Geriatrics Flashcards
1
Q
normal aging range
A
- CV: decreased cardiac output; increased peripheral resistance, systolic pressure
- respiratory: decreased elasticity of chest wall, intercostals muscle strength, cough reflex; increased anteroposterior diameter of chest, rigidity of lung tissue
- neurological: decreased nerve cells, neurotransmitters, REM sleep, blood flow to CNS
- GU: decreased glomerular filtration rate, blood flow to kidneys, bladder capacity, vaginal lubrication, hardness of erection
- GI: decreased saliva production, GI motility, gastric acid production
- MS: decreased muscle strength, body mass, bone mass, joint mobility; increased fat deposit
- integumentary: decreased skin elasticity, nail growth; increased dryness of skin, thinning of skin layers, nail thickening, hair thinning
- endocrine: decreased insulin release, thyroid function, estrogen and testosterone
- sensory: decrease visual acuity and depth perception, tear production, pupil size, accommodation, acuity of smell and taste, hearing of high frequency sounds, sense of balance changes in pain sensations; increased glare sensitivity, thickening of lens of the eye, changes in pain sensation
2
Q
dementia
A
- progressive cognitive decline
- memory impairments and aphasia or apraxia or agnosia or disturbance in executive functioning
- difficulty to remember, think clearly, communicate, take care of self
- causes mood swings, change in personality and behavior
3
Q
dementia
A
- most common form is Alzheimer’s
- risk factors: old age, family history, CV disease, environmental factors (head injury or alcohol abuse)
- delirium is not dementia: short term acute loss of some cognitive abilities
4
Q
physical safety
A
- falls: motor/strength, balance, sensory
- driving: sight/hearing, delayed reflexes
- lost: dementia
5
Q
medication safety and polypharmacy
A
- use of multiple meds: avg 6 Rx meds and OYC
- using potentially inappropriate medication
- difficulties: right time, form, dose, access refills, open bottles, read labels
- risk factor for: acute confusion, delirium, depression
6
Q
protection from elder abuse
A
- battering
- inappropriate drug/physical restraints
- force feeding, physical punishment
- nonconsensual sexual contact
- treating like infant
- enforced social isolation
- demeaning
- neglect
- abandonment
- financial exploitation
7
Q
psychosocial transition
A
- biological, social, and cultural change
- independence to more dependent role
- erikson - integrity vs despair > 60 yrs to death; strength of wisdom from experience
- ageism: discrimination, less respect and consideration
- depression is not a normal part of aging
8
Q
retirement communities
A
- naturally occurring retirement communities: aging in peace; street/neighborhood age together & support each other; access to services acquired over time
- retirement communities: built to accommodate elderly needs; downsize; upkeep services
- continuing care retirement communities: wide range of living accomodations; campus like setting; extracurricular activities; nursing care
9
Q
alternatives to aging in place
A
- assisted living facilities: provide/coordinate services; 24hr supervision/assistance; maximize dignity, autonomy, privacy, independence & safety
- nursing care facilities (nursing homes): skilled and unskilled nursing care adults and older adults with disabilities; 1/2 have dementia
10
Q
zoster vaccination
A
- routine vaccination: age 50 years or older > 2-dose series RZV 2–6 months apart (minimum interval: 4 weeks; repeat dose if administered too soon) regardless of previous herpes zoster or previously received ZVL (administer RZV at least 2 months after ZVL); age 60 years or older > 2-dose series RZV 2–6 months apart (minimum interval: 4 weeks; repeat dose if administered too soon) or 1 dose ZVL if not previously vaccinated (if previously received ZVL, administer RZV at least 2 months after ZVL); RZV preferred over ZVL
- RZV: recumbent vaccine > 2 doses, shingles, IM
- ZVL: 1 dose, Zostavax, SQ
