geriatric patient Flashcards
cardiovascular system
age related cardiac changes
ventricular wall thickening
lower vessel elasticity
respiratory system
decreased respiratory muscle mass
decreased lung elasticity
deminished laryngeal reflexes
renal and hepatic system
decreased liver mass
decreased protien building ability
slower excretion
increased urine output - mild dehydration
thermoregulatory system
loss of muscle mass and body fat
pain physiology
poorly treated chronic pain
more prone to myopathy and neuropathy
cardiovascular system anaesthetic concern
reduced cardiac reserve
more risk of cardiac disease and arrhythmias
respiratory system anaesthetic concerns
higher risk of airway obstruction and aspiration due to reduced reflexes
renal and hepatic system anaesthetic concerns
lower drug metabolism and slower excretion
pain physiology anaesthetic concerns
pre emptive pain managemnt to prevent wind up pain
pre anaesthetic exam
history
heart and lung ausculation
previous anaesthetics
blood work
analgesia
opioids preferred
methadone, morphine
decreased dose reccomended
reversable
sedation
benzodiazepines preferred
midazolam, diazapam
minimal cv depression
reversable
longer duration - liver metabolised
ketamine
for analgesia and sedation
no reversal
contraindicated in heart disease
alpha 2 agonsit
NOT RECCOMENDED
cv depression, reduced co
metatomidine
anticholinergics
only give when required for bradycardia
increase HR
