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Developmental concepts > geriatrics 2 > Flashcards

geriatrics 2 Flashcards

1
Q

polypharmacy

A

the excessive and inappropriate use of medications

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2
Q

adults over __ purchase __% of all prescription medications

A

65yrs, 30%

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3
Q

older adults are ______ to experience adverse drug reactions (ADR’s)

A

more likely

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4
Q

___ of older people take at least one unnecessary drug

A

half

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5
Q

average older adults take at least _ medications

A

5

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6
Q

average nursing home residents take _ medications

A

7

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7
Q

characteristics of polypharmacy in older adults

A
  • use of medications for no apparent reason
  • use of duplicate medications
  • concurrent use of interacting medications
  • use of contraindicated drugs
  • use of inappropriate dosage
  • use of drug therapy to treat adverse drug reactions
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8
Q

Pharmacokinetics of aging, absorption

A
  • decreased gastric acid
  • decreased stomach emptying
  • decreased gastric motility
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9
Q

Pharmacokinetics of aging, distribution

A
  • decreased body H2O
  • increased body fat
  • decreased plasma proteins
  • decreased lean body mass
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10
Q

Pharmacokinetics of aging, metabolism

A
  • decreased liver mass
  • decreased blood flow to liver
  • decreased enzyme activity
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11
Q

Pharmacokinetics of aging, excretion

A
  • decreased kidney mass
  • decreased blood flow to kidneys
  • decreased to nephron function
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12
Q

most commonly overprescribed medications (for older adults)

A
  • laxatives
  • BP meds
  • diuretics
  • diabetes drugs
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13
Q

common side effect of NSAIDs

A

GI symptoms

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14
Q

common side effect of opiods

A

sedation

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15
Q

common side effect of antidepressants, analgesics, lithium

A

confusion

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16
Q

common side effect of barbiturates, antihypertensives

A

depression

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17
Q

common side effect of antihypertensives

A

orthostatic hypotension

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18
Q

common side effect of diuretics and glucocorticoids

A

fatigue/weakness

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19
Q

Prevention of polypharmacy

A

review pts medication lists
- contraindications?
- dosage?
- pt education?
- do they make sense?

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20
Q

__% of people over age __ reported at least 1 fall in the past year

A

29%, 65yrs

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21
Q

medical treatment for falls costs more than ___ each year

A

$50 billion

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22
Q

falls can occur ___ or ___ injury

A

with or without

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23
Q

____ are the leading cause of hospitalization from injury in older adults

A

falls

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24
Q

falls are associated with:

A
  • pain
  • loss of confidence
  • functional decline
  • institutionalization
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25
Q

fall risk factors

A
  • prior falls
  • fear of falling
  • recent hospitalization
  • poor sensation
  • pain
  • difficulty with ADLs
  • age over 65
  • use of an AD
  • impaired balance, gait
  • LE weakness
  • frailty
  • orthostatic hypotension
  • polypharmacy
  • CVA or neuro diagnosis
  • incontinence
  • depression or anxiety
  • foot problems
  • cognitive impairment
  • benzodiazepine, diuretics, sedatives
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26
Q

environmental fall risk factors

A
  • slippery/uneven surfaces
  • rugs
  • poor lighting
  • obstacles in path (cords, clutter)
  • lack of grab bars or handrails
  • poorly arranged furniture
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27
Q

gait speed is correlated with multiple outcomes:

A
  • re-hospitalization
  • adl performance
  • # of meds
  • depressive symptoms
  • discharge location from hospital
  • history of multiple falls
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28
Q

cut off for community ambulation:

A

0.8-1.2m/s

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29
Q

cut off for fall risk:

A

1m/s

30
Q

cut off for independent in ADLs

A

1m/s

31
Q

cut off for less likely to be hospitalized:

A

1m/s

32
Q

max cut off for more likely to be hospitalized

A

0.6m/s

33
Q

limited community ambulator

A

0.4-0.8m/s

34
Q

cross street and normal walking speed:

A

1.2m/s+

35
Q

d/c to SNF speed

A

<0.1m/s

36
Q

household walker speed

A

0-0.4m/s

37
Q

interventions for fall prevention

A
  • balance training
  • cardiovascular endurance training
  • assistive device training
  • home environment modification
38
Q

blance outcome measures

A
  • BERG
  • Sharpened Romberg
  • 4 square step test
  • functional reach test
  • miniBEST
39
Q

self report outcome measures

A
  • MFES: modified falls efficacy scale
  • fear of falling avoidance behaviors questionaire
40
Q

functional outcome measures

A
  • 5x sit to stand
  • 30 sec sit to stand
  • TUG
  • 10m walk test
41
Q

endurance outcome measures

A
  • 6 meter walk test
  • 2 min step test
42
Q

sharpened Romberg screening

A

10 sec EO and 10 sec EC in each position:
- feet together
- semi tandem
- tandem

43
Q

TUG fall risk cut off

A
  • 13.5s
  • 8.5s for community dwelling adults
44
Q

5x STS fall risk cut off

A

11.4s

45
Q

BERG fall risk cut off

A

45/56

46
Q

disablitiy:

A

a mental or physical impairment that limits major activities in one or more ways

47
Q

types of disabilites

A
  • ambulation
  • cognitive
  • visual
  • hearing
  • medical
48
Q

__% of people age __ live with a disability

A

34%, 65+

49
Q

requirements for independent living/community:

A
  • ambulation of 400m
  • gait speed of 1.2m/s
  • carrying objects (1g milk is 8lbs)
  • ambulate of variable terrains
  • must be able to encounter obstacles
  • etc.
50
Q

IPR:

A
  • 3hr/day of rehab (PT, OT, SLP)
  • high prior function
  • not safe to go home
  • mod complexity
51
Q

SNF:

A
  • unable to preform 3hr/day of rehab
  • mod functional prognosis
  • variable prior level of function
52
Q

___ is the most powerful intervention for maintaining well being

A

exercise

53
Q

exercise for geriatrics (PT intervention)

A
  • anything is better than nothing
  • make it attainable for the pt
  • encourage them to meet their goals (playing with grandkids, cooking)
  • consider family support and what is available in the community
  • make it something they can eventually do on their own
54
Q

types of exercise for older adults

A
  • group
  • resistance
  • aquatic
  • balance
  • power!!!
55
Q

adults loose as much as __% of their strength between age __-__

A

40%, 60-90yrs

56
Q

__% of women 65-74 meet ACSM guidelines

A

14%

57
Q

__% of women 75+ meet ACSM guidelines

A

7%

58
Q

__% of women 55-64 meet ACSM guidelines

A

17%

59
Q

__% of men 55-64 meet ACSM guidelines

A

21%

60
Q

__% of men 65-74 meet ACSM guidelines

A

18%

61
Q

__% of men 75+ meet ACSM guidelines

A

11%

62
Q

low, moderate, and high intensity loading in power training are ____ for older adults

A

equally as beneficial

63
Q

intensity levels for power training

A
  • low: 20% 1RM
  • mod: 50% 1RM
  • high: 80% 1RM
64
Q

resistance training recommendations for older adults

A

Beginners:
- 1-2 d/wk
- low-mod intensity
- 1-2 sets
- 60-120sec rest intervals

trained:
- 3+ d/wk
- mod, mod-high intensity
- 3+ sets

65
Q

power training recommendations for older adults

A

Beginners:
- 1-2 d/wk
- low, low-mod, or mod intensity
- 1-2 sets
- 60-120sec rest intervals

trained:
- 3+ d/wk
- low, low-mod, mod, or high intensity
- 3+ sets

66
Q

osteoporosis intervention

A
  • loading!!!
  • under-dosing is a current problem
67
Q

interventions for pts with decreased visual acuity

A
  • large print books/computer software
  • color: bright, warm colors
  • depth: avoid patterned floors, use warm colors to highlight handrails and steps
  • contrast: bright details on dark backgrounds
68
Q

interventions for pts with hearing loss

A
  • minimize background noise
  • say their name before starting conversation
  • try rephrasing if repeating is not effective
69
Q

interventions for pts with taste/smelling loss

A
  • use additional spices and colors to enhance foods
70
Q

interventions for pts with sensory loss (envirmonment)

A
  • avoid temperature extremes from AC or heating
71
Q

IADL stands for:

A

instrumental activities of daily living

Developmental concepts (6 decks)

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