Margaret Smith Flashcards
what is margaret’s related topic?
Falls risk/Ageing and Senses
how old is she?
75
what department is she in?
medical receiving
does margaret live alone or with others?
alone
does she have a concerned family member
yes, her daughter
what is Margaret’s PMH?
- fall(ing) over past few days as a result of occassional lightheadedness
- PT usually fully independent
how does margaret sappear on arrival?
fully alert and orientated
what is margaret’s complaint?
frequent urination over a period of days
name for frequent urination?
polyuria
what impact can frequent urination have on physical health?
- dehydration/electrolyte imbalance/thirstiness
- hypotension
- tiredness (constantly going to toilet; elderly pt)
- disturbed sleep patterns
- irritation of genitalia due to consistent passage of urine and wipining (?break down of skin)
what impact can polyuria have on mental health?
- social anxiety; fear of incontinence
- depression/anxiety
- disturbed sleep/tiredness
what other micturition condition could polyuria cause?
nocturia; having to wake up in the night to urinate
another word for urination?
micturition
what is post-fall syndrome?
- common in older people
- characterised by a fear of falling
- lack of confidence & voluntary restriction on activity due to fear
- can result in mental health problems, such as depression
- can reasuly in physical health issues; UTI from not going to toilet enough, dehydtration from not making drinks
basic checks for reducing falls?
*glasses on
*hearing aids in
*non-slippery footwear/grippy socks on
what is polypharmacy?
the use of multiple medications, particularly 6≥
what are culprit medications and what do they do?
medicines which contribute to falls in a variety of ways;
*distrubed balance
*hypotension
*dizziness
*confusion
*blurred vision
what is postural hypotension?
a drop in someone’s BP upon sitting or standing up
symptoms of postural hypotension
*changes in vision
*weakness
*dizziness
*losing consciousness with/without warning
enviromental risks for falls?
*incorrect height of bed/chair
*un-worn aids; hearing aids/glassess/mobility aids
*no access to call bell
*innapropriate footwear
how soon must a falls risk assessment be carried out?
within 24 hours of admission/transfer to another ward/depaetment
Weekly or sooner if the patient falls or their condition changes
what is the somatosensory system and in relation to older people?
- the somatosensory system is within the parietal lobe of the brain
- has a network of neurones which help us recognise objects, discriminate touches and sensations
- in older people and those with neurological conditions, their system’s structure and function may have declined
- this can make foot positioning difficult; affecting mobility/increasing risk of falls
what do you think the main problem is with Margaret?
postural hypotension caused by dehydtration
why do you think this is the problem with Margaret?
- ?diabetes
- ?renal impairment
- ?medication; overuse of diuretics
what would I reccomend we do to find out what the problem is?
- urinalysis
- urine cultures (red top bottle)
how does diabetes cause polyuria?
- diabetes means excess glucose (sugar) in the blood (hyperglycaemia)
- instead of all glucose being absorbed into ECF after filtration in the kidneys, due to hyperglycaemia, the glucose amount exceeds the kidney’s capacity, resulting in glucose excreted in the urine
- glucose is a solute that draws water into the urine via omosis, resulting in excesss micturition
- as a result, dehydtration will occur, and the symptom of thirst also
another word for postural hypotension?
orthostatic hypotension
how could culprit medication be causing margaret’s lightheadedness/falls?
- some medications have symptoms of light-headedness, blurred vision, distorted balance etc. which could be causing Margaret’s falls
how could over-use of diuretics be causing margaret’s polyuria?
