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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
Q

______ torsion is counterclockwise while ______ torsion is clockwise

A

right
left

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26
Q

cupulolithiasis is ________ while canalisthiasis is ________

A

apogeotropic
geotropic

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27
Q

with cupulo, the otoconia is on the _______ intense side, while with canalis it is on the _____ intense side

A

less
more

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28
Q

PC BPPV is _____- while anterior is ________

A

upbeating
downbeating

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29
Q

signs of depression in older adults (4)

A
  • sleep disturbance
  • fatigue
  • psychomotor retardation
  • hopelessness about future
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30
Q

T or F: attention span is shorter with dementia

A

F: but it is with delirium

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31
Q

T or FL there are psychomotor changes with dementia

A

F: but there is with delirium

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32
Q

how does speech vary in dementia vs delirium

A

dementia = may be aphasic
delirium = incoherent

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33
Q

questions to id older people with depression

A

“Over the past two weeks, have you ever felt down, depressed, or hopeless?”
“Have you felt little interest or pleasure in doing things?”

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34
Q

PT treatment strategies in older people with depression

A

1 - matter of fact approach
2 - increased time for treatment
3 - small goals
4 - support system present during visits

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35
Q

what are some neurogenic factors associated with incontinence (7)

A

-CVA
-Brain tumor/injury
-PD
-type 2 diabetes
-dementia
-depression
-SCI

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36
Q

what are some non-neurogenic factors associated with incontinence

A

-S2-4 nerve root compression
-aging urinary tract
-obesity
-functional impairment
-BPH

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37
Q

what are some causes of incontinence in developed contries

A
  • obesity
  • lack of exercise
  • decrease in functional mobility
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38
Q

PD dementia is marked by decreases in…

A

1 - working memory
2 - visuospatial processing
3 - executive functioning
4 - functional ability
5 - attention

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39
Q

stage 3 AD characteristics

A

mild cog deficits – objective functional deficit interferes with a person’s most complex tasks

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40
Q

medicare part A covers what

A

hospital
SNF
home health
hospice

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41
Q

progressive resistance exercise intensity/duration/frequency

A
  • 80% of 1 RM
  • 10-24 weeks
  • 3x week
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42
Q

if a PT is the first provider to ses a pt in home health this makes them the…

A

case manager

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43
Q

what makes a home health PT unique

A
  • case manager
  • medial coordinator and direct liaison with MD
  • closer attention to vitals
  • pharm
  • OASIS
  • home safety
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44
Q

what do you have to have in order to use a restriant

A

a written physician order specifying the duration and circumstance for which restrains may be used

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45
Q

T or F: an AD may be considered a restraint

A

T if the pt cant get out of it themselves, it is a restraint

46
Q

what act regulated the use of restrains in nursing homes

A

omnibus budget reconciliation act of 1987 (OBRA)
- provides that residents have the right to be free from any physical or chemical restraints

47
Q

what are some s/s of elder abuse?

A

-arguments between caregiver and elder
-personality changes
-depression/confusion
-agitated
-trauma, unexplained bruises
-messy, dirtry clothes
-bed sores
-unexplained weight loss

48
Q

what are the goals of a PT in supporting a good death in hospice care?

A
  • reduce pain
  • optimize pt’s remaining function
  • enhance QOL
  • family ed
49
Q

to qualify for hospice

A

physicians confirmation that pt is terminally ill and prognosis is 6 mths or lessh

50
Q

how do medicare benefits for hospice work?

A
  • 2 90 day periods (recertify that it is needed after each)
  • unlimited 60 day periods (recertify after each)
51
Q

when do you stop hospice care

A
  • health condition improves
  • remission of illness
  • pt wants to stop
52
Q

T or F: PTs are required core service on the hospice interdisciplinary team

A

F: but they must be made available to any pt as needed

53
Q

what do PTs do in hospice care

A
  • caregiver ed
  • ROM/massage
  • pain management
  • pressure relief

*keep it light

54
Q

the dying process involved…

A

the decline and ultimate failure of all major organ systems

55
Q

what happens during “active death”?

A
  • cheyne stokes breathing
  • decrease in urine output
  • BP drops
  • cold blue extremeties
    *final days and hours
56
Q

Paget’s disease clinical signs

A

-pain/stiffness
-fatigue
-headache/dizziness
-bone fx
-deformity
-spinal stenosis
-bone bowing
-paraplegia
-muscle weakness

57
Q

signs of osteoporosis

A

-back pain
-compression/bone fx
-decrs height
-kyphosis
-Dowager’s hump
-decrs activity tolerance
-early satiety

58
Q

you need to use at least __% of max muscle strength to improve strength

A

60

59
Q

what is the mean duration from onset of PD to PD demetia

A

10 years

60
Q

cutt off score for TUG

A

12 sec or more = fall risk

61
Q

beta blocker suffix

A

-lol

62
Q

in general, do beta blockers increase or decrease exercise tolerance

A

decrease b/c HR cannot be increased

63
Q

T or FL anesthetics may cause confusion, delirium, or muscle weakness

A

T: so be cautious of this while working with pts right after anesthesia

64
Q

what happens to HR and VO2 max as you age

A

decreases

65
Q

you lose cells from the _____ node as you age which leads to reduced contractility

A

SA

66
Q

residual volume ______ as you age and tidal volume _______

A

increases
remains constant
*all other pulmonary decreases

67
Q

response time ________ as you age

A

increases

68
Q

as you age, hair cells, otoconia, and vestibular nerve fibers________

A

decrease

69
Q

you lose hearing from ___- to ___ frequency

A

high to low

70
Q

T or F: cerumen decreases as you age

A

F: increases

71
Q

is MSK pain usually uni or bilateral

A

uni
*systemic can be either

72
Q

T or F: systemic pain is usuall constant

A

T

73
Q

T or K: MSK pain usually has associated signs such as fever or chills

A

F but systemic deos

74
Q

with pts who are hearing impaired, speak_____- not ____

A

slower
louder

75
Q

presbycusis

A

age related hearing loss

76
Q

T or F: you lose auditory neurons as you age

A

T

77
Q

conductive hearing loss affects what part of the ear

A

outer and or middle

78
Q

what is sensorineural hearing loss

A

hearing loss caused when inner ear and or auditory nerve are affected

79
Q

is vertigo present with peripheral nystagmus

A

usually! but if it is chronic they may have compensated and it might not be as noticeable

80
Q

does nystagmus fatigue with peripheral nystagmus

A

yes

81
Q

does central or peripheral vertigo have a longer recovery

A

central

82
Q

is nausea worse with central or peripheral vertigo

A

peripheral

83
Q

is central or peripheral vertigo more likely to have UMN signs

A

central

84
Q

T or FL central vertigo gets worse with head movement

A

F: but peripheral does

85
Q

does central or peripheral vertigo have more issue with balance

A

central

86
Q

two types of BPPV

A

canalithiasis
cupulolithiasis

87
Q

________ lasts longer than 60 seconds while ______ lasts shorter than 60 secs

A

cupulo
canal

88
Q

which one has latency… canal or cupulo

A

canal

89
Q

fluid vs crystalized mem. which one does older adults lose?

A

fluid

90
Q

brain volume and weight _____ with age

A

decrease
*esp prefrontal cortex

91
Q

T or FL you lose the hippocampus as you age

A

T

92
Q

delirium is an ______ onset while dementia is _______

A

acute
grandual

93
Q

T or F: there is usually evidence of an acute illness with delirium

A

T but not dementia!

94
Q

with delirium symptoms, last _______, while with dementia they last _____-

A

days to weeks
years

95
Q

which has a change in level of consciousness? delirium or dementia

A

delirium

96
Q

T or F: aging causes incontinence

A

F

97
Q

medicare has ____ parts

A

4

98
Q

medicare part B covers what

A

outpatient pt

99
Q

medicare part c

A

supplemental insurance

100
Q

medicare part D covers

A

prescription drugs

101
Q

the min days for hospitalization before SNF stay

A

3

102
Q

how much of PT does medicare cover

A

80%

103
Q

how is medicaid funded

A

payroll taxes

104
Q

CDC PA recs

A

-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
Q

as gait speed decreases, life expectancy

A

decreases

106
Q

what does meals on wheels do

A

provides homebound older adults with a nutritious hot meal, along with a check-in and visit

107
Q

T or F: home healthy PTs make their own schedule

A

T

108
Q

what is the goal of hospice

A

to keep pt confortable int heir last days

109
Q

what part of medicare covers hospice

A

part A

110
Q

T or F: nearing death, a pt may have altered mental status

A

T

111
Q

T or F: pts often become restless near end of life

A

T

112
Q

how many sets for strengthening is best

A

3

Geriatrics (6 decks)

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