Geriatric Flashcards
1
Q
Intro
- May have _____ or _____ impairment
- Difficulty s_____
- May be ____ to present symptoms, afraid, avoid ____, don’t want to lose _____ or hear anything potentially ___ diagnosis or tx
- Turn ___ TV, radio, make sure they have their g____, hearing ___
A
- hearing, visual
- speaking
- embarassed, expenses, independence, bad
- off, glasses, aides
2
Q
Normal Physiological Changes
- ______ in SBP
- Aorta and large arteries around the heart become ____ - increase in SBP
- _____ pulse _____
- Diastolic BP typically stops rising around ___
- _____/_____ hypotension
- Decline in _____ cells (start to degenerate) of the ___ node leading to dys_____/____cardia
A
- Increase
- stiff
- widened pulse pressure
- 60
- Postural/Orthostatic
- pacemaker, SA, dysrhythmias, bradycardia
3
Q
Normal Physiological Changes
- Loss of skin _____
- Presence of a_____ p____ -well _____, purple ____. Can last for several _____. Blood _____ into the dermis from weak _____.
- Nails y_____ and t_____
- Hair _____, r_____, g_____
- Women may develop ____ facial hairs
A
- elasticity
- actinic purpura - demarcated, macule, weeks, leaking, capillaries
- yellow, thick
- thins, recedes, gray
- course
4
Q
Normal Physiological Changes
- Eyes/P______
- ___ loses elasticity, eye unable to ______ and focus on ___ objects
- Changes persist leading to (3)
- Lens loses elasticity -> impairs passage of ____ to ______ so trouble accommodating and focus on near objects
- Ophthalmoscope, fundi cannot have light ____ as well, arteries can look _____ or p___, s_____ or d_____, less _____ to them
- Less ____ leading to ___ eyes
A
- Presbyopia
- lens, accomodate, near
- cataracts, glaucoma, macular degeneration
- light, retina
- reflection, narrower, pale, straighter, duller, resonance
- secretions, dry
5
Q
Hearing
- Hearing/P______ (starge after age ___)
- First loss of ____ pitched sounds, then progresses to middle and lower ranges
- Difficulty hearing in ____ places, unable to distinguish sounds
-
Do not _____ , speak in ___ tones, slowly, and clearly
*
A
- Presbycusis, 50
- high
- noisy
- Shout, low
6
Q
Mouth and Lungs w Aging
- Mouth
- Decrease in salivary _____, ___ mouth, diminished _____
- Lungs
- Chest wall _____, respiratory muscles may _____, lungs lose some elastic _____
- Decreased capacity to ______
A
- Mouth
- secretions, dry, taste
- Lungs
- stiffens, weaken, recoil
- exercise
7
Q
Cardiovascular and PVD w Aging
- Cardiovascular
- Cardiac output ____ dt blunted responsiveness to __-____ stimulation
- HR ____, but stroke volume _____ to maintain CO
- Cardiac _____: most murmurs in young ppl are ____, but older have ____ murmurs
- Aging thickens the bases of the valve ____ with _____ tissue
- _____ of valve leaflets can occur, as this progresses the valve leaflets become less _____ and can impair blood flow ex) aortic _____
- Cardiac output ____ dt blunted responsiveness to __-____ stimulation
- PVD
- develops dt _______ plaque
A
- CV
- decreases, B-adrenergic
- drops, increases
- murmur, innocent, pathologic
- leaflets, fibrous
- Calcification, mobile, stenosis
- decreases, B-adrenergic
- PVD
- athersclerotic
8
Q
Breast/Axilla w Aging
- ______ tissue atrophies and is replaced by ___
- Breast becomes pendulous/______
- Decrease in _____ hair
A
- Glandular, fat
- flaccid
- axillary
9
Q
Abdomen w Aging
- ___ accumulates in the ____ abdomen near the ____, even with stable weight, along with weakening of the abdominal _____
- Leading to a more s___ p_____ abdomen
A
- Fat, lower, hips, muscles
- soft, protruding
10
Q
Genitalia Men and Women w Aging
- Genitalia Men
- _____ sexual interest
- But ______ lvls decline -> effects libido and sexual function -> ED
- Erectile _____
- Enlarged _____
- _____ sexual interest
- Genitalia Women
- Sexual interest ______
- Diminished _____ function
- Vaginal mucosa ____, it becomes pale and ___ with loss of _____, leading to _______ (painful sex)
- Decrease in size of ___ and _____
A
- Genitalia Men
- Continued
- testosterone
- Dysfunction
- Prostate
- Continued
- Genitalia Women
- continued
- ovarian
- thins, dry, lubrication, dyspareunia
- labia, clitoris
11
Q
MSK w Aging
- Loss of ____ dt interveterbal disk ____/shortening/even _____, also from what disease state _____
- Loss of ____ mass
- First noticed on back of ____, as atrophy of interosseous muscles causes concavities or grooves
- They ____!
- Vertebral disks becoming thinner
A
- height, thinning, collapse, osteoporosis
- muscle
- hands
- shrink
12
Q
Nervous System w Aging
- Decrease in ____ volume and cortical brain _____
- Process and retrieves information ____
- Benign forgetfulness =
- ______ - older ppl surrounded by death
- Increased risk for d____/d____/d_____
- Benign essential tremor =
- ___ reflex diminished = risk for _______
- Diminished r_______
A
- brain, cells
- slower
- can retrace steps and eventually remember
- Depression
- depression, dementia, delirium
- hands, jaw, lip - are faster and dissappear with rest - NO rigidity compared to Parkinson’s
- Gag, aspiration
- reflexes
13
Q
Common Concerns
- Actitivities of ____ ____
- _____ ADL
- Acute and persistent _____
- N______
- F_____
- Advanced _____ and _____ care
- M____ -are they taking them correctly?
- A____/S_____
A
- Daily Living
- Instrumental
- pain
- Nutrition
- Frailty
- Directives, Palliative
- Meds
- Alcohol/Smoking
14
Q
Advanced Directives
(2)
- Before a living will can guide medical decision making - ___ physicians must certify
- Patient is ____ to make medical decisions
- Patient is in the medical condition specified in the living will law (such as “_____ illness” and “permanent ______”)
- A medical power of attorney (or healthcare proxy) =
- Who cannot honor living wills or medical powers of attorney?
- What is the MOLST document?
A
Living Will
Health Care Proxy
- 2
- unable
- “terminal”, “unconsciousness”
- allows an appointed person to make medical decisions on behalf of the patient
- EMT’s
- Unless in NYS they are provided an executed (Medical Orders for Life-Sustaining Treatment)
- MOLST- physician or NP can have patient maintain their DNR/DNI status outside of hospital
15
Q
ADLs
A
- Bathing
- Dressing
- Toileting
- Transferring
- Continence
- Feeding