Patient Assessment Flashcards
What are the Social determinants of health (SDOH)?
-Health and Health care: trauma, loss, substance abuse, legal issues
-Social and Community: are they married?, family, social contacts
-Education: health literacy
-Economic: financial situation, work status, paying responsibilities (caregiver)
-Neighborhood: can they prepare food?, transportation, food stamps needed?
3 ways to improve the affordability of medications for geriatrics
-Max the min
-use generics
-enroll in the best prescription plan (Part D)
-use coupons, 4$/10$ lists, 90-day supply (for chronic meds)
-use patient assistant programs (PAP) for high cost meds or uninsured patients
What is the purpose of the max-the-min approach?
maximize the minimum number of effective and necessary meds (medication optimization)
Which tool is used to assess an adult’s health literacy?
REALM-SF
Rapid Estimate of Adult Literacy in Medicine Short Form
the higher the better
if <7 we should be concerned
What are the common sensory challenges in elderly patients, and how should they be addressed?
-visual and auditory
-read to them, talk louder, offer hearing aids, refer
What is Geriatric syndrome (I’s) referred to?
-Iatrogenesis (unintended side effects of treatment)
-Immobility
-Impaction of bowels
-Impotence
-Ianititon
-Incontinence
-Infection
-Insomnia
-Instability (walking)
-Intellectual
-Isolation
What is the most common form of elder mistreatment?
From the video
Self-neglect
fails/refuses to address physical, emotional and social needs
other signs:
-frequent ER or doctor visits
Which assessment tool can be used to assess depression?
PHQ-2
PHQ-9
GDS
What score on the GDS suggests depression?
more than 5 suggests depression
What score on the STEADI assessment tool suggests a high risk of falls?
> 4 indicates a higher risk of falls
Which assessment tool can be used to assess cognitive function?
MMSE
SLUMS or MoCA
Mini-Cog
What score on the Mini-Cog indicates cognitive impairment?
3 or lower indicates cognitive impairment
What are the symptoms of depression in elderly patients?
-fatigue
-insomnia
-irritability
-confusion
-aches and pains
What is a way to assess if an older patient can still care for themselves? (Functional assessment)
Activities of daily living (ADL)
Instrumental Activities of Living (IADLs)
Environment
Fall risk
What are the Activities of Daily Living?
Eating
Bathing
Dressing
Transferring
Toileting
Instrumental Activities of Daily Living
-shopping
-preparing the food
-housework
-managing finance
-transportation to visits
Which tools are used to assess the risk of falling?
STEADI
Fall Risk Questionnaire (FRQ)
Timed Up and Go Test
Ask for fear of falling
How many seconds of the Timed Up and Go Test suggest an increased risk of falling?
> 12 seconds
