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Developmental Concepts > Lecture 4 > Flashcards

Lecture 4 Flashcards

1
Q

Adults over 65 purchase __% of all perscription medication

A

30%

Also older adults are more likely to experience adverse drug reactions

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2
Q

The average older adult takes _ medications

The average nursing home resident takes _ medications

A

Older Adult: 5

Nursing home resident: 7

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3
Q

Polypharmacy definition

A

Excessive/Inappropriate use of perscription medications

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4
Q

____ of all old people take atleast one unnecessary drug

A

half

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5
Q

How does aging effect drug absorption?

A

Decreased gastric acid

Decreased stomach emptying

Decreased gastric motility

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6
Q

How does aging effect drug distribution

A

Decreased Body H20

^ Body fat

Decreased plasma proteins

Decreased lean body mass

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7
Q

How does aging effect drug metabolism

A

Decreased liver mass

decreased bloodflow to liver

decreased enzymatic activity

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8
Q

How does aging effect drug excretion

A

Decreased kidney mass

Decreased bloodflow to kidneys

Decreased nephron function

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9
Q

What kind of medications are most commonly overperscribed

A

Laxatives

BP medication

Diuretics

Diabetes medication

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10
Q

What is the common side effect of NSAIDS

A

GI symptoms

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11
Q

What is the common side effect of opiods

A

sedation

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12
Q

What is the common side effect of antidepressants/ analgesics/ lithium

A

Confusion

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13
Q

What is the common side effect of barbiturates and antihypertensive medication

A

Depression

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14
Q

What is the common side effect of antihypertensives

A

orthostatic hypotension

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15
Q

What is the common side effect of Diuretics and glucocorticoids

A

Fatigue/weakness

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16
Q

–% of adults 65+ report a fall once a year

A

29%

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17
Q

Medical treatment for falls costs about ____ a year

A

50billion

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18
Q

Fall risk factors

A

Besides the obvious:

Polypharmacy

Use of Assistive Device

Depression/Anxiety

Fear of falling

Recent hospitalization

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19
Q

What is the 6th vital sign

A

Gaitspeed

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20
Q

What is the cutoff for community ambulation

A

0.8m/s

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21
Q

What is the cutoff gaitspeed for being dependent in ADLs AND more likely to be hospitalized

A

Under 0.6m/s

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22
Q

Whats the gaitspeed cut off for being independent and less likely to be hospitalized

A

Over 1m/s

23
Q

What outcome measures are for balance

A

BERG balance scale

Sharpened romberg

4 square step test

functional reach test

MiniBEST

24
Q

What outcome measures are best for “Functional” measurement

A

5xSTS

30s STS

TUG

10mWT

25
Q

What tests are best for measuring endurance

A

6MWT

2min step test

26
Q

What outcome measures are considered self report

A

MFES

fear of falling avoidance questionarre

27
Q

What is the cutoff in gaitspeed for being D/Ced to a skilled nursing home vs being D/Ced back home

A

0.1m/s

28
Q

What is the cutoff gaitspeed for needing intervention to reduce fall risk

A

1m/s

29
Q

Household walker gait speed

A

0.4 m/s

30
Q

limited community ambulator gait speed

A

0.4-0.8m/s

31
Q

community ambulator gaitspeed

A

0.8-1.2

32
Q

Cross street ambulator gait speed

A

1.2m/s+

33
Q

The sharpened romberg uses what 3 stances?

A

Feet together

Semi tandem

Tandem

34
Q

How far do you walk before you turn around in the TUG test?

A

3m

35
Q

What is the cutoff value for fall risk during a TUG test

A

13.5

36
Q

What is the cutoff fall risk for a 5xSTS?

A

11.4s

37
Q

What are the different categories of disability

A

Ambulation

Cognitive

Visual

Hearing

Medical

38
Q

What percent of people over 65 have atleast one disability

A

34%

39
Q

What percent of people over 65 have an ambulatory disability

A

21%

40
Q

What activities are ADLs

A

Bathing

Dressing

Toileting

Transfering

Eating

41
Q

what activities qualify as IADLs

A

Shopping

Preparing meals

Taking medications

Housekeeping

Using transportation

Managing finances

Using the phone

42
Q

Medicare is for

A

People over 65 or people with disabilities

43
Q

Medicaid is for

A

Low income

Persons responsible for minor/pregnant

Disability

44
Q

Requirements for independent community living

A

1.2m/s gait speed

Ambulation distance 400m

Carrying objects around 8lbs (gallon of milk)

Ambulate varions terrain

Stairs/curbs

45
Q

Inpatient rehab

A

3 hours of therapy per day (PT OT SP)

high prior level of function

Moderate complexity

46
Q

Skilled nursing facility

A

Unable to participate in 3 hours of therapy

Moderate functional prognosis

Variable level of prior function

47
Q

Long term acute care

A

Poor Prognosis

High complexity of medical needs

Less need for skilled therapy

48
Q

Hospice care

A

Life expectancy under 6 months

49
Q

MOLST/POLST

A

advanced care directives for physician to order life sustaining care

50
Q

DNR

A

Advanced care directive: do not resuscitate

51
Q

Adults lose __% of their strength between 60-90

A

40%

52
Q

Review this

A

K

53
Q

FITT recommendations for geriatric w/ osteoporosis

A

Aerobic 4-5 times a week, Moderate intensity

Resistance. 1-2 nonconsecutive days. Adjust weight so last two repetitions are challenging. High intensity is beneficial if they can tolerate it.

Flexibility 5-7 days a week, hold static stretch for 10-30 seconds, 2-4 repetitions

54
Q

Review this

A

K

Developmental Concepts (7 decks)

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