Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IP > Older Adults > Flashcards

Older Adults Flashcards

1
Q

Malnutrition increases the risk of

A

Delirium
Depression
Falls
Impaired activity/ function
Mortality
Poor surgical outcome
Longer hospital stay
Readmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Determinants of food intake in older adults living with nutrition risk (low or poor food intake)

A

Low income
Live alone
Have low social support
Do not socialize frequently
Don’t drive
Report that they are depressed
Are disabled
Take 5+ meds
Poor oral health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How to detect malnutrition in community

What are the interventions one can do

A

Nutri-screen

Interventions:
- meal programs / assistance
-cooking and grocery support
-transportation
-financial support
-social programs
-dietitian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mobilization recommendations for frail older adults

A

Exercise 3 times per week for 30-45 min at an intensity of moderate- vigorous

Do various modalities including aerobic, resistance, balance and flexibility

10-20 min of training should be dedicated to aerobic training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mobilization recommendations for pre frail older adult

A

3 times per week, 45-60 min of moderate to vigorous intensity

30-40 min should be for resistance and balanced training activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Recommendations for mobilization to non frail older adult

A

150 min / week of moderate to vigorous activity

Muscle and bone strengthening 2 days per week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What screening tool do you use to detect potential alcohol problems in older adults

A

SAMI tool
Senior alcohol misuse indicator

A score of >1 suggests that the respondent is a problem drinker or an at risk drinker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pieces method is a method for what? And what does it stand for
And what do you do with it?

A

Help screen and assess behaviors in an efficient yet comprehensive way

P-physical
(Get collatersl info on physical causes such as pain, constipation, dehydration, hypoxia, hypotension, hunger, infection, disease, illness, drug related side effects

I-intellectual
-neurological condition that changes the way the pt may perfect or respond to his/ her environment and affects his/her functional ability

E-emotional

C-capabilities (compare ADL to the demands of the environmental)
Low demand= can trigger bordom , anger
High demand = trigger feelings of frustration, anxiety, avoidance, helplessness

E- environment (does jt meet the needs of the pt)

S- social/ cultural
Previous social habits vs now, social interaction, specific cultural aspects

What do you do with it ?
Create a plan that could be the main cause/ causes of his behavior

Follow up
Remember that nature of dementia is progressive and plan should be readjusted if something worked yesterday but not tomorrow

  • monitor caregiver burnout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Do you need to report elder abuse in LTC ?

A

Yes , long term care homes act indicates that it is mandatory to report to the ministry of health and long term care, abuse when you suspect or have evidence that elder abuse is taking place in a long term care home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Do you report elder abuse who don’t live in a long term care home?

A

The law does not require anyone to report the abuse.

Victims or anyone who suspects elder abuse can report their concerns to the police or to health or social services or get advice from a lawyer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diagnosis of CKD

A

If ACR >3, measure again 1-2 times over in the next 3 months (at least 2of 3 results >3 = CKD)

If eGFR <60, measure again in 3 months

You confirm CKD diagnosis after 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do you refer CKD to nephrology

A

If eGFR <30 and/or ACR >60
Esp if comorbid conditions and lab values with trends of urine ACR? EGFR , BPs, CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can you do in primary care to manage CKD?

A

Manage hypertension
Slow CKD down
Reduce risk factors
Minimize further kidney injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

7 As of dementia

A

Anosognosia (the person doesn’t know they don’t know)

Amnesia (memory loss)

Aphasia (problems with speech)

Agnosia (inability to recognize and attach objects; faces, smells and meaning

Apraxia (loss of ability to plan, initiate and sequence purposeful movement)

Altered perception (changes in perception for example visuospatial challenges in understanding concept of time)

Apathy (loss of drive to initiate activities)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which opioids should be avoided in older adults

A

Meperidine
Tramadol
Methadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diabetes diagnosis for older adults

A

FBG >7
A1C >6.5%

Could do random >11.1
OGTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should you stop screening for diabetes in older adults

A

Unlikely to be beneficial after 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are A1C targets for functionally independent older people

A

<7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Functionally dependent older adult, what is the A1C target

A

<8%

20
Q

Frail elderly or with dementia, what is the A1C target

A

<8.5%

21
Q

Which test may be used to predict which individuals will have difficulty learning to inject insulin

A

Clock drawing test

22
Q

Which anti diabetic agents should be used with caution with older people

A

SU- avoid , higher risk of hypoglycemia

DPP4- second like to metformin

23
Q

First line agent for insomnia in elderly

A

CBT-insomnia

24
Q

Which pharmacological options could you choose for older adult with insomnia

Which meds do you avoid?

A

Lower dose doxepin <6mg (TCA)
Or
Melatonin

Avoid:
-benzos
-z drugs
-antihistamines (d/t anticholinergic effect)

25
Q

Osteoporosis risk factors

A
26
Q

What happens if your T score is > -2.5
Or
Your 10 yr fracture risk is <15%

A

Low risk
Do not recommend pharmacotherapy

R/a 5 years

27
Q

What if your 10year fracture risk is 15-19.9%
Or
Tscore is <-2.5 and age is <70

A

Suggest pharm therapy

28
Q

What if 10 year fracture risk is >20%
Or
Tscore is <-2.5

A

Recommend pharm

29
Q

What are Nonpharm options for osteoporosis

A

Balance and muscle strengthening exercises twice weekly

Suggest eating foods rich in calcium and protein (1200mg of PO intake)

Suggest vitamin D 400units (19-50y without osteoporosis)

Health Canada recommends 600units if osteoporosis

30
Q

What age should you do BMD with no risk factors

A

70

31
Q

Age 55 with previous fracture , when should you do BMD

A

Obtain BMD and calculate frax

32
Q

What do you worry about with biphosphonate therapy

A

Atypical femoral fracture

33
Q

Signs and symptoms of atypical femoral fracture

A

Thigh or groin pain, unilateral or bilateral

34
Q

Management of AFF

A

stop biphosphonate stat
Refer to ortho surgeon stat
Plain xray stat

Should have a drug holiday after 5 years of biphosphonate therapy
Or 3 years with annual IV

Reasonable approach:
-measure BMD after 2-3 years of drug holiday and recalculate FRAX
- if lost BMD and is in high risk , resume for another 3-5 years

35
Q

When is drug holidays not recommended and when is it recommended

A

If you’ve had a previous fracture of spine or hip = not recommended

Recommended if:
Deemed high risk at the onset of therapy (>20% fracture risk)
-no prior history of vertebral fracture or hip fracture
-no fragility fracture
-femoral neck BMD Tscore is >- 2.5

36
Q

Gout flare first line options

A

NSAIDs (initiate 24 hours of acute gout attack)
Indomethacin is superior 25-50mg TID

Colchicine (not recommended >36h after symptoms)
1.2 mg initially then 0.6mg 1h later for total 1.8mg

Oral corticosteroids
Prednisone 25-50mg po daily x 5 days then stop

You want to avoid starting or stopping allopurinol during attacks as it may destabilize the microtophi and prolong the attack.

37
Q

What should you monitor for with couchicine and NSAIDs

A

If at renal risk = SCr

Colchicine = CBC, CK, renal function q6months

38
Q

Non pharm approaches to hyperuricemia

A

Diet low purine
Weight loss
smoking cessation
Decrease alcohol (esp. beer)
Drink 2L of water per day
Exercise

Acute attack : rest, elevate limb, ice, avoid contact

39
Q

Non pharm approaches to hyperuricemia

A

Diet low purine
Weight loss
smoking cessation
Decrease alcohol (esp. beer)
Drink 2L of water per day
Exercise

Acute attack : rest, elevate limb, ice, avoid contact

40
Q

When do you initiate maintenance / prophylaxis dose for gout

A

Recurrent attacks >2/ year
Uric acid levels >800
Chemotherapy
Advanced tophi on radiographic image
CKD > stage 2

41
Q

What is first line for maintenance / prophylaxis gout treatment

A

Allopurinol 100-300mg daily

Wait 2 weeks post flare to start

Target uric acid <360

42
Q

What do you monitor with allopurinol

A

Renal function and uric acid levels Q 3 months for 1st year then Q6motnhs

Can reverse tophi after months to years of use

43
Q

Which meds causes hyperuricemia and gout

A
44
Q

Which condition causes gout

A
45
Q

3 Ds risk factor of gout

A

Drugs ( ACEI/ARB, ASA, Chemo, cyclosporine, diuretics (HCTZ, loop), ethambutol, lead, levodopa)

Diseases (HTN, CKD, obesity, hyperglycaemia, hyperlipidemia, surgery/ trauma)

Diet (purine rich foods (alcohol, fish, red meat)

IP (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions