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Geriatrics Theory > lecture 1 > Flashcards

lecture 1 Flashcards

1
Q

aged, aging, elder, elderly, old

A

> /= 65

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2
Q

young-old

A

65-74

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3
Q

middle-old

A

75-84

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4
Q

old-old

A

85+

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5
Q

fastest growing segment of aging population?

A

85+, old-old

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6
Q

elite-old, centernarians

A

100+

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7
Q

ave life span for female infants

A

81.1

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8
Q

ave life span for male infants

A

76.2

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9
Q

frail

A

related to functional status, not age

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10
Q

what % live in community?

A

95%

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11
Q

what % live in CA FL NY PA TX OH IL MI

A

52%

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12
Q

what % live in urban areas?

A

77%

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13
Q

fastest growing group of elders

A

women 85+

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14
Q

what % of those >65 live alone?

A

> 36%

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15
Q

changes in elder pop? what we know

A 
^ in absolute # of persons 65+
^ in % of persons 65+
^ life exp at birth & at age 65
dramatic changes in ethnic div
major ^ in education achievement
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16
Q

changes in elder pop? what we dont know

A
  • implications of current lifestyle/behavior patterns on future health status
  • availab/type of health care resources
  • disease/tx response patterns for diff demograph groups
  • implications of scientific/technical advances for health & quality of life
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17
Q

top 10 causes of death in elders

A 
heart disease
cancer
cerebrovascular diseases
COPD and assoc conditions
pneumonia/ flu
diabetes
accidents
septicemia
kidney disease
alzheimers
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18
Q

elder abuse

A

battering, verbal abuse, exploitation, denial of rights, forced confinement, neglected med needs, personal harm, usually at the hands of someone responsbile for assisting them in ADLs

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19
Q

what happens as violence in society increases?

A

likely ^ in elder abuse

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20
Q

how much abused/neglected elders are there each year?

A

> 2 mil

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21
Q

how much elder abuse is under reported?

A

est 80%

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22
Q

how much of abuse involves elders?

A

40%

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23
Q

why are elders reluctant to report abuse?

A

fear worse/unsure situation if they get moved

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24
Q

abuse is usually related to what?

A

limited resources of time, money, coping, help, substance abuse

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25
Q

what % is financial abuse?

A

46%

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26
Q

neglect by self

A

story about woman who didnt wanna abuse friendship with woman who drove her to tx.
most frequent type of mistx

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27
Q

largest # of elderly living at home alone

A

women 75+, can be subject to self neglect, abuse and exploitation by hired caregivers

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28
Q

what is related to long-standing problems in a relationship?

A

verbal abuse/ neglect

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29
Q

“better quicker”

A

philosophy in hospitals- pts sent home earlier with more sophisticated needs and more demands on the family for care.

30
Q

why is the “better quicker” philosophy not good?

A

increases stress, fam can be resistant to care for pt. pt may get inadequate care, neglected

31
Q

families/cg at home make up what % of care?

A

80%

32
Q

why do families take care of pts?

A

mostly due to costs of institutional care

33
Q

physical assessment

A

normal aging and comorbidities

nutritional assessment

34
Q

functional assessment

A

ADLs, InstumentalADLs, timed up and go, gait/balance

35
Q

psychological assessment

A

cognitive/mental status assessment

ie depression assessment, mental exams

36
Q

social assessment

A

relationships and network size

37
Q

spiritual assessment

A

doesnt have to be religion. do you have faith? something that can sustain you when youre sick?

38
Q

normal aging changes

A 
alterations at all levels
dec reserve/efficiency
-intracell
-cellular
-tissue
-organ
-system
39
Q

cumulative effect of inc vulnerability

A

diff maintaining homeostasis

diff responding to stress

40
Q

top 10 chronic conditions

A 
HTN
arthritis
heart disease
hearing impairment
cataracts
deformity/ortho impairment
chronic sinusitis
diabetes
tinnitus
visual impairment
41
Q

functional evaluation

A

tell about typical day, ADLs, IADLs, performance measures

42
Q

nutrition eval

A

nutrition screening ?aire, current wt, wt trend, BMI, Albumin, Cholesterol

43
Q

underweight BMI

A

< 18.5 kg/m2

44
Q

healthy weight BMI

A

18.5-24.9

45
Q

overweight BMI

A

25-29.9

26- protective for immune system

46
Q

obese BMI

A

> 30.0

47
Q

albumin level

A

3.5-4 g/dL

48
Q

less than 3.5 albumin means what

A

malnourishment

49
Q

why use prealbumin?

A

actually see more quickly over time. Half life is 2 days vs. 12-18 days for albumin.

50
Q

cholesterol

A

160-200

51
Q

cognitive, mental status screening

A

remember 3 objects
mini mental status exam (MMSE)
Short portable mental status ?aire (SPMSQ) 10 items
clock drawing test

52
Q

depression screening

A

GDS geri dep scale

53
Q

full scale GDS

A

30 y/n ?s

54
Q

short scale GDS

A

15 items

55
Q

if pt has plan to kill themselves

A

get help right away

56
Q

if pt just feeling depressed, say they dont wanna live

A

need to follow up, but not an emergency situation

57
Q

assessment of SS

A 
if something happens, who can help u?
how long do you see yourself being able to manage?
primary cg?
is cg burdened?
resources?
58
Q

polypharm

A

know why each drug given.
know AE.
know interactions bw other drugs.

59
Q

pharmacokinetics

A

how body acts on drugs, how drug moves on body. ADME

60
Q

pharmacodynamics

A

actual effects, results. was there toxicity? was it efficacious?

61
Q

what happens if someone is on digoxin while anemic?

A

drug wont be connected to proteins (albumin) and will stay in blood. There will be digoxin toxicity. will see halo/yellow spots, bradycardia, NV, HA

62
Q

most drugs are metabolized thru the?

A

liver

63
Q

most drugs are excreted thru the?

A

kidneys

64
Q

Drug-receptor interactioin

A

inc BBB permeability and receptor sensitivity; CNS side effects common.

65
Q

Circulation

A

dec HR/BP regulation stability; toxicity common

66
Q

Metabolism

A

dec liver mass and hepatic BF; dec metab; enzyme changes may inc drug 1/2 life

67
Q

Excretion

A

dec renal BF, GFR, # functional nephrons; renal excretion slowed, inc drug 1/2 life.

68
Q

Absorption

A

gastric emptying, GI motility, dec efficient

69
Q

Distribution

A

dec lean body mass, total h20 and plasma protein; inc risk of drug toxicity.

70
Q

loop diuretics

A

low K causes digoxin toxicity. K enhances action of drug… can have arrythmias.

71
Q

QSEN competencies

A
  1. Patient-centered care
  2. Teamwork/collab
  3. EBP
  4. Quality improvement
  5. Safety
  6. Informatics
72
Q

patient centered care

A

to recognize the pt or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for pt’s preferences, values, and needs.

Geriatrics Theory (3 decks)

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