Home Health Care Flashcards
What are some signs of sleep apnea?
Lack of energy in the morning
Snoring
Nightmares
What is sleep apnea?
It is a serious sleep disorder in which breathing repeatedly stops and starts. Disruptions to sleep occur due to tissue relaxation in the airways. The relaxed tissues can block the airways. This can happen multiple times a night
If the patient snores loudly and feel tired even after a full night’s sleep, they may have sleep apnea
Are OTC products for sleep apnea useful?
NO, they are all ineffective, get CPAP or surgery
How do CPAP machines work?
They deliver a flow of air down the airways to prevent relaxed tissues from dropping and blocking the airways
How do varicose veins develop?
It is caused by the failure of the valves in their veins of the lower limbs. This results in pooling of blood in the veins. This causes the bulbosity on the legs of usually older women
How do graduated compression socks work?
They have higher compression at the ankle and pressure decreases on a gradient as you move up the leg. This pressure gradient promotes blood in the vein to flow up
What level in compression socks can be dispensed without an MDs prescription?
Under 20mmHg
Need an MD to write a prescription for compression socks that deliver pressures greater than 20mmHg
What are some symptoms that need higher pressures?
20-30mmHg: Patient has tired, aching legs. They may have mild varicose veins
30-40mmHg: Can control edema and has more severe varicose veins
40-60mmHg: Patient has got some serious issues
Are OTC products for varicose veins particularly effective?
No, they all offer low efficacy
What patient profiles benefit from flight compression socks?
Flights that are over 6h and have at least 1 CV risk factor
Is there a push in the healthcare system towards institutional care (receiving more care in the hospital)?
No, institutional care is getting more expensive every year. The healthcare system is trying to increase the amount of care delivered in the home
What is the sizing guideline for canes?
The cane’s handle should be level with the wrist. This alignment allows proper fitting, something that reduces strain
What is the sizing guidelines for crutches?
Leave a gap (two fingers) between armpit and the under arm support on crutches
What is a pharmacist’s role in urinary incontinence?
We are not the experts in these field, but we should be able to provide some advice
Is urinary incontinence common?
Yes, almost 3.3 million people have incontinence
Many older adults are transitioned into care homes once they develop incontinence
More common in women vs. men
What are the types of urinary incontinence?
Stress incontinence (accounts for 50% of urinary incontinence cases)
Urge incontinence (overactive)
Overflow incontinence (urinary retention)
Drug-induced urinary incontinence
What can cause stress incontinence?
Coughing, sneezing, laughing, and lifting can all result in the leakage of urine
The urine leaks due to bladder weakness or increase in abdominal pressure
What are some factors that can worsen stress incontinence?
Pregnancy
Menopause
What can be done to improve the patient’s quality of life in relation to stress incontinence?
Pelvic floor muscle exercises (Kegel) can be performed to improve control over urination
Intra-vaginal devices and surgical options can also be used to improve control over urination (review slides 41-43)
Review slide 44 for the theraputics benefits of Poise bladder supports
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Hong long can Impressa supports be used for?
Up to 12h everyday
Impressa should not be used during the patient’s period
What are some risk factors for stress incontinence in men?
Post-prostate surgery
What can cause an a premature high volume release of urine?
The detrusor muscle will contract before the bladder is full (large amounts of urine are released uncontrollably)
What are some risk factors of urge incontinence?
No definite cause is found in most cases
UTI (likely)
How can non-pharmacological agents help with urge incontinence?
Bladder training/ Kegel
What is overflow incontinence (urinary retention)?
The bladder is always full, the urine has a hard time escaping the bladder
Affects men over women
What can cause overflow incontinice (urinary retention)?
Prostatic enlargement
Diabetic neuropathy
What agents are used in overflow incontinence?
The following 2 drugs are more effective at reducing bladder constriction:
Tamsulosin
Finasteride
Surgical procedure (prostate reduction)
How does finasteride help in overflow in reducing urinary retention?
Finasteride is a 5a reductase enzyme inhibitor, this prevents the conversion of Testosterone into DHT, a product that is responsible with BPH and hair loss in men
How does tamsulosin work in reducing urinary retention?
It is an alpha adrenergic antagonist and it prevents the stimulation of alpha receptors
What are some drug interactions with urinary incontinence drugs?
Benadryl (first gen antihistamines, and has anti-cholinergic activity)
Amytriptyline (also has anti-cholinergic activity)
What is the effects of anti-cholinergic drugs in patients with incontinence?
In overactive bladder, anti-cholinergic effects reduce contraction of bladder smooth muscle (prevents spasms that would otherwise drain the bladder uncontrollably)
In overflow incontinence, anti-cholinergic effects reduce contraction of bladder smooth muscle. Preventing a full bladder from emptying due to the suppression of muscle action
What is the state of incontinence pads today?
They are fairly low profile, but retain enough absorbability for an entire release of urine
What is a stoma in relation to ostomy care?
A surgery where the large intestine is dissected and its end is put through the abdominal wall
There are two types of ostomies:
Colostomy (these patient have lost some large intestine function, so the dissection is more distal)
Illeostomy (these patient have lost all function in the large intestine and it is bypassed via a stoma through the abdominal wall)
Review slide 71 for a detailed description of how ostomy bags work
Is cool or warm air better for allergy symptoms?
It doesn’t matter, the device delivering warm water is more antibacterial because the heat kills off pathogens
When is heat for an injury preferred?
Chronic injuries (Back Pain, Muscle Aches, Old injuries, muscle spasms)
When is an ice pack better for injuries?
Acute injuries (Tendonitis, Plantar fasciitis, fresh injuries, sprains, strains)
What is better for injury recovery, rest or movement?
Movement is preferred in injury recovery
Rest was the traditional recommendation, but there are growing calls against this advice
Should ice be applied to injuries?
Not official, but it seems like applying ice may disrupt pro-healing inflammatory processes
