Gero Flashcards
What age is considered geriatric?
over 65
Respiratory changes
Increases: FRC, residual volume, dead space
also: minute ventilation, compliance
Decreases: vital capacity, total lung capacity
also:lung elasticity, chest wall compliance, response to hypercarbia and hypoxia, protective airway reflexes
does Vd/Vt ratio inBohr equationcrease or decrease with age?
Increases
Bohr equation
Do elderly have signs of both restrictive and obstructive disease?
Yes
What is the most specific test of renal failure?
serum creatinine clearance (24hrs) to assess GFR
What nervous system thresholds increase?
Threshold increases in proprioception, hearing and vision.
Dosages for locals and general anesthetics are _____
Reduced
MAC reduced 4% each decade after 40
What are the #1 and #2 risk factors for post-operative cognitive dysfunction?
OLD AGE AND ORTHO SURGERY
Do the elderly have more fat?
Yep - prolongs elimination of lipophilic drugs
Do the elderly have more fat?
Yep - prolongs elimination of lipophilic drugs
Do the elderly have increased heat loss?
Yes
Three things that put them at risk - decreased metabolic rate, decreased heat production, deficient thermostat control
Renal Changes?
Decreased blood flow (10% per decade)
Decreased GFR
Decreased renal mass
Impaired sodium handling
Decreased concentration
Decreased dilution
Impaired fluid handling
Decreased drug excretion
Decreased renin-aldosterone response
Impaired potassium excretion
What happens to serum creatinine?
Serum creatinine is the same r/t decrease in muscle mass and decreased production of creatinine
More kidney stuff
Decreased blood flow to renal in this population increases their risk of acute renal failure
Proper fluid management important
Predisposed to hyperkalemia and hypokalemia with the prescription of diuretics
Epidurals
More sensitive to spinal from lower volume of csf
Epidural- anesthetic tends to have a more cephalad spread
