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Geriatrics > Final Review > Flashcards

Final Review Flashcards

1
Q

factors associated with aging pop (4)

A

1 - fertility rate declining
2 - size of birth is stable
3 - life expectancy
4 - mortality rate is decreased

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2
Q

antidepressants side effects (6)

A

fall risk (tricyclic… this is why we hate it)

nausea, sleep changes, tremor, fatigue, dizziness

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3
Q

beta blocker effects

A

decrease HR and BP by 20-3-%
decreased cardiac output
decreased blood flow

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4
Q

beta blocker SIDE EFFECTS

A

bradycardia
hypotension

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5
Q

PT considerations for beta and ca channel blockers (4)

A
  • exercise at the same time each day
  • HR should be 40-75% of Karvonen’s formula
  • PRE adjunct to HR
  • pt should carry nitroglycerine
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6
Q

side effects of NSAIDs (4)

A

GI bleeding
renal impairment
increased BP
negates cardioprotective benefit of aspirin

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7
Q

what may happen in the lungs with anesthesia

A

bronchial secretions may accumulate

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8
Q

how can we help reduce bronchial secretions

A

early mobilization

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9
Q

two overall factors that control human agng

A

1 - environmental 65%
2 - genetic 35%

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10
Q

what does an active lifestyle do in relation to aging

A

it helps you build aphysiologic reserve to prolong feeling the decline of normal aging

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11
Q

what are some factors associated with age related decline

A
  • physical inactivity (primary)
  • inadequate nutrient intake
  • excess body weight
  • smoking
  • excess alcohol
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12
Q

how does the physical stress theory explain aging

A

tissues are able to tolerate and adapt to environment changes more in successful aging compared to non-successful aging
better maintenance of homeostasis

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13
Q

as you age, heart weight, left ventricle wall thickness, left atrium size, and arterial stiffness _______-

A

increases

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14
Q

systolic BP ______- with age

A

increases

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15
Q

systemic pain comes on ______ while MSK pain is….

A

sudden
sudden or gradual

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16
Q

how is systemic pain usually described? what about MSK?

A

systemic = knifing/throbbing
MSK = achy/cramping

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17
Q

acronym for skin probs screening

A

A = asymmetry
B = border
C = color
D = diameter
E = evolving

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18
Q

red flags for cancer

A

CAUTIONS
-changes in bowel or bladder
-a sore that does not heal in 6 weeks
-unusual bleeding or discharge
-thickening or lump in breast or elsewhere
-indigestion or difficulty swallowing
-obvious change in a wart or mole
-nagging cough or hoarseness
-supplemental signs and symptoms

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19
Q

is presbycusis sensorineural or conductive? bilateral or unilateral?

A

sensorineural
bilateral

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20
Q

what can cause conductive hearing loss

A
  • excessive ear wax
  • malformation of pinna
  • middle ear infection
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21
Q

T or F: vertigo is always present with central nystagmus

A

F

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22
Q

Does nystagmus fatigue with central vertigo? is there latency?

A

no and no

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23
Q

direction changing nystagmus is common in people with

A

stroke
*central vertigo

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24
Q

in seated, downbeating nystagmys is usually associated with ______ lesions while upbeating is associated with _______-

A

cerebellar
brainstem

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25
______ torsion is counterclockwise while ______ torsion is clockwise
right left
26
cupulolithiasis is ________ while canalisthiasis is ________
apogeotropic geotropic
27
with cupulo, the otoconia is on the _______ intense side, while with canalis it is on the _____ intense side
less more
28
PC BPPV is _____- while anterior is ________
upbeating downbeating
29
signs of depression in older adults (4)
- sleep disturbance - fatigue - psychomotor retardation - hopelessness about future
30
T or F: attention span is shorter with dementia
F: but it is with delirium
31
T or FL there are psychomotor changes with dementia
F: but there is with delirium
32
how does speech vary in dementia vs delirium
dementia = may be aphasic delirium = incoherent
33
questions to id older people with depression
"Over the past two weeks, have you ever felt down, depressed, or hopeless?" "Have you felt little interest or pleasure in doing things?"
34
PT treatment strategies in older people with depression
1 - matter of fact approach 2 - increased time for treatment 3 - small goals 4 - support system present during visits
35
what are some neurogenic factors associated with incontinence (7)
-CVA -Brain tumor/injury -PD -type 2 diabetes -dementia -depression -SCI
36
what are some non-neurogenic factors associated with incontinence
-S2-4 nerve root compression -aging urinary tract -obesity -functional impairment -BPH
37
what are some causes of incontinence in developed contries
- obesity - lack of exercise - decrease in functional mobility
38
PD dementia is marked by decreases in...
1 - working memory 2 - visuospatial processing 3 - executive functioning 4 - functional ability 5 - attention
39
stage 3 AD characteristics
mild cog deficits -- objective functional deficit interferes with a person's most complex tasks
40
medicare part A covers what
hospital SNF home health hospice
41
progressive resistance exercise intensity/duration/frequency
- 80% of 1 RM - 10-24 weeks - 3x week
42
if a PT is the first provider to ses a pt in home health this makes them the...
case manager
43
what makes a home health PT unique
- case manager - medial coordinator and direct liaison with MD - closer attention to vitals - pharm - OASIS - home safety
44
what do you have to have in order to use a restriant
a written physician order specifying the duration and circumstance for which restrains may be used
45
T or F: an AD may be considered a restraint
T if the pt cant get out of it themselves, it is a restraint
46
what act regulated the use of restrains in nursing homes
omnibus budget reconciliation act of 1987 (OBRA) - provides that residents have the right to be free from any physical or chemical restraints
47
what are some s/s of elder abuse?
-arguments between caregiver and elder -personality changes -depression/confusion -agitated -trauma, unexplained bruises -messy, dirtry clothes -bed sores -unexplained weight loss
48
what are the goals of a PT in supporting a good death in hospice care?
- reduce pain - optimize pt's remaining function - enhance QOL - family ed
49
to qualify for hospice
physicians confirmation that pt is terminally ill and prognosis is 6 mths or lessh
50
how do medicare benefits for hospice work?
- 2 90 day periods (recertify that it is needed after each) - unlimited 60 day periods (recertify after each)
51
when do you stop hospice care
- health condition improves - remission of illness - pt wants to stop
52
T or F: PTs are required core service on the hospice interdisciplinary team
F: but they must be made available to any pt as needed
53
what do PTs do in hospice care
- caregiver ed - ROM/massage - pain management - pressure relief *keep it light
54
the dying process involved...
the decline and ultimate failure of all major organ systems
55
what happens during "active death"?
- cheyne stokes breathing - decrease in urine output - BP drops - cold blue extremeties *final days and hours
56
Paget's disease clinical signs
-pain/stiffness -fatigue -headache/dizziness -bone fx -deformity -spinal stenosis -bone bowing -paraplegia -muscle weakness
57
signs of osteoporosis
-back pain -compression/bone fx -decrs height -kyphosis -Dowager's hump -decrs activity tolerance -early satiety
58
you need to use at least __% of max muscle strength to improve strength
60
59
what is the mean duration from onset of PD to PD demetia
10 years
60
cutt off score for TUG
12 sec or more = fall risk
61
beta blocker suffix
-lol
62
in general, do beta blockers increase or decrease exercise tolerance
decrease b/c HR cannot be increased
63
T or FL anesthetics may cause confusion, delirium, or muscle weakness
T: so be cautious of this while working with pts right after anesthesia
64
what happens to HR and VO2 max as you age
decreases
65
you lose cells from the _____ node as you age which leads to reduced contractility
SA
66
residual volume ______ as you age and tidal volume _______
increases remains constant *all other pulmonary decreases
67
response time ________ as you age
increases
68
as you age, hair cells, otoconia, and vestibular nerve fibers________
decrease
69
you lose hearing from ___- to ___ frequency
high to low
70
T or F: cerumen decreases as you age
F: increases
71
is MSK pain usually uni or bilateral
uni *systemic can be either
72
T or F: systemic pain is usuall constant
T
73
T or K: MSK pain usually has associated signs such as fever or chills
F but systemic deos
74
with pts who are hearing impaired, speak_____- not ____
slower louder
75
presbycusis
age related hearing loss
76
T or F: you lose auditory neurons as you age
T
77
conductive hearing loss affects what part of the ear
outer and or middle
78
what is sensorineural hearing loss
hearing loss caused when inner ear and or auditory nerve are affected
79
is vertigo present with peripheral nystagmus
usually! but if it is chronic they may have compensated and it might not be as noticeable
80
does nystagmus fatigue with peripheral nystagmus
yes
81
does central or peripheral vertigo have a longer recovery
central
82
is nausea worse with central or peripheral vertigo
peripheral
83
is central or peripheral vertigo more likely to have UMN signs
central
84
T or FL central vertigo gets worse with head movement
F: but peripheral does
85
does central or peripheral vertigo have more issue with balance
central
86
two types of BPPV
canalithiasis cupulolithiasis
87
________ lasts longer than 60 seconds while ______ lasts shorter than 60 secs
cupulo canal
88
which one has latency... canal or cupulo
canal
89
fluid vs crystalized mem. which one does older adults lose?
fluid
90
brain volume and weight _____ with age
decrease *esp prefrontal cortex
91
T or FL you lose the hippocampus as you age
T
92
delirium is an ______ onset while dementia is _______
acute grandual
93
T or F: there is usually evidence of an acute illness with delirium
T but not dementia!
94
with delirium symptoms, last _______, while with dementia they last _____-
days to weeks years
95
which has a change in level of consciousness? delirium or dementia
delirium
96
T or F: aging causes incontinence
F
97
medicare has ____ parts
4
98
medicare part B covers what
outpatient pt
99
medicare part c
supplemental insurance
100
medicare part D covers
prescription drugs
101
the min days for hospitalization before SNF stay
3
102
how much of PT does medicare cover
80%
103
how is medicaid funded
payroll taxes
104
CDC PA recs
-150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic exercise/week -muscle strengthening at least 2 days a week that work all major muscle groups
105
as gait speed decreases, life expectancy
decreases
106
what does meals on wheels do
provides homebound older adults with a nutritious hot meal, along with a check-in and visit
107
T or F: home healthy PTs make their own schedule
T
108
what is the goal of hospice
to keep pt confortable int heir last days
109
what part of medicare covers hospice
part A
110
T or F: nearing death, a pt may have altered mental status
T
111
T or F: pts often become restless near end of life
T
112
how many sets for strengthening is best
3

Geriatrics (6 decks)

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