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Geri Quiz > November 9th Quiz > Flashcards

November 9th Quiz Flashcards

1
Q

Risk factors for adverse drug events

A
  • 6 or more chronic conditions
  • 9 or more meds
  • 12 or more doses per day
  • low BMI/BW
  • prior adverse rxn
  • over 85 y/o
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2
Q

5 worst drug classes for elderly

A
  • anticholinergics
  • benzodiazipines
  • NSAID
  • antidepressants
  • statins
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3
Q

What are 2 reasons that older people have drug side effects

A
  • decreased lean body mass

- decreased glomerular filtration rate

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4
Q

What are the effects of dementia meds

A
  • falls

- lethargy

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5
Q

Effects of PPIs/H2 receptor blockers

A

risk of

  • C diff
  • pneumonia
  • malabsorption
  • osteoporosis
  • Dementia
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6
Q

Instead of NSAIDs you should use?

A
  • Tylenol, 650mg po qid

- maybe low does oxycodone

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7
Q

BEERS criteria

A

list of 34 medications to avoid with older adults, and guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults.

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8
Q

Definition of skilled care

A
  • PT is considered skilled if “of a high level of complexity, or the patient’s condition requires the judgment and skills of a PT”
  • higher level of clinical judgment and reasoning
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9
Q

APTA guidelines for documentation

A
  • type and level of skilled assistance given
  • clinical decision making
  • analysis of patient progress
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10
Q

What are the fundamental PT principles

A
  • overload using RPE and RPM
  • specificity w/ application to fxnal goal
  • motor learning
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11
Q

3 things to document during pt refusal

A
  • explain patient’s concern
  • strategies used to address concern
  • explanation of why treatment is needed
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12
Q

What makes therex skilled

A
  • objective tests and measures
  • different exercises targeted at same m group
  • task analysis
  • exercises to meet pts needs
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13
Q

When is therex not skilled?

A
  • supervision
  • repetitive exercises
  • continual cueing
  • no reassessment
  • recumbent machines
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14
Q

Indications for skilled gait training

A
  • slow gait speed
  • decreased balance during gait
  • instruct a pt with altered WB status
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15
Q

Skilled gait training can include

A
  • ID of gait deviation
  • feedback strategies
  • elastic resistance
  • less supportive ADs
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16
Q

Non skilled gait training

A
  • walking to gain endurance/distance
  • gait needs assistance
  • repetition for distance
  • constant cueing
17
Q

When is transfer training appropriate

A

-if pt lacks ability to motor plan the sequence or is unsafe

18
Q

What memory is affected with age

A
  • short term
  • encoding
  • retrieval w/ Alz
19
Q

How is long term memory affected with age

A
  • memories stored in past are not affected unless brain damage or dementia
  • making new memories is affected
20
Q

Procedural memory

A

-automatic, implicit (riding a bike)

21
Q

Semantic memory

A

-declarative, explicit, (factual)

22
Q

Episodic

A

autobiographical (recall of personal experiences)

23
Q

Order of memory loss with alzhiemers

A
  1. episodic (recent first)
  2. semantic
  3. sometimes procedural
24
Q

What is preserved with dementia

A
  • procedural
  • recognition
  • knowledge, wisdom
  • emotions
25
Q

How to promote procedural memory

A
  • promote attention
  • self generated info
  • allow pts to struggle
26
Q

What is the most common type of dementia

A
  • alzheimers 40%
27
Q

What is the earliest and essential clinical manifestation of AD

A

-selective memory impairment

28
Q

AD signs and sxs

A
  • memory loss
  • personality changes (depression, agression)
  • inability to communicate
  • progressive decline in physical abilities
29
Q

What are the 3 drugs most problematic for falls

A
  • benzodiazipines
  • antipsychotics
  • muscle relax
30
Q

What sensory/motor changes may occur prior to cognitive changes with AD

A
  • olfactory
  • vision
  • hearing loss
  • fine motor impairments
31
Q

What is the hallmark of delirium-

A

sudden and rapid change in mental function

32
Q

How to communicate with demented

A
  • positive reinforcement
  • always use name
  • short and simple
  • be patient
  • accuracy of information
33
Q

How to create brain reserve

A
  • exercise
  • fatty fish
  • green leafy veggies
  • socialization
  • lower stress
34
Q

Delirium

A

-acutely altered mental status characterized by inattention and a fluctuating course

35
Q

5 criteria of delirium

A
  • disturbance in attention
  • develops over a short period, with fluctuating severity
  • disturbance in cognition
  • consequence of another medical condition or substance
36
Q

Impacts of delirium

A
  • increased 1 year mortality
  • increased risk of institutionalization
  • development of dementia
  • prolonged mechanical ventialtion
  • longer ICU/hospital stay
37
Q

The confusion assessment method CAM 4 components

A
  1. acute onset and fluctuation course
  2. inattention
  3. disorganized thinking
  4. altered level of consciousness
    - first 2 must be present to be positive
38
Q

How to prevent delirium

A
  • early mobz
  • room set up
  • regular sleep cycle
  • hearing aids/glasses
  • hydration/nutrition
  • family education
  • pain management
39
Q

5 nonverbal signs of pain

A
  • facial grimacing
  • guarding
  • limited ROM
  • increased vital signs
  • restlessness

Geri Quiz (2 decks)

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