Intro to Geriatrics Flashcards
Anatomical changes in the CV system
decreased contraction and filling capacity → less CO
Physiological changes in the CV system
changes in conduction → tachy and bradyarrhythmias, decreased efficiency, decreased catecholamines
Changes in the conduction system of the heart
decreased due to fibrosis or ischemia, “irritable” → trigger → increased HR → tachyarrhythmias.
Generally slows down
Arterial changes in the CV system
increased stiffness, atherosclerosis
Venular changes in the CV system
decreased valves, thrombosis, PE
Disease r/t aging CV system
HTN, TIA/CVA (carotid- occlusion, vertebral- hypotension)
CNS changes in the elderly: conduction and transmission
moving slower and not as strong → results in not having the same coordination or muscle control
CNS changes: threshold for arousal
Blurred, needs a greater signal
CNS changes: adaptation to physiologic stressors
Reduced
CNS changes: recovery time in autonomic system
Increased time needed to return to baseline
Respiratory changes in the elderly
Normal at rest, compromised under stress
Anatomical changes in the respiratory system
decreased expiration → decreased elasticity, muscle weakness, skeletal deformities and reduced capacity of lungs
Functional changes in the respiratory system
decreased ventilation and PaO2
Anatomical changes in the kidneys
Nephron degeneration
Physiologic changes in the kidneys
decreased ability to concentrate urine, decreased renal blood flow, decreased acid-base adaptation when stressed
Diseases and problems with the kidneys in the elderly
inadequate fluid intake, fluid loss d/t vomiting and diarrhea, shock due to hemorrhage, cardiac failure, sepsis, injudicious use of diuretics, sodium phosphate enemas
Bladder changes in older women
estrogen deprivation, atrophy, decreased secretions → urinary incontinence, dyspareunia, menopause signs/symptoms
Bladder changes in older men
gradual decrease in testosterone, decreased libido and sexual function, decreased energy, increased body fat, osteoporosis, decreased muscle mass, decreased body hair
General GI changes
Dentition and nutrition changes because they’re eating less
Esophageal changes
decreased motility, hiatal hernia (stomach pushing up through the LES)
Stomach changes
decreased acid, intrinsic factor, motility
Colon changes
decreased motility
Pancreatic changes
decreased secretions
Liver changes
decreased size and blood flow; decreased CYP450 activity
Musculoskeletal changes: structure and function
atrophy, decreased O2
Joint changes
erosion, degeneration, calcification/ossification of ligaments
Skeletal degeneration changes
osteoporosis → kyphosis
Musculoskeletal changes in the elderly can lead to what?
Fractures and falls
Skin and derm changes
Changes in skin, nails, hair → decreased elasticity and turgor, increased pigmentation
Sensory changes
decreased vision and hearing
Frality defintion
a state of vulnerability to poor resolution of homeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homeostatic reserves until minor stressor events trigger disproportionate changes in health status.
Geriatric syndromes definiton
multifactorial health conditions that occur when the accumulated effects of impairments in multiple systems render an older person vulnerable to situational challenges
Types of geriatric syndromes
Dementia, delirium, urinary incontinence, falls, gait disturbances, dizziness, syncope, hearing impairment, visual impairment, osteopenia, malnutrition, eating and feeding problems, pressure ulcers, sleep problems
Comprehensive geriatric assessment
Cost and coverage
Adherence
Safety
Attaining therapeutic goals
History-taking problems
Medication organization
Assessing and monitoring drug therapy
Drug-related problems in the elderly
Underuse
Overuse
Inappropriate prescribing
5 Ms of Geriatrics
Mind, mobility, medications, multi-complexity, matters most
Prescribing cascade: what is it?
One drug is prescribed to combat the effects of another one and so on and so forth. Some of these prescribing cascades are legit and CAN help with symptomatic relief, but knowing that a symptom a patient is experiencing is a side effect of the drug is the most important part!
