Fragility and delirium Flashcards
Define acopia
patients who are unable to cope with activities of daily living
- dont have acute medical problems
- deemed to be an inappropriate admission
4 ways in which pharmacokinetics is altered in older people
reduced 1st pass met (?reduced liver blood flow)
age-dependent decline in creatinine clearance
delayed gastric emptying, secretions, reduced splanchnic blood flow
reduced lean mass, increased body fat, decreased plasma albumin
define fragility
A physiologic state of increased vulnerability to stressors that results from decreased physiologic reserves and dysregulation of multiple physiologic systems.
-have difficulty in maintaining homeostasis
define disability and co-morbidity
disability - Difficulty or dependency in carrying out activities essential to independent living
co-morbidity - Concurrent presence of 2 or more medically diagnosed diseases.
Heightens the risk of disability and mortality over and above the risk of individual disease.
what is delirium
acute confusional state, impaired consciousness and change in cognition
transient and fluctuant
brain failure
what are some symptoms of delirium
memory impairment disorganised thinking and concentration hallucinations disturbed psychomotor behaviour - restless or slow change in sleep pattern
what are the two types of delirium
Hyperactive
Hypoactive
what are some precipitants/risk factors for delirium
infection, drugs constipation, pain, urinary retention unfamiliar surroundings and people surgery electrolyte imbalance sensory deprivation
what are some ways to manage delirium
treat cause hydration and nutrition adequate lighting familiar staff cohort bay in view of nurses station re-orientate patient -patients lack capacity
what are some ways to prevent delirium
Nurse in a well lit area and try to keep the staff the same
Keep noise down at night
Regular bowel motions
Encourage fluid intake and eating
Review medications regularly
Encourage photos and contact with friends and family
