geriatric (ch 3, 28, 29, 31) Flashcards
altered state of consciousness
- cognitive deficits
- emotionally labile
- fluctuating and acute
delirium
causes of delirium (I WATCH DEATH)
Infections
Withdrawal Acute Metabolic Trauma CNS Pathology Hypoxia
Deficiencies Endocrinopathies Acute vascular Toxins/drugs Heavy metals
what meds cannot be given to older adults
benzos
Tx delirium
- look for underlying cause
- frequent reorientation
- close supervision
- avoid restraints
loss of previous levels of cognitive, executive, and memory function in a state of full awareness
dementia
dementia S+S
- personality change
- aphasia
- visuospatial functioning
- level of awareness and alertness intact
- chronic
Tx meds for dementia (2)
cholinesterase inhibitor (prevents breakdown acetylcholine) memantine (delays worsening)
Tx dementia
- avoid arguments
- redirect/distract
- calm environment
- simplify tasks
prevention cognitive symptoms of dementia
- vitamins (folid acid, C, gingko, vit b12)
- physical exercise
- social engagement
- manage stress
- quit smoking
- quit drinking
RF depression in elderly
- widowhood
- physical disability
assessment for depression in elderly
geriatric depression scale
S+S depression in elderly
- decreased energy
- sleep problems
- pain
- weakness
- GI disturbances
- delusions
S+S bipolar in elderly
- irritable (not euphoric)
- paranoid (not grandiose)
- dysphoric mania
- pressured speech
- flight of ideas
- hyperactivity
- morbid and pessimistic thought content
Tx bipolar in elderly
- lithium (consider decreased renal clearance and neurotoxicity)
- valproic acid for behavioral disturbances
possible causes psychosis
- delirium
- dementia
- depression
- substance
- sensory impairment
- isolation
- polypharamcy
most commonly abused substance in elderly
alcohol
2 classes meds that can worsen cognitive functioning in elderly
- benzos
- antipsychotics
what does the pain assessment in advanced dementia scale include (5)
- breathing independent of vocalization
- negative vocalization
- facial expression
- body language
- consolability
1-3 = mild pain 4-6 = moderate pain 7-10 = severe pain
psychosocial theory of aging: ability of individual to adapt to changing roles predicts adjustment to aging
role theory
psychosocial theory of aging: actions, roles, and social pursuits are important for satisfactory aging
activity theory
psychosocial theory of aging: mutual withdrawal occurs between aging person and others
disengagement theory
psychosocial theory of aging: life satisfaction and activity are expressions of enduring personality traits
continuity theory
psychosocial theory of aging: individuals are viewed as members of an age group with similarities to others in the group
age stratification theory
psychosocial theory of aging: modern society devalues the contributions of elders and elders themselves
modernization theory
