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older adults > older adults - final exam > Flashcards

older adults - final exam Flashcards

1
Q

more than 80% of older adults have

A

chronic medical conditions resulting in pain
osteoarthritis
PVD

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2
Q

pain is associated wih

A 
depression
sleep disturbances
dereased socialization
isolation
slowed GI = constipation
immune impaired
functional loss
increasing dependency
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3
Q

untreated pain can potentially cause

A 
tachycardia
increased myocardial oxygen consumption
delirium
immobility
splinting
atelectasis
pneumonia
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4
Q

characteristics of acute pain

A

fron injury, surgery or tissue damage
autonomic activity ass. = tachycardia, diaphoresis
time limited
subsides with healing

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5
Q

characteristics of chronic pain

A

more than 3-6 months
may or may not be from a disease
no autonomic activity
ass. w/ functional loss, disability, mood and behavior changes
reduced quality of life
treatment may be complicated by other diseases

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6
Q

pain scale that is more valid in older pop

A

verbal description

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7
Q

The ACCM recommends

A

using the numeric rating scale in the ICU

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8
Q

tylenol products potentially cause

A

liver damage

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9
Q

indicates the use of more medication than is clinically indicated 5+ drugs

A

polypharmacy

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10
Q

takes _ to _ prescriptions and _ OTC drugs at a time

A

4-5; 2

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11
Q

fills _ to _ prescriptions/yeart

A

12-17

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12
Q

main source of income is

A

social security

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13
Q

average spent for meds

A

$955

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14
Q

ambulatory

A

2-4 pres. drugs

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15
Q

in long term care

A

2-20 pres. drugs

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16
Q

_% of population takes _% of the prescription medication

A

13; 30

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17
Q

physician factors that lead to polypharmacy

A 
presuming pt. expects. pres. med
no med. review
no investigation of clinicals setting
complex, unclear instructions
automatic refills
lack of knowledge of geriaric clinical pharmacology
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18
Q

patient factors leading to poly pharmacy

A 
multiple doctors
hoarding/sharing
inaccurate reporting of all meds
assuming med. is indefinite
changes in daily routine
declining cognition, funds, function, living alone
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19
Q

preventing polypharmacy

A

written instructions
sensitivity to lack of funds - MSW referrral
brown bag exam every visit
pill boxes

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20
Q

5th leading cause of death

A

adverse drug reactions

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21
Q

falls from

A

orthostatic hypotension

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22
Q

changes in body drug distribution

A

higher percentage of fat
decreased total body water
decreased plasma albumin concentration

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23
Q

absorption changes

A 
delayed gastric emptying
decreased gastric acidity
decreased splanchic blood flow
mucosal edema
disease
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24
Q

changes in body composition changes

A

serum concenration of water-soluble drugs

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25
Q

change in fat mass affects

A

concentration of fat-soluble medications

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26
Q

drug clearance changes

A

altered liver metabolism

decreased renal excretion of drugs

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27
Q

decreased baroreceptor responses cause increased susceptibility to

A

positional changes

volume changes

28
Q

anticholinergic problems

A 
confusion
orthostatic hypo.
dry mouth
blurred vision
urinary retention
29
Q

these meds cause anticholinergic effects

A

TCAs

30
Q

effects of antiemetics

A 
confusion
ortho. hypo
blurred viision
falls
dry mouth
urinary retention
31
Q

% in hospital from iatrogenic complications

A

36%

32
Q

geriatric syndromes

A 
pain
falls
polypharmacy
incontinence
pressure ulcers
cognitive impairment/delirium
33
Q

fastest growing segment of US pop

A

old old 85 +

34
Q

frailty is 3 or more of the following

A 
unplanned weight loss (10lb in last yr)
weakness (dec. grip strngth)
poor endurance and energy
slowness
low activity
35
Q

risks of frailty

A 
dependency
institutionalization
falls
injuries
hospitalizations
slow recovery from illness
mortality
36
Q

this alone can start the geriatric cascade

A

hospitalization

37
Q

fear starts the downward spiral…..

A

fear - overly cautious - dec. activiy levels - muscle weakness - loss of mobility - loss of independence - social isolation and depression

38
Q

to prevent the cascade

A

identify frail pts
know the indicators of frailty & increased risk for poor outcomes
assess functional status before & during
observe for delirium
be aware of atypical disease presentation

39
Q

end stage frailty

A

Irreversible
hospice care
comfort & dignity

40
Q

respect for autonomy is the basis for

A

informed consent

41
Q

beneficence conflict when

A

pt. disagrees w/ treatment recommendations

42
Q

actions that serve the best interests of patients

A

beneficence

43
Q

first do no harm; must be balanced w/ beneficence

A

non-maleficence

44
Q

ageism or stereotyping is a form of

A

unethical thinking

45
Q

percent of informal caregivers are

A

women

46
Q

_ rely on families and friends for support/assistance

A

75%

47
Q

families provide _% of caregiving

A

families

48
Q

3 stages of caregiver burnout

A

frustration
isolation
despair

49
Q

provides for managemen of assets in case of disability (only for financial matters)

A

statutory durable power of attorney

50
Q

authorizes an agent to make health care decisions in the event of incapacity

A

medical power of attorney

51
Q

expresses the desire of grantor not to be kept alive by extraordinary means when grantor has been diagnosed w/ a terminal condition

A

advanced directive

52
Q

the legal means to care for a person and/or his estate when he can’t do so for himself

A

guardianship

53
Q

assisting w/ suicide or ending life by request

A

active euthanasia

54
Q

speeding death by treatment to prevent suffering or disease extension

A

double effect

55
Q

allowing death by forgoing extraordinary measures

A

passive euthanasia

56
Q

view death as inevitable and natural part of life cycle

A

death-accepting

57
Q

refuse to believe that death would take anything away and believe it could be overcome

A

death-defying

58
Q

refuse to confront death, believe that death is antithetical to living and that is not a natural part of human existence

A

deth-denying

59
Q

the process of psychological, social and somatic reactions to the perception of loss

A

grief

60
Q

cultural response to loss

A

mourning

61
Q

the state of having suffered a loss

A

bereavement

62
Q

the ability to comprehend info, consider options, evaluate risks, make a decision and communicate that decision

A

capacity

63
Q

only be decided judicially

A

competence

64
Q

pain management
physical suffering can always be alleviated
mot resricted to those who are dying or those enrolled in hospice programs

A

palliative care

65
Q

medieval concept of hospitality
care for patients at home
replaces medicare coverage for the terminal illness
can be provided in nursing home or inpatient setting

A

hospice

66
Q

resources for caregivers

A 
adult day care
respite programs
caregiver support groups
community mental health services
organizational resources by type of disease or illness

older adults (1 decks)

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