Physiology

Question 0

Infection

Answer 0

Commonly atypical

• high temp is 37.7
• often go untreated because of this
• change in mental status
• change in balance and mobility, just don’t feel good
• can be often UTI

Question 1

Pain assessment

Answer 1

• decrease in ADLs
• decrease in activities
• behavioral change
• ask family
• irritation or change in mood
• sleeping more

Question 2

Presentation of sepsis

Answer 2

Atypical

- doesn’t always show with Leukocytosis and fever but instead shows as decreased appetite and or functional status

Question 3

What predisposes older adults to infection?

Answer 3

Diabetes mellitus (skin UTI)
Chronic obstructive pulmonary disease (pnuemonia)
Poor swallowing or gag reflex (aspiration pneumonia)
Long term indwelling catheters (UTI)
Prosthetic devices (artificial joints leading to septic arthritis)
Altered mental status

Question 4

Detecting atypical presentations

Answer 4

Problem focused history
Physical examination
Analyze data to determine whether or not an atypical presentation may exist

Question 5

What is a comprehensive problem focused history

Answer 5

First modifying your typical questions to pick up the atypical presentations
Thinking beyond the classic symptoms

Question 6

Physical exam

Answer 6

Fidgeting
Change in cognition
Restlessness 
Agitation 
Anxiety

Question 7

Goals of geratological nursing

Answer 7

• Achieve optimal function
• Maintaining homeostatic regulation
• Facilitate psychological functioning, maintenance of life styles and optimal quality of life
• Facilitate suitable access to and benefit of the health care and other systems
• Preserve or develop meaningful relationships. Including family and social support networks
• Identity safety risks and possible alternatives and advocate for the right of the client to live at personal risk without endangering others

Question 8

Predisposing factors to falls

Answer 8

Secondary diagnosis ( especially cardiovascular disease )
Advancing age
Recent admission
History of falls
Change in mental status
Transferring activities or the use of assistive devices

Question 9

What is a fall

Answer 9

Sudden
Uncontrolled
Unintentional
Downward displacement of the body to the ground of other object

Question 10

Near fall

Answer 10

Close to but doesn’t hit the ground

Precursor to falls

Question 11

Unwitnessed

Answer 11

On the floor and no one has seen it or knows how they got there

Question 12

Physical injuries from falls

Answer 12

Fractures
Hematoma
Transient confusion
Soft tissue injury

Question 13

Other issues with falls

Answer 13

1. Psychosocial- “ fear of falling”
2. Hosptitalization: latrogenesjs, infections, medications, deconditioning, immobility, functional change, disability, death

Question 14

Fall assessments tool

Answer 14

Schmid assessment tool
Risk assessment within 24 hours
Any change in status
With quarterly documentation