Older persons Flashcards
Risk factors for falling
lower limb muscle weakness
vision problems
balance/gait disturbances
polypharmacy
incontinence
>65
fear of falling
depression
postural hypotension
arthritis in lower limbs
psychoactive drugs
cognitive impairment
Causes of primary syncope
dehydration
missed meals
extended standing in warm environment
vasovagal response
causes of secondary syncope
hypoglycaemia
dehydration
anaemia
infection
anaphylaxis
arrhythmias
valvular heart disease
HOCM
carotid sinus syndrome
orthostatic syncope
predisposing factors to acute confusional state
age > 65 years
background of dementia
significant injury e.g. hip fracture
frailty or multimorbidity
polypharmacy
precipitating effects for acute confusional state
infection: UTI
metabolic: e.g. hypercalcaemia, hypoglycaemia, hyperglycaemia, dehydration
change of environment
any significant cardiovascular, respiratory, neurological or endocrine condition
severe pain
alcohol withdrawal
constipation
features of acute confusional state
memory disturbances (loss of short term > long term)
may be very agitated or withdrawn
disorientation
mood change
visual hallucinations
disturbed sleep cycle
poor attention
acute kidney injury definition
increase in serum Cr 26umol/L within 48 hours
increase in serum Cr>1.5times above baseline value within 1 week
urine output <0.5ml.kg.hr for >6 consecutive hours
renotoxic drugs
ACE-I/ARBs
Spironolactone
Diuretics
Gentamicin - may need dose adjustment if necessary for treatment
NSAIDs
when to give dialysis in AKI
Persistently high potassium that is refractory to medical treatment
Severe acidosis (pH<7.2)
Refractory pulmonary oedema
Symptomatic uraemia (pericarditis, encephalopathy)
Drug overdose (e.g. aspirin)
complications of AKI
Hyperkalaemia
Pulmonary oedema
Metabolic acidosis leading to nausea, vomiting and drowsiness
Chronic kidney disease
Death
