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Semester 3 PM Exam 6 > Geriatric Assessment > Flashcards

Geriatric Assessment Flashcards

1
Q

Additional health status questions

A

Do you have visual problems
Do you have hearing difficulties
Have you been experiencing any light headedness
Have you fallen in the last year
Fear of falling
How many times have you left your home in the last year
Do you need assistance when you leave your home
Have you had a bone scan done recently

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2
Q

Additional questions - vision

A

Have you ever had eye surgery
Do you wear glasses
When was your last eye exam

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3
Q

Additional questions - hearing

A

Do you use a hearing aid

When was your last hearing exam

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4
Q

Additional questions - light headedness

A

Dizziness

Spinning or vertigo

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5
Q

Additional to systems review - musculoskeletal system

A

Height in typical standing posture
Height in erect standing
Height in conscious erect standing

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6
Q

Additional to systems review - genitourniary

A

Bladder - urinary freq, urgency, incontinence, color, difficulty
Bowel - changes in regularity

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7
Q

Red flags from history

A

Resting HR (more than 120 or less than 50)
Resting SBP (more than 200 or less than 90)
Resting DBP (more than 110)
Weight gain (more than 4-6 lbs a day)
Ankle edema
Acute angina
Acute dizziness

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8
Q

Choosing the best test

A

Should reflect a similar population
Should be easy to perform
Should have strong measurement properties

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9
Q

F words

A

Fun - Function - Frailty - Failure

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10
Q

Fun ages

A

until about 50, maybe 65

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11
Q

Function ages

A

50 or 65 until 75 or 85

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12
Q

Frailty ages

A

75 or 85 until 95 or 90

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13
Q

Failure ages

A

85 or 90 until 100

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14
Q

Functional Markers - Fun category

A

TUG (less than 8 sec)
FSST (less than 10 sec)
30 sec chair rise (more than 15)

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15
Q

Functional Markers - Function category

A

TUG (9-20 sec)
FSST (10-15 sec)
30 sec chair rise (9-14)

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16
Q

Functional Markers - Frail Category

A

TUG (more than 20 sec)
FSST (15-20 sec)
30 sec chair rise (less than or equal to 8)

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17
Q

Frailty defined as

A

a clinical syndrome in which 3 or more of the following are present:

  • Unintentional weight loss
  • Weakness
  • Slow walking speed
  • Low physical activity
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18
Q

Frailty definition - unintentional weight loss defined as

A

10 pounds in last year

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19
Q

Frailty definition - weakness defined as

A

Grip strength
less than 30 kg men
less than 18 kg women

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20
Q

Frailty definition - slow walking speed

A

Less than .65 m/s for 15 feet

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21
Q

Frailty definition - low physical activity

A

cal burned

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22
Q

The prevalence of frailty is

A

difficult to determine
5-8% of people over 65
33% of people over 85 - need assistance with at least one ADL

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23
Q

Functional Markers - Failure category

A

TUG (more than 20 sec)
FSST (more than 20 sec)
30 sec chair rise (0)

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24
Q

2 minute step test is associated with

A

the ability to perform lifestyle tasks like walking and climbing stairs
It is an alternate to the 6 min walk test

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25
Q

2 minute step test - equipment required

A

Stopwatch
Tally counter
Tape measure or metric ruler
Masking tape or whiteboard marker

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26
Q

2 minute step test - establishing knee lift height

A

Mark on the wall the height from ground to participants mid thigh (btw patella and iliac crest)

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27
Q

Where to stand with 6 minute walk test

A

off to side and a little behind

You do not want to set their pace for them

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28
Q

2 minute step test

A

Pretty high for geriatric population

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29
Q

Four Square Step Test - test of

A

dynamic balance that clinically assess the persons ability to change directions while stepping
NOT good for visually impaired
Looking at dynamic balance

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30
Q

Four square step test - what is it

A

pt instructed to stand in square 1 facing square 2 and then as fast as they can they step into 2, 3, 4, 1, 4, 3, 2, and 1

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31
Q

Four square step test - requires patient to step

A

forward, backward, and sideways to right and left

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32
Q

Four square step test - equipment

A

stopwatch and 4 canes

33
Q

Cut point for fall risk - FSST

A

If it takes more than 15 seconds for them to do it

34
Q

30 second chair rise provides a measurement of a persons

A 
lower body (leg strength) 
Associated with the ability to perform lifestyle tasks like climbing stairs, getting in and out of vehicles
35
Q

Equipment for 30 sec chair rise

A

Chair with a straight back and a seat at 43 cm

Stop watch

36
Q

30 sec chair rise instructions for participant

A 
Sit in middle of the chair
Cross arms over chest
Keep feet flat on floor
Keep back straight
On signal begin to rise to full stand and then sit back down
37
Q

Cut point for 30 sec chair rise

A

less than 10 is an indication of poor leg strength

As yet, there is no fall risk for this test

38
Q

Timed up and go test was developed as a

A

brief screen for mobility and fall risk

Has good test-retest reliability and Sn and Sp for falls

39
Q

What is timed up and go measuring

A

Time it takes for an individual to stand up from a standard arm chair, walk 3 meters, turn, walk back to chair, sit down again
No physical assistance
Can use normal walking aid if their norm

40
Q

Cut point for TUG

A

Vary depending on population studied

Generally more or equal to 14 seconds

41
Q

Seated step test is a measure of

A

exercise tolerance, fitness for activity and endurance

Graded exercise test that’s less intense than submax or max bike, treadmill testing

42
Q

Seated step test is completed in

A

4 stages
Pt seated in chair or wc and asked to alternately place each foot on edge of step or raised bar for period of time
Each level is performed at inc level of exercise intensity

43
Q

Stages for seated step test - Step 1

A

Alternate placement of heel on raised edge 6 in high at rate of 1 step per second (2.3 mph walking)

44
Q

Stages for seated step test - Step 2

A

Alternate placement of heel on raised edge 12 in high at rate of 1 step per second (2.9 mph walking)

45
Q

Stages for seated step test - Step 3

A

Alternate placement of heel on raised edge 18 in high at rate of 1 step per second (3.5 mph walking)

46
Q

Stages for seated step test - Step 4

A

Alternate placement of heel on raised edge 24 in high at rate of 1 step per second (3.9 mph walking)

47
Q

Seated step test - vitals

A

HR and BP monitored at two minutes and five minutes
Vitals after every stage?
HR under 75% of age predicted max at 5 min means you continue to next stage

48
Q

Physical performance test

A

Measures several aspects of function
ADL and AIDL
Simple, inexpensive
Takes about 10 minutes

49
Q

Test for physical performance test

A 
Write a sentence
Simulate eating
Lifting a book and place it on shelf
Donning and doffing a jacket
Picking up a penny from floor
Turning 360 while standing
Walking 50 feet
50
Q

Gait Speed - to determine

A 
gait speed while walking
To evaluate mobility 
Need pathway of 3 meters - can do 4, 5, or 10
Allow 2 meters for acc and deceleration
Good reliability
51
Q

Gait speed - procedures

A

Instruct pt to walk at comfortable pace for trial run for entire distance
Then test gait speed at comfortable pace
Then instruct pt to walk at fast pace for trial run
Then test gait speed at fast pace
Give 2 trials
Obtain the gait speed and divide by distance

52
Q

Scores for Gait speed

A

0.5 m/s is sufficient for community ambulators
Less than 1 m/s = well functioning people at high risk of health related outcomes
1.2 - 1.3 m/s usual adult walking

53
Q

Functional status questionnaire can be used as a

A

self administered functional assessment for providing info on patients physical, psychological, social and role function

54
Q

Functional status questionnaire - can be used as both

A

screen initially for problems

And to monitor patient over time

55
Q

Sections of functional status questionnaire

A 
Physical function in ADLs
Psychological function
Role function
Social function
Variety of performance measures
56
Q

Cognitive tests - Mini mental

A

One of the most frequently used cognitive screens

57
Q

Equipment for mini mental

A

Form

Pencil

58
Q

Mini mental - tool consists of

A

two sections
First verbal responses and addresses orientation, memory, and attention
Second respond to verbal and written commands

59
Q

Score for mini mental -

A

Out of 30
More than 24 = cognitively intact
Less than 23 = cognitive impairment

60
Q

Cognitive exam - MoCA

A

Rapid screen of cog abilites
Best for Alz, dementia, stroke, parkinsons
Looks at visuospatial, naming, memory, attention, language, abstraction, recall and orientation

61
Q

Short portable mental status questionnaire (SPMSQ) - assess

A

Short reliable tool that assesses cognitive impairment

62
Q

Short portable mental status questionnaire - measures

A

Orientation, memory function related self care, remote memory and capacity to perform mental operations

63
Q

Scoring for Short portable mental status questionnaire

A

0-2 errors = normal mental functioning

8 or more errors = severe cognitive impairment

64
Q

Saint Louis Mental Status Exam

A

30 point screening questionnaire to identify people with mild cognitive disorder

65
Q

Saint Louis Mental Status Exam - time and what it is testing

A

7 minutes

Orientation, verbal recall, calculation, naming, attention, executive function

66
Q

Saint Louis Mental Status also takes what into consideration -

A

Education

67
Q

Geriatric Depression Scale

A

Assesses depression and suicide ideation in elderly
30 item questionnaire Y or N questions
Score of 11 or above indicated depression

68
Q

Dyspnea Scale

A 
1 = light, barely noticeable 
2 = moderate, bothersome
3 = moderately severe, very uncomfortable 
4 = most severe or intense dyspnea ever experienced
69
Q

RPE

A

6 - 20

70
Q

Anginal scale

A

1 = lightly barely noticeable
2= moderate, bothersome
3 = severe, very uncomfortable
4 most severe pain ever experienced

71
Q

Rib/Pelvis Distance -
Less than 1 fingerbreadth
Less than 2 fingerbreadths
More than 2 fingerbreadths

A

Less than 1 fingerbreadth = fracture with high certainty
less than 2 fingerbreadths = may need radiographs
More then 2 fingerbreadths = rule out fracture with high degree of certainty

72
Q

Strength test - arm curl test

A

To assess upper body strength required for household and other activities that involve carrying and lifting
5 lb women
8 lb male

73
Q

Procedure for arm curl test

A

Have pt perform bicep curls using good form throughout

Count curls completed in 30 seconds

74
Q

Grip strength

A

Measures strength of grip

Need dynamometer

75
Q

Procedure for grip strength

A

Subject is seated with shoulder adducted, neutrally rotated, elbow flexed to 90 deg, forearm neutral, wrist btw 0 and 30 deg of DF
Squeeze as hard as possible for 3 sec

76
Q

Future older adults - higher levels of educational attainment =

A

lower mortality
better health
reduced poverty
less likelihood of being alone

77
Q

Before 2005 - what percent of adults had 4 or more children

A

35%

78
Q

After 2005 - what percent have 4 or more children

A

11%

Need for formal care will increase

79
Q

Future older adults - older adults can now expect to live

A

18.7 yrs on avg more than in 1980s and will continue to inc

Longer time in workforce - older women will have pensions now

Semester 3 PM Exam 6 (2 decks)

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