History & Examination Flashcards
what’s the projected percentage of the population that will be over the age of 65 in 2030? What’s the fastest growing age group in the United States?
20%
age 85 and over.
how will the population age over 65 change by race by 2050
non-hispanic whites will decrease by 22 percent
hispanics will increase from 7 to 20 percent.
blacks, asians, and others will increase
what types of adults over 65 tend to live alone the most?
Females >males.
black and non hispanic whites of all female races
black men of all male races
what percentage of older adults report good to excellent health? who tends to rate their health is better?
76% total
non hispanic whites rate their health as good more than other races
If an older adult reports unintentionally lost 10 pounds or more over the last year and/or fatigue, what are you concerned about?
advanced progressive illness
depression, cancer, and chronic digestive system problems
about how many people between the ages of 65 and 74 meet physical activity guidelines? >85 people?
14%
4%
how many adults have one chronic condition? how many have at least 2?
80%
50%
What are the top two chronic conditions affecting older adults?
hypertension (54%M, 57%F)
arthritis (45%M, 56%F)
heart disease
What’s the most prevalent self-reported condition causing activity limitation in older adults?
arthritis/other musculoskeletal
heart/circulatory comes next
Arthritis is more prevalent in what older adult population?
obese individuals
women>men
older people with chronic dizziness or imbalance are how many times more likely to fall in comparison with older people who do not experience these problems?
2 to 3 times mroe
What’s the most prevalent sensory impairments among persons over 70 years and over? what are three others, ranked most to least prevalent?
balance impairment 75.3%
loss of feeling in feet 27.2%
hearing impairment 26.3%
visual impairment 15.4%
What percentage of individuals over age 65 reported a functional limitation? how many had difficulty with IADLs? how many lived in a facility?
41%
12%
4%
percentage of medicare enrollee age 65 and over with functional limitations by setting— who has most percetage with 3 or more ADL limitations?
long term care facilities (68% of them)
common physical activities that are difficult to perform for people over 65 (highest percent of people who can’t do it to lowest)
walking 2-3 blocks stooping/kneeling lifting 10 lbs reaching over head write/ grasp small objectst
What is the OPTIMAL?
APTA’s Outpatient Physical Therapy Improvement in Movement Assessment Log
an insturment that measures difficulty and self-confidence in performing 22 movements that a pt/client needs to accomplish in order to do various functional activities
each item rated 1-5
1= no difficulty
5= unable to do
What is the Katz ADL Index?
tool that assesses BASIC ADLs (bathing/dressing/toileting/transfering/continence/feeding).
no formal reliability and validity reports
used extensively as a flag for function
0= lowest = pt very dependent
6=highest= pt independent
What is the Lawton IADL scale?
provides self-reported information about functional skills necessary to live in the community (using phone, shopping, food prep, housekeeping, laundry, mode of transportation, responsibility for own meds, ability to handle finances)
for each item 1= highest
0=dependent
what’s the ABC scale?
subjective measure of confidence in performing various ambulatory activities without falling. Patients rate their balance confidence on 16 items on a rating scale that ranges from 0-100
What is SPLAT?
mnemonic for fall history Symptoms (differentiate accidental fall from syncope) Previous falls Location of fall Activity at time of fall Time of fall
What drug classes that are common in older adults?
-psychotropic meds: sedatives-hyptonic antianxiety antidepressants antipsychotics -neurologic agents -analgesics and anti-inflammatory drugs -cardiovascular drugs
Bone mineral density. normal, osteopenia, osteoperosis cut offs
greater than -1.0 normal
-1.0 to -2.5 osteopenia
<-2.5 osteoporosis
What’s included in cardiovascular/pulmonary systems review?
heart rate, respiratory rate, blood pressure, and edema
What’s included in Integumentary systems review?
pliability (texture), presence of scar formation, skin color, and skin integrity
What’s included in the Musculoskeletal system review?
gross symmetry, gross range of motion, gross strength, height, and weight
What’s included in the Neuromuscular system review?
general assesment of gross coordinated movement (ie balance, gait, locomotion, transfers, and transitions) and motor function (motor control and motor learning)
What’s included in the Communication ability systems review?
affect, cognition, language, and learning style, the assessment of the ability to make needs known; consciousness; orientation (person, place, and time); expected emotional/behavioral responses; and learning preferences (ie learning barriers, educational needs)
Blood Pressure: Optimal? Pre-HTN? HTN Stage 1? HTN Stage 2? HTN Stage 3?
HR should increase by how much per MET level?
Orthostatic hypertension?
Optimal= 120/80 Pre-HTN= 120 to 139/80-89 HTN Stage 1= 140-159/90-99 HTN Stage 2= 160-179/100-109 HTN Stage 3= >or= 180/ >or=110
HR should increase 10-12bpm and SBP should increase 10-12 mmHG per MET level
Orthostatic HTN= drop in SBP by 20mmHG or DBP by 10mmHG
If pt has either resting or exercise HTN, refer for medical management.
What is normal aging integument?
What should you look out for?
thinning dermis; wrinkles; decreased collagen and elastin; more prone to hermorrhages (senile purpura)
look out for:
- skin tears secondary to decrease in pain perception at site of purpura
- skin conditions such as xerosis (dryness), cellulitis, shingles, scabies
- skin cancer
- pressure ulcers (decubiti) [heels, sacral area, occiput]
what are the 3 heights you need to include?
height in typical standing posture
height in conscious erect posture
max height during lifetime
What should be included about bladder and bowels to systems review?
urinary frequency urgency incontinence reduced force of stream difficulty initiating dysuria color
bowel: changes in regularity.
