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Final exam for patient assessment skills > Geriatric assessment powerpoint > Flashcards

Geriatric assessment powerpoint Flashcards

1
Q

Insomnia

Pseudoephedrine

Stimulants (amphetamines)

___________

A

Caffeine

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1
Q

History of Falls

Antipsychotics

________________

Tricyclic antidepressants

Opioids

______________ (glyburide, sliding scale insulin)

A

Benzodiazepines

Hypoglycemics

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2
Q

Beers Criteria: Drug- Drug Interactions

How can we intervene?

Opioids and Benzos

A
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3
Q

ACE inhibitors+triamterene= increased risk of ____________

A

hyperkalemia

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4
Q

Warfarin+NSAIDS increased risk of _________

A

GI bleeding

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5
Q

Oral corticosteroids and NSAIDS increased risk of __________

A

GI bleeding

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6
Q

Opioids and Benzos increased risk of_________

A

respiratory depression

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7
Q

HOW TO USE THE BEERS CRITERIA

Medications that are potentially inappropriate not definitely inappropriate

Use the rationale and recommendation section to guide decision making – why is it on the list?

Consider safe alternatives, including non-pharm options when recommending against a Beers Criteria med

Be patient-specific

If you recommend against a med/discontinuation, plan for ___________

A

tapering

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8
Q

WHAT MEDS ARE INAPPROPRIATE?

Zolpidem (CNS, falls, confusion)

Cyclobenzaprine (drowsy, falls)

Tramadol (falls, drowsy)

Omeprazole (osteoporosis)

Ropinirole (used for restless legs)

Oxybutynin (used for UI, anticholinergic SE)

Verapamil (HFrEF)

Atenolol (tired, masking hypoglycemia)

Premarin (long term use of estrogen not good)

A
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9
Q

Motor system

Assess the patient’s gait- gait can be changed by both musculoskeletal and neurologic disorders.** Observe the rate, rhythm, and arm motion of the patient while walking**

Ask the patient to walk away from your normally

Ask the patient to walk toward you on ___________

Ask the patient to walk away from you on the heels

Ask the patient to walk back to you in a normal gait

A

tiptoe

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10
Q

_________-stand close to catch the person in case he or she starts to falls

Ask the patient to stand up, with his or feet together and arms to the side

Once the patient is in a stable position, ask the patient to close his or her eyes and then hold that position

Wait ______ to ______ seconds

A person should be able to maintain _______and balance without visual orientation

A

Romberg test

20 to 30 seconds

posture

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11
Q

Assess risk of falling and ask pts 3 questions which are

older adults (65 years or older)

taking more than or equal to _____chronic medications

take ____high risk medication or any time patient presents with an acute fall

A

4

1

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12
Q

Three key questions to ask patients to assess falls

Feels unsteady when ______or walking?

Worries about ___________?

Fell in the ______year
If yes ask how many times?, were you injured

A

standing

falling

past

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13
Q

Screened not at risk

prevent future risk by recommending effective prevention strategies

Educate patient on fall prevention

Refer to community ________or fall prevention program

Reassesses ________or any time patient presents with an acute fall

___________ answers to three key questions and education provided to patient

Share answers to three key questions with the patient’s primary care provider using the Provider Consult Form

A

Educate

exercsise

yearly

Document

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14
Q

Screened at risk

_________patient’s modifiable risk factors.

Document answers to three key questions and education provided to patient

Identify medications that increase fall risk
-Schedule medication review w/patient

-Review medications utilizing the Community Pharmacy Falls Risk Checklist and a geriatric-specific medication decision-support tool (e.g., The UNC High Risk medication recommendations or the Beers Criteria)

Identify any ______________ (MTPs) associated with the use of high-risk medications

Inquire about postural hypotension

Symptoms of ____________ or dizziness from lying to standing?

Can assess for postural hypotension by measuring ________from lying to standing

Reduce risk by recommending effective prevention strategies

Educate patient on fall prevention

Refer to community exercise of fall prevention program

A

Assess

medication therapy problems

lightheadedness

blood pressure

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15
Q

Coordinate care with primary care or prescribing provider to reduce identified risk factors using effective interventions

Share answers to three key questions and education provided to patient with the patient’s provider using the Provider Consult Form

Share identified MTPs and recommendations with patient’s provider using the Provider Consult form.
Medication information should include medication name, strength, dose, and frequency.

Refer to provider for an evaluation of gait, strength, and balance using the Provider Consult Form

Response received from provider–>_________with patient in 30-90 days. Discuss ways to imrpove patient receptiveness to the patient-provider care plan and address barrier(s)

A

Follow-up

16
Q

Response not received from provider within 7 days

call provider’s office to verify the received the provider consult form

_______ provider consult form if provider did not receive it.

A

Resend

17
Q

Ask about Falls

Do you feel unsteady when __________ or walking?

Do you ________ about, or have a fear of, falling?

Have you fallen in the past year,
If yes, how many times?

Do you feel dizzy or lightheaded when getting up from laying or sitting to standing? (orthostatic hypotension)

A

standing,

worry

18
Q

TUG=

A

Timed Up and Go

19
Q

Timed Up and Go to assess _______

Equipment:stopwatch

Directions: Pts wear their regular footwear and can use a walking aid, if needed. Begin by having the pt stit back in a standard arm chair and identify a line 3 meters, or 10 feet away on the floor

Note: Always stay by the pt for safety

Instruct the pt

When I say “Go”, I want you to:

Stand up from the chair.

_________ to the line on the floor at your normal pace

Turn

Walk back to the chair at your normal pace.

Sit down again.

On the word “go” begin timing

Stop timing after pt sits back down.

Record Time

A

mobility

walk

20
Q

An older adult who takes more than _____seconds to complete the TUG is at risk for falling

A

12

Final exam for patient assessment skills (17 decks)

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