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Clinical Disciplines II > prevention > Flashcards

prevention Flashcards

1
Q

health status of older adult composed of:

A

number of chronic diseases

Underlying physiologic changes in aging

Susceptibility to acute illness and injuries

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2
Q

what are some dz’s that are major causes of mortality?

A 
Heart disease
cancers (esp. lung, colorectal, breast)
lung disease
cerebrovascular disease/stroke
pneumona and influenza
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3
Q

what percentage of older adults have HTN?

A

40%

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4
Q

How many older adults have survived an MI or other heart problems?

A

1/3 have heart dz

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5
Q

what percentage of older adults have difficulty w/their everyday activities of daily living (ADL’s)

A

40%

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6
Q

what percentage o disability with ADL’s occur chronically/progressively? catastrophically (ie. hip fx)?

A

50%

50%

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7
Q

what are some precursors to disability?

A

difficult walking

cognitive impairment

visual impairment: affect ADL’s (taking meds) and walking

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8
Q

how do we modify the consequences of disease?

A 
health habits
screening: high risk for dz
immunizations: decrease risk 
access to health care
education: manage their own dz's
community services: support
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9
Q

what is primary prevention?

A

intervention to prevent disease or injury occurrence

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10
Q

what is secondary prevention?

A

intervention for those with early condition to prevent progression into complications

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11
Q

what is tertiary prevention?

A

efforts to improve care to avoid later complications

Can involve rehabilitation to optimize function

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12
Q

what is a major health outcome of chronic disease?

A

disability

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13
Q

benefit of prevention dependent on what 2 factors?

A

Prevalence of the problem

Likelihood of an effective intervention

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14
Q

in the older adult, how does prevention differ?

A

Target is typically prevention of syndromes such as falls, dizziness, and functional decline

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15
Q

what is iatrogenic disease and is it a problem for older adults?

A

= illness caused by medical examination or treatment

YES

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16
Q

what are some examples of primary prevention?

A 
vaccines
BP monitoring
smoking cessation
exercise
cholesterol
NA restriction
seat belts
social support
home environment eval
med review
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17
Q

what are some examples of secondary prevention?

A 
mammography
FOB, colonoscopy
hypothyroidism
vison
oral cavity
TB
skin care: hygiene/growths
18
Q

what are some examples of tertiary prevention?

A 
proactive primary care
comprehensive geriatric assessment
foot care
denal care
toileting efforts 
rehab/exercise
dietary protein
19
Q

what are the most feared outcomes of disability

A

loss of independence

20
Q

recommendations from ACP and ASIM?

A

broad screening:
IADL/ADL, cognitive, health status eval

for pt’s who at risk for becoming disabled or losing independence to identify where the prob. might exist

21
Q

recommendations from USPTF?

A

welcome to medicare visit

“periodic” screening in pt’s who are asxs w/out dz

persons 65+ y/o: screen, counsel, immunize

22
Q

what is included in a medicare visit?

A

eval med/fam hx, current health conditions, rx’s

check BP, vision, wt., ht for baseline care

pt’s status w/preventive screenings, immunizations

order tests depending on pt’s general health/medical hx

give checklist w/medicare-covered screenings and preventive services they need

23
Q

what is included in an annual wellness visit?

A

complete health risk assess

review list of providers

fam/med hx

depression, functional changes, safety

ht., wt. BMI, BP, cognitive status

written screening schedule

provide pt. education/refer

24
Q

what are things you need to include in your visit in order to provide effective preventative care for older adults?

A

immunizations

cancer screenings

screening for identification of psychosocial problems

screening for cognitive impairment

25
Q

A pt can achieve increased balance, stamina, Cardiovasc condition, strength, osteoporosis prevention, fall prevention through….

A

regular physical activity for a total of 150 mins (mod-intensity) weekly

26
Q

what suggests poor nutrition?

A

low body mass index or unintentional weight loss of >10lbs in 6 mo’s

27
Q

calorie needs ____ w/age, and nutritional requirements _____?

A

decline

remain the same

28
Q

what tool can help you assess nutritional status?

A

MNA = mini nutritional assessment

29
Q

what are ways to prevent osteoporosis and degenerative joint dz (DJD)?

A

pharmacologic, exercise, diet

walking: modest incr in skeletal load and limited benefit

strength training: effective for improving/maintaining bone mass

30
Q

what factors influence prevention of disability?

A

genetics, health status, comorbidities, mood, cognition, and beliefs

31
Q

what is the most preventable problem in the older adult?

A

iatrogenic prob’s

32
Q

what are some iatrogenic problems in older adults?

A 
underdiagnosis
bed rest
polypharmacy
environment hazards
transfer trauma
delirium
fluid overload, dehydration
overuse of abx
33
Q

what are some special risks of hospitals for older adults?

A

diminished reserves in cognitive, renal, and hepatic function

34
Q

how can elective surgery result in sepsis and death?

A

postop oversedation with pain meds –> decline in respiratory function w/ need for mechanical ventilation –> ventilator-assoc. pna –> sepsis and death

35
Q

how can hospital admission for pna or CHF lead to deconditioning, delirium, and sepsis?

A

lead to immobility –> UTI (catheter for monitoring UO) –> deconditioning, delirium, and sepsis

36
Q

what are potential complications of bed rest?

A 
Pressure ulcers
Bone resorption
Hypercalcemia
Postural hypotension
Atelectasis and pna
constipation
contractures
depression/anxiety
37
Q

what are potential complications of bed rest?

A 
Pressure ulcers
Bone resorption
Hypercalcemia
Postural hypotension
Atelectasis and pna
constipation
contractures
depression/anxiety
thromboembolism
38
Q

what are ways to prevent iatrogenic events?

A

Prescribe new medication only when necessary (Beer’s criteria)

optimize function and physical activity regardless of the environment

39
Q

how many pt’s 65+ y/o living at home suffer a fall each year?

living in LTC facilities?

A

home = 1/3

LTC = 1/2

40
Q

complications of falls in older pt’s

A 
injuries
fx's (hip, femur, humerus, ribs)
subdural hematoma
hospitalization
disability
41
Q

even if falling does not result in significant injury, significant disability may still result d/t…

A

the fear of falling, loss of self-confidence, and restricted ambulation

42
Q

additional management for fall prevention?

A

PT/OT therapy
gait/muscle training for strength
eval for assistive devices for ambulation
use of hip protectors

Clinical Disciplines II (4 decks)

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