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Special Populations > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

Cardiovascular changes

A
  1. Heart hypertrophies
  2. Cardiac output declines
  3. Arteriosclerosis (stiffening of vessels)
  4. Atherosclerosis (plaque build up)
  5. Electric conduction system deteriorates - less pacemaker cells; dysrhythmias
  6. Muscle degeneration of the heart - decreased SV, CO, and contractility
  7. Valve degeneration
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2
Q

Respiratory changes

A
  1. Decreased elasticity of the lungs and size/strength of respiratory muscles
  2. Calcification of costochondral cartilage
  3. Less lung capacity/increased residual volume
  4. Chest wall stiffens
  5. Dulled respiratory drive and slower reaction to hypoxemia
  6. Decreased number of alveoli and increased trapping of air
  7. Lung defences are less effective, decreased cough/gag reflexes
  8. Ciliary mechanisms slow, less effective at clearing bronchial secretions
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3
Q

Immunological changes

A
  1. More prone to infections/secondary infections

2. Older patients may not have a fever associated with infection

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4
Q

Integumentary changes

A
  1. Wrinkling and lost elasticity -thinner, more fragile skin
  2. Drier skin - decreased sweat activity and oil production
  3. Epidural cells develop slower
  4. High risk of infection (cellulitis)
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5
Q

Aneurysm

A

Weakness in artery that produces balloon defect

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6
Q

Aortic dissection

A

Inside wall of artery tears and allows blood to collect between arterial wall layers

Prone to rupture
Risk factors include trauma and sustained hypertension

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7
Q

Stroke

A

Leading cause of long-term disability

Mainly caused by atherosclerosis
Risk doubles every decade after 35 years

TIA - temporary disturbance of blood supply to the brain that results in sudden, temporary decrease in brain function

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8
Q

Pneumonia

A

Inflammation of the lung

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9
Q

COPD

A

Bronchial obstruction and airway inflammation

Affects 10% of older population

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10
Q

Pulmonary embolism

A

Blood vessel supplying the lung becomes blocked by a clot

Risk increases with age due to immobility

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11
Q

Main symptom of stomach/duodenal ulcers

A

Dyspepsia (indigestion)

Caused by regular use of NSAIDS or H.Pylori bacteria

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12
Q

Delirium

A

Acute brain syndrome or confusion state that is temporary and usually reversible

Disorganized thoughts, hallucinations/delusions, decreased LOC, pupillary response

Risks include intoxication/withdrawal, medical conditions, psychiatric disorders, malnutrition, environmental emergencies

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13
Q

Dementia

A

Irreversible brain failure that causes progressive loss of cognitive abilities, psychomotor skills, and social skills

Diagnosed when two or more brain functions are impaired
Loss of cognitive functions, memory/attention problems, inability to perform daily tasks, and mood swings

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14
Q

Alzheimer’s disease

A

May present with altered behaviour

Confusion, changes in personality/judgment, difficulty with daily activities

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15
Q

Parkinson’s disease

A

Two or more of the following: resting tremor of extremity, slowness of movement, rigidity/stiffness of extremities or trunk, poor balance

Caused by degeneration of substantia nigra

Dyskinesia, dementia, depression, autonomic dysfunction, postural instability

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16
Q

Osteoporosis

A

Decrease in bone mass leading to reduction in bone strength and greater susceptibility to fracture

Rapid bone loss for women following menopause

17
Q

Osteoarthritis

A

Progressive disease of the joints that destroys cartilage, promotes formation of bone spurs in joints, and stiffness in joints

Usually several joints affected causing substantial disability/disfigurement

18
Q

DELIRIUMS mnemonic

A 
Drugs, toxins, dehydration
Emotional (psychiatric)
Low PaO2
Infection
Retention of stool or urine
Ictal (state/event, eg., seizure, stroke, HA)
Undernutrition, underhydration
Metabolism
Subdural hematoma
19
Q

Risk factors of trauma in the elderly

A
  1. Slower reflexes
  2. Visual/hearing disturbances or deficits
  3. Equilibrium disorders
  4. Overall reduction in agility
20
Q

Affects of changes to metabolism on drugs/toxins

A
  1. Decreased hepatic (liver) drug elimination
  2. Decreased renal function
  3. Changes to body composition and response to drugs affecting the CNS
21
Q

Dirty dozen - drugs/classes of drugs implicated most often in toxic reactions

A
  1. Anti-inflammatory (NSAIDS)
  2. Antibiotics
  3. Anticholinergics/antihistamines
  4. Anticoagulants (warfarin)
  5. Antiarrythmics (amiodarone, lidocaine)
  6. Antidepressants (tricyclics, SSRIs)
  7. Antihypertensives (diuretics, alpha/beta blockers)
  8. Antipsychotics (phenothiazines, atypical)
  9. Digoxin
  10. Insulin/oral anti diabetics
  11. Narcotics
  12. Sedative hypnotics
22
Q

GEMS diamond

A
  1. Recognize patient is geriatric - possible issue with aging
  2. Environmental assessment - too hot or cold, hazards
  3. Medical assessment - medical problems and medications
  4. Social assessment - social network, death of loved one
23
Q

CHAPS (EMS program)

A

Community health and prehospital support program

24
Q

Oncology

A

Deals with cancer diagnosis and treatment

25
Q

Advanced directive

A

“Living will” or “personal directive”

Set of written instructions specifying actions to be taken for a person’s health if they become incapacitated

26
Q

Power of attorney

A

Written authorization that empowers an individual to represent or act on another person’s behalf in private, business, and other affairs

27
Q

Goals of care

A

Medical order to describe or communicate the general aim or focus of care including location of that care

R- medical care and interventions including resuscitation if required, followed by ICU admission
M - medical care and interventions excluding resuscitation
C - medical care and interventions focused on comfort

28
Q

Most common cancers

A
  1. Lung
  2. Breast (women)
  3. Prostate (men)
  4. Colorectal
29
Q

Types of palliative care

A

Early - the person is functioning and ambulatory with a life expectancy more than months

Advanced - decreased functioning and assistance required with a life expectancy months

Terminal - bed ridden and requiring full-time care with a life expectancy of days to weeks

30
Q

Stages of cancer

A

Stage 0 - no cancer, but abnormal cells that can become cancerous
Stage 1 - small mass in one area that is in the early stages
Stage 2 or 3 - larger and spread to nearby tissue and/or lymph nodes
Stage 4 - spread to other parts of the body and is advanced/metastatic

31
Q

TNM system (cancer)

A

Tumour (T) - rated 0 to 4 and describes how large the tumour is and possibly the location

Node (N) - rated 0 to 3 and tells if the cancer has spread to lymph nodes

Metastasis (M) - 0 or 1 to tell if it has spread

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