Geriatric Considerations Flashcards
What should you consider about the length and type of surgery in terms of geriatric patients?
- Better for 1-2 hr. surgeries than 4-6 hrs.
- Takes longer to recover from surgeries
What types of surgeries has an increased risk for complications for geriatric patients and why?
What should you do?
-Thoracic or abdominal surgery because it is harder to mobilize secretions through activity
- Coughing and Deep Breathing
- Incentive Spirometry
How do you overcome teaching a geriatric patient who usually have decreased hearing and vision?
- Speak face to face, speak slowly, and articulat
- Write in large dark letters
What respiratory problems do geriatric patients generally have?
- Spend more energy to exhale
- Less cilia so more likely for aspiration
What occurs in geriatric patients in terms of the respiratory system?
- Decreased vital capacity
- Decreased tidal volume
- Decreased pulmonary reserve
- Decrased ability to cough
- Decreased thoracic compliance
- Decreased lung tissue
What does common respiratory problems in geriatric patients result in?
- Increased work to ventilate and decreased ability to eliminate anesthetic agents
- More likely to have COPD
What is the most lethal post-operative infection?
Pneumonia
What are some ways decrease the chance to get pneumonia and atelectasis?
- Get them up and moving
- Cough and Deep Breath
- Incentive Spirometry
- Meticulous oral hygiene (esp. with ventilation)
What are some problems of the circulatory system for geriatric patients?
- Atherosclerosis
- Decreased Blood Vessel Elasticity
- Hypertension
- Less blood volume
-Venous return to the heart is decreased which can lead ot peripheral edema and DVT
What is one thing that can occur when working with geriatric patients?
Orthostatic Hypotension
What can increase the risk of an MI and what if the geriatric patient does have an MI before surgery?
- Heart Block
- Postpone for 6 months and find out the cause of MI
If a patient has heart failure, what should you do as a nurse?
Assess…
- SOB
- DOE (Dyspnea On Exertion)
- JVD
- Crackles on Lung Sounds
- Pulmonary Edema
What problems do geriatric patients are most likely to have concerning the renal system?
Hepatic system?
- Decreased renal perfusion
- Incontinence
- Retention
- UTI
- Decreased Thirst Perception
-Decreased liver function
How common is postoperative delirium and short term memory loss in geriatric patients?
Not uncommon
What is one thing to note the difference between delerium and dementia?
- If LOC is altered it is probably delerium and is reversable as opposed to less likely to reverse
