Geriatrics Flashcards
Ageism actions
calling them sweetie or honey
directing questions at family member rather than patient
routine delivery of care for all patients over a specific age instead of applying clinical decision making
Number of __ units decrease so each one must innervate a larger number of muscle fibers resulting in motor unit hypertrophy.
motor
Increase in ___ mass. Infiltration of this is a predictor of mobility restriction.
fat
Adults begin to experience decrease in bone mass in
40s and 50s
Type __ fibers are denervated
IIb
___% decline in strength per decade especially during sixth and seventh.
10
Decreased ___ of muscular contraction.
velocity
Decreased ability to
perform forceful and alternating movement
Decreased skeletal bone mass after ___ decade.
fourth
Decrease in
brain size
Decrease in nerve
conduction velocity which results in overall decrease in central processing.
Decrease in processing times that affect
nociceptors and other peripheral receptors
Decreased sense of
pain, joint proprioception and coordination, decreased somatosensory input, impaired balance reactions and reflexes and increased gait instability.
Decreased __ density in heart.
myocyte
Decreased ___ node pacemaker cells.
SA
Increased cardiac ___.
afterload
Decreased sensitivity to ___-____ stimulation.
beta-adrenergic
Increased ____ and ____ of heart valves.
calcification and fibrosis
Increased ___ tone leading to increased SBP.
vascular
Decreased arterial ___ and ____.
elasticity and compliance
Decreased ___ muscle strength.
inspiratory
Decreased ___ (respiratory value)
FEV1
Increased ___ volume following maximal expiration.
residual
As VC decreases, RV ___. TLC stays the same.
increases
What do you need to consider with thermal modalities?
monitor tolerance
Present with blunted
fever response
Exhibit higher blood ___ levels secondary to reduction n number and function of beta cells in pancreas as well as an increase to peripheral resistance to insulin.
glucose levels
Decreased __ and __ sensations.
taste and smell
Sensation associated with the need to urinate is often
delayed or nonexistent in older adults.
Medical conditions such as ___ and __ result in detrusor muscle instability which leads to overactive bladder.
alzheimers
parkinsons
Presbycusis
progressive hearing loss beginning in 4th decade
Visual impairment starts…
and is associated with
75 years old
falls, depression, functional decline
How to help visual impairment issues?
use contrasting colors to highlight edge of steps, thresholds, transition areas
remove throw rugs
use diffuse lighting
allow for extra time when transitioning from bright to dark and vice versa
maintain clear hallways and rooms
have hand rails, preferrably two
Episodic memory
personally experienced events
Semantic memory
knowledge of facts
procedural memory
performance of skills
What memory is affected to a greater degree?
episodic
What type of attention is is lost?
divided
ability to dual task
General intelligence begins to decline when
50s and 70s
Crystallized intelligence
accumulation of knowledge and skills
is crystallized intelligence maintained?
yes and can even improve
Fluid intelligence
speed and ability to reason and problem solve
how is fluid intelligence impacted?
declines
MCI does not infer that individual will progress to
dementia
Delirium
memory, orientation and arousal may all be affected
commonly experienced with hospitalization, post-surgically, during course of untreated medical condition or side effect of certain meds
Pharmacokinetics
study of what happens to the drug once in body
absorption, distribution, metabolism, excretion
Metabolism
component of drug clearance in liver
Excretion system
kidneys
Pharmacodynamics
study of how a drug exerts therapeutic effects on body at cellular or organ level.
Polypharmacy two forms
rational
irrational
Rational polypharmacy
multiple meds to treat multiple medical issues or to treat a single issue where each drug works together to control symptoms.
Irrational polypharmacy
excessive or duplicate or contraindicated meds are prescribed to treat a medical condition.
Two most common forms of medication related problems
non-adherence
adverse drug reaction
Adverse drug reactions
n/v
diarrhea
constipation
nervousness
drowsiness
confusion
delirium
depression
tachycardia
orthostatic hypotension
falls
weakness
dyskinesia
Three drugs responsible for 1/3 of all ER visits
digoxin, warfarin, insulin
