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Geriatrics > Hyper and Hypo Thermia > Flashcards

Hyper and Hypo Thermia Flashcards

1
Q

past what age does thirst sensation decline?

A

50

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2
Q

a core temp over what is hyperthermia?

A

105 F

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3
Q

list some complications of heat stroke

A

Myocardial damage
renal failure
seizures
hepatocelullar necrosis

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4
Q

with early hyperthermia will you sweat?

A

Yes but not with late

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5
Q

Why do elderly have difficulty with temp regulation?

A

Loss of diurnal variation (rise)
Diminished sweating
Abnormal vasoconstrictor response

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6
Q

What is hypothermia?

A

Core temp < 35C or < 95F

increased heat loss with decreased heat production

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7
Q

Early signs of hypothermia

A

Fatigue, weakness, slowed gait, cool skin, shivering

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8
Q

Moderate signs of hypothermia

A

Cold skin, cyanotic, bradycardia, arrhythmia, hypotensive, hypo-reflexive, slowed pupillary rxn

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9
Q

Severe signs of hypothermia

A

Areflexia, fixed pupils, apneic, non-responsive, v. fib

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10
Q

What is a key finding of hypothermia?

A

J wave (Osborne wave) follows the QRS complex

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11
Q

Other labs that treat hypothermia

A

CMP, BUN, creatinine, clotting factors, CBC, urine/serum toxicity screens, thyroid, cardiac enzymes

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12
Q

Treatment of hypothermia

A

Warm IV fluids, warm core before limbs, anticipatory monitoring

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13
Q

What are anticipatory monitoring in hypothermia?

A

Metabolic acidosis
Cardiac decompensation/arrhythmias
Hyperkalemia, hypoglycemia
Renal failure

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14
Q

What is numb, swollen, erythematous area?

A

Frostnip (non-freezing)

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15
Q

Distal extremities & exposed skin

Cold, hard, white & numb; dry vs. wet gangrene

A

Frostbite

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16
Q

pale, edematous, clammy, cold, numb foot/feet

A

Immersion foot (non-freezing)

17
Q

How do you treat frostnip, immersion foot, frostbite?

A

Rewarm

Wound care in frostbite

18
Q

What is passive treatment for hypothermia and what temp should it be done at?

A

> 32 C or 89.6 F, evidence shivering

Remove wet clothes and from cold env’t
Warm fluids, heated blankets

19
Q

What is active treatment for hypothermia and what temp should it be done at?

A

< 89.6F (also cardiac instability,toxin, trauma, or co-morbidity)

Heated and humidified O2
Warmed IV infusion (Lavage or ECR)

20
Q

How to prevent hypothermia?

A 
Warm layered clothing
Wind protection & moisture wicking
Foot wear allows for circulation
Head covering
Community outreach
21
Q

What is hyperthermia?

A

Core temp > 40.6C or >105F

increased heat input with decreased heat output

22
Q

Dizzy s/p exercise/exertion in hot weather

Pale & sweaty, moist & cool skin, HR increased, core temp normal

A

Heat syncope

23
Q

Treatment for heat syncope and heat fatigue

A

rest, oral rehydration, cooler & less humid environment

24
Q

Weakness, dizzy, HA, malaise, NAUSEA, syncope with prolonged standing in heat
PE: appear tired, sweaty, tachycardia, MS INTACT, NORMAL TEMP or < 40C or < 104F

A

Heat exhaustion

25
Q

d/t exposure to elevated ambient temp or overexertion

Pale & sweaty, moist & cool skin, HR increased, core temp normal

A

Heat fatigue

26
Q

Muscle cramps in legs due to exertion in hot weather, core temp normal

A

Heat cramps

27
Q

How do you treat heat cramps?

A

Rx: cool environment, oral rehydration, IV NS, rest

28
Q

How do you treat heat exhaustion?

A

Rx: Remove to cool environment, rest, supine, IV fluids/electrolyte replacement

29
Q

hypoglycemia, coronary syndrome/MI, sepsis should be ruled out for what problem?

A

Heat exhaustion

30
Q

Weakness, HA, malaise, CONFUSED, delirious

PE: skin hot & dry, supine tachycardia, tachypnea, ALTERED MENTAL STATUS, T > 40 C or > 104 F

A

Heat stroke

31
Q

What are some causes of heat stroke?

A

Thermoregulatory dysfunction, heat wave exposure (2-3 days exposure)

32
Q

CBC, clotting factors, electrolytes, BUN, creatinine, LFT, monitor urine output, core temp via rectal or esophageal probe

What are these labs for?

A

Heat stroke

33
Q

What is treatment for heat stroke?

A

Admit & ID underlying cause

Ddx: sepsis, meningitis, CVA, meds/drugs, thyroid storm, malignant hyperthermia, neuroleptic malignant syndrome (from antipsychotics), serotonin syndrome (SSRIs)

Manage shivering/prevent seizures
Anticipatory monitoring

34
Q

What is prescription for heat stroke?

A

Rapid cooling (continually wet & fan the skin; Add ice packs (groin & axilla))
IV hydration NS
PRN sedation to prevent agitation, seizures
Prevent aspiration if vomiting
DIC: platelets & fresh frozen plasma

35
Q

Prevention of hyperthermia

A 
Access to air conditioning in excessively hot weather
Avoid exertion
Maintain hydration
Loose fitting/ventilating clothing
Community outreach

Geriatrics (18 decks)

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