

distribution

A
  • increase in fat
  • decreased albumin
  • lipophilic meds: increased T1/2
  • hydrophilic meds: decreased T1/2
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17
Q

metabolism

A
  • decreased hepatic blood flow
  • decreased CYP3A4
  • no change in phase II metabolism
  • increased T1/2
  • increased risk of metabolite accumulation
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18
Q

elimination

A
  • decreased GFR
  • delayed elimination
  • increased exposure to toxic metabolites
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19
Q

adverse drug reaction

A
  • a specific rxn usually related to the pharmacology of the drug
  • pruritis caused by morphine
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20
Q

adverse drug event

A
  • any injury due to drug therapy. includes ADRs

- prescribing, dispensing, administration, adherence problems and therapeutic failures

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21
Q

adverse event

A
  • any adverse event not exclusive to medication therapy

- DVT following hip replacement

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22
Q

adverse outcome

A
  • any poor health outcome that may be related to med or other factors
  • stroke due to poorly controlled HTN
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23
Q

top 5 med classes leading to ED

A
  • hematologic
  • cardio
  • endocrine
  • CNS
  • anti-infective
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24
Q

activation of M1 & M2 are importatnt for

A

learning and memory

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25
Q

STARTcriteria

A

ACEI/ARB, bisphosphonates, anti-HTN, Ca +D

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26
Q

STOPP criteria

A

CNS and psychotropic drugs, GI, musculoskeletal, analgesic, duplicates

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27
Q

leading source on the safety of prescribing meds for older adults

A

BEERS criteris

28
Q

functional age-related eye changes

A

presbyopia, decreased tear production, visual field constriction, decreased refractive power, decreased dark adaptation

29
Q

structural age-related eye changes

A

rising intraocular pressure, rod cell loss, liquefaction of vitreous gel, decreased lens translucency

30
Q

glaucoma treatment

A
  • decrease aqueous

- beta blocker or PG analog

31
Q

most common cause of low vision in the US

A

cataracts

32
Q

conductive causes of hearing impairment

A
  • obstructive of auditory canal
  • tympanic membrane impairment
  • middle ear abnormalities
33
Q

sensorineural causes of hearing impairement

A
  • age related
  • autoimmune disease
  • noise trauma
  • meds- AGs, loop diuretics, NSAIDs, salicylaes, macroldes, vanc
34
Q

MMSE

A

assesses cognitive impairment

  • 27-30: normal
  • 21-26 mild
  • 11-20 moderate
  • 0-10 severe
35
Q

low health literacy risk factors

A

lack of internet, older age, lack of health insurance,

36
Q

signs of low health literacy

A
  • poor eye contact when asked to read
  • being defensive in conversation
  • blaming lack of knowledge on sensory deficit
37
Q

implications of low health literacty

A
  • increased BP, poor glycemic control, low self- reported health, low patient satisfaction, higher rates of hospitalization, non-adherence
38
Q

Geriatric syndrome definition

A

multifactorial common conditions in the geriatric population associated with morbidity and mortality

39
Q

geriatric syndromes are problems that affect

A
  • cognitive, sensory, motor, psychosocial

- resulting in a loss of function

40
Q

measurements of function of IADLs

A
  • ability to use the phone, shopping, food preparation, housekeeping, laundry, transportation, med management, ability to handle finances
41
Q

measurements of function of ADLs

A

bathing, dressing, self-feeding, hygiene, continence, transferring

42
Q

oropharyngeal dysphagia

A

difficulty initiating swallowing or coordinating movement of food or liquid from the mouth to the upper esophagus

  • most common form in older adults
  • causes- stroke, PD
43
Q

esophageal dysphagia

A
  • difficulty transporting food or liquid through the esophagus into the stomach
  • any med carries the risk of esophageal injury when administered improperly
  • causes- dry swallowing, drug induced
44
Q

non-crushable meds

A

donepezil 23mg, duloxetine, omeprazole, potassium, dabigatran, mirabegron

45
Q

involuntary weight loss

A

significant weight loss of 5% over

46
Q

strongest factors for falls

A

abnormalities in gait and balance

47
Q

high risk factors for falls

A
  • time frame of 1 month post hospital discharge
  • suffered a fall w/in 12 months
  • diagnosed as frail
  • acute illness
  • exacerbation of chronic illness
48
Q

frailty characteristics

A

unintentional weight loss, exhaustion/fatigue, lower energy expenditure, slow gait speed/ slow performance, weak grip strength/ sarcopenia
- must have 3/5 to be considered frail

49
Q

elements of informed consent

A 
competence
disclosure
assurance of understanding
volunteriness
signed authorization
50
Q

medicare eligiility

A
  • those over 65
  • under 65 with diabilities
  • ESRD
51
Q

medicare part D eligibility

A
  • medicare A or B
  • 65
  • regardless of income or health
52
Q

caregiver burden risk factors

A

female sex, low education , depression, cohabitation, financial stress, social isolation

53
Q

types of elder abuse

A

financial exploitation, caregiver neglect, self-neglect, psychological/emotional, physical, sexual, abandonment

54
Q

what are advance directives?

A
  • written instructions about future medical care (end of life choices)
  • include living will and medical power of attorney
55
Q

what is a durable power of attorney?

A
  • a legal form that states who you want to make medical decisions
  • the person is authorized to speak for you ONLY if you are unable
56
Q

what is a living will?

A
  • a written legal document with your wishes about medical treatment
  • right to accept or refuse treatment
  • detailed end of life decisions
57
Q

life-sustaining treatments

A

resuscitation, mechanical ventilation, tube feeding, dialysis

58
Q

DNR

A

do not resuscitate

59
Q

DNI

A

do not intubate

60
Q

DNH

A

do not hospitalize

61
Q

hospice care qualifications

A
  • medicare part A benefit
  • terminally ill
  • must have
62
Q

CII meds for hospice patients

A

may be faxed!

63
Q

non-verbal signs of pain

A

facial expression, verbalizations, acting out, guarding, breathing, consolability, PAIN-AD

64
Q

pain treatment

A

opiates first line

65
Q

constipation management

A
  • hydration, promote movement, fiber
  • preventative: stool softeners, bulk-forming agents
  • PRN- stimulants, MOM, osmotic laxatives
66
Q

dyspnea management

A
  • first line: opiates- decrease ventilatory drive (morphine or fentanyl)
  • BZD: releive anxiety
  • oxygen to correct hypoxia- for social functioning and discomfort
67
Q

delirium management

A
  • treat underlying cause

- meds: haloperidol, BXD

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