Geriatric Syndromes (1) Flashcards

1
Q

what is a geriatric syndrome

A

multifactorial/multi-organ

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2
Q

what do geriatric syndromes have

A

interacting components

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3
Q

interacting components

A

situation specific stressors

age related co-morbidities

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4
Q

what do geriatric syndromes impact

A

QOL

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5
Q

what causes a pressure ulcer

A

malnutrition

bedrest

changes in integ system

dehydration

increase exposure to moisture

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6
Q

B –> bed rest

A

bladder & bowel incontinence and retention

bed sores

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7
Q

E –> bedrest

A

electrolyte imbalance

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8
Q

D –> bedrest

A

deconditioning

depression

demineralization of bones

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9
Q

R –> bedrest

A

ROM loss and contractures

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10
Q

E (2) –> bedrest

A

energy depletion

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11
Q

S –> bedrest

A

skin problems

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12
Q

T –> bedrest

A

trouble

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13
Q

what are older adults susceptible to –> malnutrition

A

to host intrinsic and extrinsic factors

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14
Q

intrinsic factors -> malnutrition

A

decreased digestive enzyme production

dentures

dry mouth

impaired mobility

decreased smell and taste

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15
Q

dentures -> malnutrition

A

difficulty chewing (esp foods rich in protein)

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16
Q

dry mouth -> malnutrition

A

difficulty swallowing

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17
Q

impaired mobility -> malnutrition

A

difficulty shopping and cooking

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18
Q

decreased smell and taste -> malnutrition

A

decreased appetite

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19
Q

extrinsic factors -> malnutrition

A

low income

depression

social isolation

dietary restrictions d/t co-morbidities

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20
Q

what does dehydration cause

A

delayed wound healing (esp pressure ulcers)

dry mucous membranes

rapid pulse

extremity weakness

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21
Q

who is at an increased risk of dehydration

A

older adults

d/t co-morbidities

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22
Q

what tests are not reliable for dehydration

A

skin turgor at sternum

d/t skin changes

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23
Q

what tests do we use for dehydration

A

lab tests

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24
Q

who has incontinence

A

30% of women over 65

> 50% of nursing home residents

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25
Q

two categories of incontinence

A

established

transient

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26
Q

established incontinence

A

result of neurological damage, intrinsic bladder or urethral pathology

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27
Q

transient incontinence

A

result of diet, meds or illness

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28
Q

types of incontinence

A

stress

urge

mixed

overflow

fxnal

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29
Q

stress –> incontinence

A

d/t physical stress or increased abdominal pressure

30
Q

urge –> incontinence

A

sudden urge to urinate and the inability to hold it until reaching the bathroom

31
Q

mixed –> incontinence

A

combination of mixed and fxnal

32
Q

overflow –> incontinence

A

accidental loss of urine from chronically full bladder

33
Q

fxnal –> incontinence

A

inability to get to a bathroom d/t physical limitation, inability to manage clothing

34
Q

interventions –> incontinence

A

hydration

enema

bulking agents

antidiarrheal agents

biofeedback

physical therapy

35
Q

PT –> incontinence

A

pelvic floor PT referral

36
Q

falls

A

unplanned descent to the floor or onto a piece of furniture

w/ or w/o injury

37
Q

what is the leading cause of death from injury among older adults

A

falls

38
Q

most common cause TBI

A

falls

39
Q

consequences of falls

A

institutionalization

decreased QOL

40
Q

decreased QOL –> falls

A

fear of falling

loss of fxn

decreased socialization

41
Q

fear of falling –> falls

A

decreased participation in activities

42
Q

how deaths per yr are secondary to falls

A

~ 650k

43
Q

intrinsic risk factors for falls (1)

A

fear of falling

hx of falls

advanced age

muscles weakness

44
Q

intrinsic risk factors for falls (2)

A

balance and gait problems

poor vision

hypotension

CVA, PD, dementia

incontinence

45
Q

extrinsic risk factors for falls (1)

A

no stair handrails

poor stair design

no bathroom grab bars

dim lighting

46
Q

extrinsic risk factors for falls (2)

A

trip hazards (pets, electrical chords)

slippery/uneven surfaces

psychoactive meds

improper use of ADs

47
Q

postural stability/control systems

A

sensory

central processing

NM system

48
Q

sensory –> falls

A

somatosensory

vision

vestibular

49
Q

central processing –> falls

A

ankle strategy

hip strategy

stepping strategy

reaching strategy

suspensory strategy

50
Q

NM system –> falls

A

mm strength

ROM

posture

51
Q

postural control

A

COG is w/in the base of support during static and dynamic activities

52
Q

somatosensory inputs come from

A

joints, tendons, muscles

53
Q

what do somatosensory inputs tell us

A

CNS body segment position in space

54
Q

examples of somatosensory inputs

A

vibration

proprioception

2 point discrimination

55
Q

somatosensory inputs in older adults

A

decreased

especially vibration

56
Q

visual input helps

A

maintain vertical position

57
Q

examples of visual input

A

visual acuity

depth perception

contrast sensitivity

58
Q

visual input in older adults

A

decreased

59
Q

vestibular –> falls

A

angular acceleration of head via semicircular canals

60
Q

how is the vestibular system affected

A

decreased ability to adjust to bodily equilibrium

61
Q

why is the vestibular system impaired in older adults

A

d/t progressive loss of peripheral hair cells and vestibular nerve fibers

62
Q

central processing includes

A

ankle, hip and stepping strategies

63
Q

most commonly used strategy –> central processing

A

ankle

64
Q

ankle strategy -> central processing

A

used to control postural sway and small perturbations

tib anterior

65
Q

hip strategy -> central processing

A

used on narrow moving spaces, moderate perturbations

66
Q

what muscles are used with hip strategy -> central processing

A

hip extensors

hip flexors (large change in COG)

67
Q

stepping strategy -> central processing

A

used in large perturbations

taking step forward/backward

68
Q

when is the stepping strategy used -> central processing

A

when COG is outside BOS

69
Q

standing balance recovery strategies

A

reaching strategy

suspensory strategy

70
Q

reaching strategy –> standing balance

A

moving arm to grasp or touch object for support

71
Q

suspensory strategy –> standing balance

A

bending knees during gait or standing activities to lower COG

improving postural stability (crouched posture)