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6011 Clinical Reasoning Final Exam COMPLETE ☑️ > Module 14: Geriatrics > Flashcards

Module 14: Geriatrics Flashcards

1
Q

Geriatric Assessment

-3 Important factors

A
  1. Focus on elders w/ complex problems
  2. Emphasizes functional status and quality of life
  3. Takes advantage of inter professional team of providers

BEST teams are interpersonal

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2
Q

5 I’s of Geriatrics

A
  1. Immobility
  2. Intellectual impairment
  3. Incontinence
  4. Instability
  5. Iatrogenesis — S/E of meds and other treatments
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3
Q

Tenets of Geriatric Care?

A
  1. Safety
  2. Quality of life
  3. Function

Also,

  • Identify goals
  • Advocacy
  • Inclusion of family and caregivers
  • Postpone dependency
  • Proactive care
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4
Q

Geriatric Syndromes

A
  1. Dementia, Delirium, Behavioral changes
  2. UI
  3. Falls, gait abnormalities, dizziness
  4. Weight loss, malnutrition, Sleep disorders
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5
Q

Geriatric Things to Keep in Mind?

A
  1. Under reporting Sx’s
  2. Interviewing pt and caregiver separately may yield different results
  3. Nonspecific and altered presentation of disease
  4. Blunted fever response
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6
Q

NonSpecific Sx’s to Expect

A
  1. Self-neglect
  2. Confusion
  3. Apathy
  4. Falling
  5. Incontinence
  6. Fatigue, Dyspnea, anorexia
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7
Q

Common Altered Presentations of Specific Illinesses

A
  1. Infection w/out Leukocytosis, fever or tachycardia
  2. Apathetic thyyrotoxicosis
  3. Silent malignancy
  4. MI w/out chest pain
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8
Q

Medications and Geriatrics

A
  1. Always avoid medications w/ high Anticholinergic S/Es — Ex: Benadryl
  2. Polypharmacy - 5 or more Rx meds
  3. Beers List— Document use of these meds if used

Goals - Always look for meds that can be stopped

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9
Q

HIGH Alert Drug Classes

A
  1. Diuretics
  2. Antiarrhythmics
  3. Antiparkinsonian medications
  4. Anticoagulants
  5. Psychoactive medications
  6. Analgesics
  7. Hypoglycemics
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10
Q

DANGEROUS Meds in Geriatrics

A
  1. Diazepam (Valium)
  2. Oxybutynin (Ditropan)
  3. NSAIDs
  4. Benadryl
  5. Omeprazole (Prilosec)
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11
Q

Cockcroft-Gault Formula

A
  1. Creatinine clearance formula
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12
Q

Effective Prescribing

A
  1. ALWAYS do a medication history
  2. All meds should have a diagnosis
  3. Know the medication you prescribe
  4. Consider cost
  5. Simple regimens
  6. Discuss treatment goals
  7. Look for medication to D/C
  8. Caution w/ new medications
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13
Q

Social Assessment

A
  1. Ethnic, spiritual and cultural background
  2. Availability of personal support system
  3. Economic Well-being
  4. Safety of home environment
  5. Elder mistreatment
  6. Advance directives
  7. Availability of EMERGENCY help
  8. Occupational hx/interests
  9. ETOH and Rx use
  10. ASSESSMENT of caregiver**
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14
Q

Functional health

A
  1. Function = 6th vital sign — PRESERVE function is key
  2. Katz index of independence in activities of daily living
  3. Lawton Instrumental Activities of Daily living
  4. Get up and Go test — 10 seconds is normal for examTEST — more than 20 seconds - Refer
  5. Vulnerable Elders Survey — frailty measure
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15
Q

Quality of Life

A
  1. Do you think you have a good quality of life?

- Advance directives, DNR, power of attorney

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16
Q

Mini-Cog Test

A
  1. 3 words that pt will read back then remember
  2. Clock drawing test
  3. After the clock drawing, ask them the 3 words

ONLY used for SCREENING

17
Q

Nutritional History

A
  1. Unintended weight loss is an INDEPENDENT predictor of mortality*
18
Q

Senile Purpura

A
  1. Large bruise that is non-trauma related and connected to sun exposure
19
Q

Ear Assessment

A
  1. May be confused for Dementia

2. Hearing aids are not covered by Medicaid

20
Q

Mouth assessment

A
  1. An Epulis is an extra skin tag on the gums that may keep dentures from fitting correctly
  2. Dentures are NOT covered by Medicaid
21
Q

Respiratory Assessment

A
  1. Listen to the bases first **
  2. Weakened gag reflex, decreased cough reflex and ciliary action w/ in effective cough
    - Risk for Silent aspiration
    - Infiltrates
22
Q

MSK Assessment

A
  1. Asian Woman < 127 lbs is higher risk for osteoporosis
  2. Can lose 2 inches in trunk
  3. 30-50% loss of muscle mass
  4. ALWAYS assess gait and balance TEST
  5. Fine finger movements and movement of each joint
  6. Tremors
  7. Timed Get up and Go test
  8. Bone density screening
23
Q

Endocrine

A
  1. Hypothyroid from Hashimoto’s thyroiditis is common in older adults
24
Q

Female Reproductive

A
  1. OVARIES should NOT be palpable in older age**TEST

2. Stop PAP at age 65 w/ no risks unless in high risk behavior

6011 Clinical Reasoning Final Exam COMPLETE ☑️ (3 decks)

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