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Patient Care II > Older Adult > Flashcards

Older Adult Flashcards

1
Q

What is the average life expectancy (2020 statistic)?

A

78.9 (compared to 47 in 1900)

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2
Q

Individuals who do not have debilitating disease live healthy lives into their

A

80’s and 90’s

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3
Q

What is the focus on assessing the older adult?

A

Focus is on healthy or “successful” aging

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4
Q

What are the goals of care for the older adult?

A

No just maximize life span, but maximize health span

Maintain function
Fulfilling, active lives
Promote healthy aging

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5
Q

In older adults there is a decline in function of pacemaker cells, these affects are in response to what?

A

Response to physiologic stress

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6
Q

Will older adults have a widened ausculatory gap?

A

Yes, systolic HTN will cause widened pulse pressure due to vessels stiffening

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7
Q

Do older adults have different respiratory rate than normal?

A

No, stays unchanged

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8
Q

What is actinic (solar or senile) purpura due too?

A

Loss of subcutaneous tissue (esp. fat) with aging

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9
Q

What changes occur in older adults nails?

A

Loose luster, yellow, and thicken, especially toes (fungal infection?)

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10
Q

What is presbyopia?

A

Age related vision loss, need for reading glasses

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11
Q

What eye conditions are older adults at higher risk?

A

Glaucoma, macular degeneration, and cataracts (refractive and retinal errors)

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12
Q

What type of tone do older adults tend to loose most frequently?

A

Higher tones

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13
Q

Decreased salivary secretions and sense of taste in older adults tend to be due to what?

A

Medications

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14
Q

Increased work of breathing can be found in older adults due to what physiologic change?

A

Chest wall stiffening

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15
Q

An S3 heart sound after age 40 strongly suggests what?

A

Heart Failure

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16
Q

An S4 can be heard in healthy older adults, but usually suggests what finding?

A

Decreased ventricular compliance and impaired ventricular filling

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17
Q

Aortic sclerosis and aortic stenosis increase what risk?

A

Morbidity and mortality

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18
Q

As we age, does sexual interest remain intact?

A

Yes

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19
Q

Benign prostatic hyperplasia (BPH) typically begins in what decade of life?

A

Third decade

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20
Q

At what age does menstrual periods usually cease?

A

48-55

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21
Q

What are the top three geriatric syndromes?

A

Malnutrition, Sleep Disorders, and Depression

22
Q

What multidimensional problems exist in older adults?

A

Hearing
Vision
Polypharmacy
Morbidity

23
Q

How should you approach the visit with an older adult?

A

Well-lit, moderately warm room
Minimal background noise
Safe chairs
Face the patient and speak to them
Adjust the pace and content of the interview
Allow time for open-ended questions
Include family members and caregivers
Carefully assess symptoms
Ensure written communication

24
Q

You should allow for open-ended questions and for the patient to _______ during the visit?

25
What functional status' should be assessed at every visit of an older adult?
Activities of Daily Living (ADL's) Instrumental Activities of Daily Living (IADL's)
26
What are examples of Instrumental Activities of Daily Living (IADL's)?
Food shopping, driving or using public transportation, using the phone, housework/home repair, making meals, laundry, taking meds, handling finances
27
On average, how many prescriptions is a patient discharged to a skilled nursing facility prescribed?
14
28
What is the phenomenon "Prescribing Cascade?"
Adverse drug reaction is misinterpreted as a new medical condition, and so new medication is prescribed
29
How should polypharmacy be avoided?
Start low and go slow in prescribing Thorough medication history
30
What criteria is used to assess inappropriate drug prescribing in older adults?
Beers Criteria
31
What are the 5-categories of concern in the Beers Criteria?
Drugs that are potentially inappropriate Drugs that should typically be avoided Drugs to use with caution Drug-drug interactions Drug dose adjustment based on kidney function
32
Falls are associated with what in older adults?
Decline in functional status Increased chance of nursing home placement Increased risk of death Greater use of medical services
33
What is the most modifiable risk factor for falls in older adults?
Medications
34
What are the key questions to ask when assessing fall risk?
Have you fallen in the past year? Do you feel unsteady when standing or walking? Are you worried about falling?
35
If a patient answers yes to any of the fall risk screening assessment questions what physical exam components should be completed?
Gait evaluation Strength Balance (Timed Up and Go)
36
What is the best cognitive screening assessment in early decline, but isn't good in late decline?
MOCA
37
The mini-mental status exam is best used for monitoring what?
Cognitive decline
38
Is depression a normal part of aging?
No depression is not normal, older adults have a high rate of successful suicide attempts
39
What is a major cause of social and emotional distress in older adults?
Urinary incontinence
40
What types of physical activity should be encouraged to promote a healthy lifestyle in older adults?
Aerobic Muscle strengthening Flexibility Balance
41
What two alcohol screeners should be provided to prevent unhealthy alcohol use in older adults?
AUDIT-C CAGE (American Geriatric Society)
42
What are the recommended vaccines in older adults?
Tetanus (every 10 years) Annual influenza Zoster starting at 50 Pneumococcal Vaccine
43
What is the Pneumococal immunization recommendation for people age 65 or older (without previous vaccine or unknown vaccine status)?
1 dose of either PCV15 or PCV20 PPSV23 1 dose at least 1 year later if PCV15 used
44
What are the ages colorectal screening are recommended by USPSTF?
45-75
45
What are the ages breast screening are recommended by USPSTF?
biennial mammogram ages 50-74
46
When do cervical cancer screens end?
Age 65
47
What is the best test for colorectal cancer screeing?
The one the patient will do
48
Advanced care planning should be done when?
At all ages, not just older adults
49
What are the types of advanced directives?
Durable Power of Attorney for Healthcare Living Will Physician order for life-sustaining treatment (POSLT) DNR/DNI
50
When is the only time advanced directives should be acted upon?
When the patient loses the ability to make decisions for themselves

Patient Care II (11 decks)

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