Geriatrics Flashcards
acute respiratory distress syndrome
respiratory insufficiency marked by progressive hypoxemia, due to severe inflammatory damage
advance directive
legal document prepared when a person is alive, competent, and able to make informed decisions about health care. The document provides guidelines on treatment if the person is no longer capable of making decisions.
ageism
discrimination against aged or elderly people
Alzheimer’s disease
a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior. It affects 4 million American adults.
aneurysm
abnormal dilation of a blood vessel, usually an artery, due to a congenital defect or a weakness in the wall of the vessel.
ankylosing spondylitis
a form of inflammatory arthritis that primarily affects the spine
anorexia nervosa
eating disorder marked by excessive fasting
anoxic hypoxia
an oxygen deficiency due to disordered pulmonary mechanisms of oxygenation
aortic dissection
a degeneration of the wall of the aorta
aphasia
absence or impairment of the ability to communicate, speak, sign or write. Can be sensory, motor, or global
assisted living
housing for the elderly or disabled that provides nursing care, housekeeping, and prepared meals as needed
autonomic dysfunction
an abnormality of the involuntary aspect of the nervous system
brain ischemia
injury to brain tissues caused by an inadequate supply of oxygen and nutrients
cataracts
medical condition in which the lens of the eye loses its clearness
comorbidity
having more than one disease at a time
congregate care
living arrangement in which the elderly live in, but do not own, individual apartments or rooms and receive select services.
delirium
an acute alteration in mental functioning that is often reversible
dysphagia
inability to swallow or difficulty swallowing
dysphoria
an exaggerated feeling of depression or unrest, characterized by mood of general dissatisfaction, restlessness, discomfort, and unhappiness
elderly
a person age 65 or older
dementia
a deterioration of mental status that is usually associated with structural neurologic disease. It is often progressive and irreversible
epistaxis
nosebleed
fibrosis
the formation of fiber-like connective tissue, also called scar tissue, in an organ
functional impairment
decreased ability to meet daily needs on an independent basis.
geriatric abuse
a syndrome in which an elderly person is physically or psychologically injured by another person
geriatrics
the study and treatment of diseases of the aged
gerontology
scientific study of the effects of aging and of age-related diseases on humans
glaucoma
group of eye diseases that results in increased intraocular pressure on the optic nerve; if left untreated, it can lead to blindness
glomerulonephritis
a form of nephritis, or inflammation of the kindeys; primarily involves the glomeruli, one of the capillary networks that are part of the renal corpuscles in the nephrons
heatstroke
life-threatening condition caused by a disturbance in temperature regulation; in the elderly, characterized by extreme fever and, in extreme cases, delirium and coma
hepatomegaly
enlarged liver
herpes zoster
an acute eruption caused by a reactivation of latent varicella virus (chickenpox) in the dorsal root ganglia; also known as shingles
hiatal hernia
protrusion of the stomach upward into the mediastinal cavity through the esophageal hiatus of the diaphragm
hypertrophy
an increase in the size or bulk of an organ or structure; caused by growth rather than by tumor
hypochondriasis
an abnormal concern with one’s health, with the false belief of suffering from some disease, despite medical assurances to the contrary; commonly known as hypochondria
immune senescence
diminished vigor of the immune response to the challenge and rechallenge by pathogens
incontenence
inability to retain urine or feces because of loss of sphincter control or cerebral or spinal lesions
intracerebral hemmorrhage
bleeding directly into the brain
intractable
resistant to cure, relief, or control
kyphosis
exaggeration of the normal posterior curvature of the spine
life-care community
communities that provide apartments/homes for independent living and a range of services, including nursing care. Usually the elderly own their own homes.
maceration
process of softening a solid by soaking in a liquid
Marfan syndrome
hereditary condition of connective tissue, bones, muscles, ligaments, and skeletal structures characterized by irregular and unsteady gait, tall lean body type with long extremities, flat feet, and stooped shoulders. The aorta is usually dilated and may become weakened enough to allow an aneurysm to develop
melena
a dark, tarry stool caused by the presence of “digested” free blood
Meniere’s disease
a disease of the inner ear characterized by vertigo, nerve deafness, and a roar or buzzing in the ear.
mesenteric ischemia or infarct
death of tissue in the peritoneal fold (mesentery) that encircles the small intestine; a life-threatening condition.
nephrons
the functional units of the kidneys
nocturia
excessive urination during the night
old-old
an elderly person age 80 or older
osteoarthritis
a degenerative joint disease, characterized by a loss of articular cartilage and hypertrophy of bone
Parkinson’s Disease
chronic, degenerative nervous disease characterized by tremors, muscular weakness and rigidity, and a loss of postural reflexes
personal-care home
living arrangement that includes room, board, and some supervision
polycythemia
an excess of RBC. In a newborn, the condition may reflect hypovolemia or prolonged intrauterine hypoxia
polypharmacy
multiple drug therapy in which there is a concurrent use of a number of drugs
pressure ulcer
ischemic damage and subsequent necrosis affecting the skin, subcutaneous tissue, and often the muscle; result of intense pressure over a short time or low pressure over a long time; also known as a pressure sore or bedsore
pill rolling motion
an involuntary tremor, usually in one hand or sometimes in both, in which fingers move as if they were rolling a pill back and forth
pruritus
itching; often occurs as a symptom of some systemic change or illness
retinopathy
any disorder of the retina
senile dementia
general term used to describe an abnormal decline in mental functioning seen in the elderly; also called “organic brain syndrome” or “multi-infarct dementia”
Shy-Drager syndrome
chronic orthostatic hypotension caused by a primary autonomic nervous system deficiency
sick sinus sydrome
a group of disorders characterized by dysfunction of the sinoatrial node in the heart
silent myocardial infarction
a myocardial infarct that occurs without exhibiting obvious signs and symptoms
spondylosis
a degeneration of the vertebral body
Stokes-Adams syndrome
a series of symptoms resulting from heart block, most commonly syncope. the symptoms result from decreased blood flow to the brain caused by the sudden decrease in cardiac output
stroke
injury to or death of brain tissue resulting from interruption of cerebral blood flow and oxygenation
subarachnoid hemorrhage
bleeding that occurs between the arachnoid and dura mater of the brain
substance abuse
misuse of chemically active agents such as alcohol, psychoactive chemicals, and therapeutic agents; typically results in clinically significant impairment or distress.
tinnitus
ringing or tingling sound in the ear
transient ischemic attack
reversible interruption of blood flow to the brain; often seen as a precursor to a stroke
two-pillow orthopnia
the number of pillows needed to ease the difficulty of breathing while lying down; a significant factor in assessing the level of respiratory distress
urosepsis
septicemia originating from the urinary tract
Valsalva maneuver
forced exhalation against a closed glottis, such as with coughing. This maneuver stimulates the parasympathetic nervous system via the vagus nerve, which in turn slows the heart rate
varicosities
an abnormal dilation of a vein or group of veins
vertigo
the sensation of faintness or dizziness; may cause a loss of balance
factors in decreased medication compliance
limited income memory loss limited mobility sensory impairment multiple drug therapies fear of toxicity childproof containers duration of therapy
factors in INCREASED medication compliance
good pt-physician comms belief that disease is serious drug calendars/reminders compliance counseling easy-open packaging multi-compartment pillboxes transportation svc to pharmacy clear, simple direction in large type ability to read
Conditions that complicate eating among the elderly:
respiratory problems abd pain N/V, often due to meds poor dental care medical problems: hyperthyroidism, hypercalcemia, and chronic infections Meds ETOH and drug abuse depression and anorexia poverty problems with shopping or cooking
Effects of malnutrition in elderly
vitamin deficiencies
dehydration
hypoglycemia
electrolyte abnormalities
Complicating factors in geriatric assessment
misreported symptoms multiple diseases multiple complaints chronic vs. acute signs diminished response to pain altered temperature regulating mechanism
Common symptoms of senility
delirium confusion distractibility restlessness excitability hostility
physiological effects of aging on respiratory system
decreased cx wall compliance
loss of lung elasticity
increased air trapping due to smaller airways
reduced str and endurance of respiratory muscles
cough and gag reflex reduced
physiological effects of aging on cardiovascular system
left ventricular hypertrophy
hardening of arteries
changes in heart rate, rhythm, effeciency
physiological effects of aging on the neurological system
brain tissue shrinks loss of memory depression AMS impaired balance
physiological effects of aging on the endocrine system
lowered estrogen production (women)
decline in insulin sensitivity
increase in insulin resistance
physiological effects of aging on GI system
diminished digestive functions
decreased saliva
decreased esophageal and intestinal motility
physiological effects of aging on Thermoregulatory System
reduced sweating
reduced shivering
physiological effects of aging on Integumentary system
skin thins and becomes more fragile
physiological effects of aging on musculoskeletal system
loss of bone strength
loss of joint flexibility and strength
physiological effects of aging on renal system
loss of kidney size and function, anemia, HTN
physiological effects of aging on genitourinary system
loss of bladder function
physiological effects of aging on immune system
diminished immune response / immune senescence
physiological effects of aging on hematologic system
decrease in blood volume and/or RBCs
vasodepressor syncope
“fainting”, may occur after emotional distress, pain, prolonged bed rest, mild blood lost, prolonged standing, anemia, fever
orthostatic syncope
occurs when rising from seated or supine position. May be caused by hypovolemia, venous varicosities, prolonged bed rest, autonomic dysfunction; drugs, esp. HTN medicine
vasovagal syncope
occurs as a result of a Valsalva maneuver
cardiac syncope
due to transient reduction in cerebral blood flow due to a sudden decrease in cardiac output. Possibly due to silent MI or arrythmia
strategies for reducing stroke risk:
control HTN Rx arrhythmias and coronary artery disease Rx of blood disorders Smoking cessation cessation of recreational drugs moderate use of ETOH exercise nutrition
Diabetes places the elderly at increased risk of other complications, including:
atherosclerosis delayed healing retinopathy blindness altered renal function severe peripheral vascular disease (foot ulcers and amputations)
The leading cause of suicide
depression
risk factors for suicide
chronic illness physical impairment unrelieved pain living in a youth-oriented society family issues financial problems isolation and loneliness substance abuse low serotonin bereavement family history of suicide
