Final Lecture #4 Flashcards
fluids, aeration, nutrition, communication, activity, pain, elimination, social skills.
FANCAPES assessment
sleep disorders, probs w/ eating/feeding, incontinence, confusion, evidence of falls, and skin breakdown.
SPICES assessment
6 = high (pt is independent) and 0 = low (pt is highly dependent on another person)
KATZ
IADLs (instrumental activities of daily living)?
Task for independent living needed to maintain one’s home (tool = Lawton daily living scale). Determine how dependent the pt will be on their own. Make sure to ask what they can independently do around the home.
MMSE?
Screen for and monitor cog function, gross screening for dementia. Not a diagnosis, test: orientation, short term memory, and attention, calculation ability, language, and construction, must be able to read, write, and be English proficient. Give them different words to say, what a clock looks like, etc.
Clock drawing test (CDT)?
Screen and diagnose dementia, not for MCI. Provide plain paper with circle on it, tell pt to draw a clock with numbers, make sure to pay attention. Scoring: 1-2 = normal, >3 represents a cog deficit.
MINI COG?
screens for MCI and dementia, equivalent to MMSE, combo MMSE and CDT. Short term memory and executive function, must hear, hold pencil, and write number. Directions: step 1 = say 3 unrelated words, clearly; step 2 = ask pt to draw a clock; step 3 = ask pt to repeat the words said in step 1. Score 3-5 = negative for dementia.
geriatric depression scale, centers for epidemiologic studies depression scale, and Cornell scale for depression in dementia.
mood assessments
Older American resources and services assessment (OARS)?
Divided and scored in 5 sub-scales: social resources, mental health, physical health, and ADLs. Aids in
Home safety evaluation probs and interventions?
Bathroom, bedroom, kitchen, living room, telephone, steps, home mgmt., safety, and leisure. Make sure their locks work and get what they need out of cabinets. Assess the pts room and make sure pts fam hasn’t taken anything that they don’t need to have in their room.
Thermoregulation?
o Neurosensory changes? Diminished or delay of perception of environmental temp changes
o Physiological changes? Impair cooling and warming responses to environmental temp changes
o Meds and ETOH: impair vasomotor response, inhibit neuromuscular activity, suppress metabolic heat generation, and/or dull awareness of surroundings. Changing with the older population, impairing them to control their body temp. Be aware of what they are putting in their system that can cause body temp changes.
hyperthermia?
more older adults die from excessive heat than from all other natural disasters combined, elderly is not likely to turn their air conditioning on during the summer. Heat fatigue – temp = norm – pale/diaphoretic – elevated HR. Heat exhaustion – temp norm or mild evaluation – cool and clammy – tachycardia, thirsty, AMS, nausea, cramping. Heat stroke – medical emergency with high morality. Temp – quickly elevates to >104 – flushed hot and dry – tachycardia, MS change, hypotension, hyperventilation (cellular and organ damage). Prevention: drink 2-3 L of cool fluids daily, stay in, wear appropriate clothing, take temperate showers, apply cold wet compress, evaluate meds for risks, avoid ETOH.
Hypothermia?
First signs may be confusion and disorientation (core temp <35 (95F)). Risk factors: impaired circulation, DM, adrenal and thyroid dysfunction, malnutrition, excessive ETOH use, use of sedatives, anxiolytics, and antidepressants.
SAFE DRIVE?
o S = Safety record
o A = Attention skills
o F = Family report
o E = Ethanol use
o D = Drugs
o R = Reaction time
o I = Intellectual impairment
o V = Vision and visuospatial function
o E = Executive functions
