Select Geriatric Syndromes/ Pressure Ulcers Flashcards
- _____ ____r: Any lesion caused by unrelieved extemal pressure resulting in the occlusion of blood flow, tissue ischemia, and cell death
Pressure ulce
a. Impaired or restricted ______ is an important agent in the developmem of the pressure ulcers.
mobility
- Aging Skin
a. Skin loses _________ and immune response
sensation
- Aging Skin
b. Skin is ____ as resistant to the development of pressure ulcers
not
- Aging Skin
c. ___ warning signs may precede pressure ulcer formation
No
- Pressure ulcers may signal ____________, impaired dermatological functioning, and comorbidities.
malnutrition
- Mortality increases __-___ for people with pressure ulcers and six-fold for people with non-healing ulcers.
four-fold
- In dark-skinned people, Ulcers may be difficult to see; look for:
i) Discoloration
ii) Warmth
iii) ______
iv) Induration
v) Hardness
Edema
Staging Pressure Ulcers
3. Stage ___: Full-thickness skin loss involving the subcutaneous tissue
3
Staging Pressure Ulcers
4. Stage ___: Extensive tissue damage which extends to muscle, bone, or underlying structures
4
Staging Pressure Ulcers
1. Stage __: Intact skin with erythema that does not blanch
1
Staging Pressure Ulcers
2. Stage ___: Partial-thickness lesions extending into the epidermis and dermis
2
Staging Pressure Ulcers
- Stage 4:
a. Staging is not possible when _____ is present
until the devitalized tissue is removed and the
base of the wound can be seen
eschar
Staging Pressure Ulcers
- Stage 4:
b. Once a pressure ulcer is staged the healing
wound is not _________.
restaged
- Describe the wound’s location, shape, ______, size, type, and color
distribution
- _____________- is a reliable risk factor for pressure ulcer development, along with increased morbidity and mortality.
Hypoalbuminemia
Treatment Pressure ulcer:
1. Remove source of ischemic injury: Relieve ______
pressure
Treatment Pressure ulcer:
2. Wound care _____ consult
specialist
Non-operative for stage ____ and ___ pressure
ulcers
I and II
Stage III and IV ulcers may require ______
interventions
surgical
c. Approximately ___ to ____% of pressure ulcers are superficial and heal by secondary intention. As soon as pressure is relieved on otherwise healthy, vascularized skin, clinical improvement can be evident within 48 hours.
70% to 90%
Treatment Pressure ulcer:
6. ___ management, as needed
Pain
Treatment Pressure ulcer:
7. ______ consult and assessment
Nutritional
- Rehabilitation and ____ therapy
physical
- The literature suggest that approximately 6% of elderly report being abused, and it is estimated that ___ times as many are unreported
five
Elder Abuse
2. Women are more at risk than ____.
men
Elder Abuse
3. Most of the time (__%) the victim knows the abuser.
90%
Elder Abuse
4. Embarrassment, feeling overwhelmed, intimidation, and ____ contribute to reporting and addressing abuse.
isolation
Elder Abuse
5. Early intervention by addressing caregiver _____ through education, counseling, and referral to community agencies is prudent.
stress
Types of Elder Abuse:
1. Physical abuse
a. \_\_\_\_\_\_ that results in physical pain or injury
i) Pushing
ii) Slapping
iii) Hitting
iv) Improper physical restraintsViolence
Elder Abuse:
2. \_\_\_\_\_\_ or psychological abuse
a. Bestowing mental anguish
i) Intimidation
ii) Threatening
iii) Shunning
iv) Isolation
v) Insulting
vi) YellingEmotional
- ___ ____
a. Forced or non-consensual sexual activity
i) Rape
ii) Sexual harassment
iii) Forced viewing of pornography
iv) Molestation
v) Demented, delusional, sedated, and mentally
retarded individuals cannot give consent
Sexual abuse
- _____ ______
a. Misappropriate funds
i) Withdrawing money from accounts
ii) Removing valuable possessions
iii) Signing over of assets
Financial exploitation
- ______ neglect
a. Disregarding or ignoring needs of elders
i) Isolating the elder
ii) Unhealthy diet, oversedation
iii) Non-hygienicliving conditions
iv) Non-attention to one’s physical state
Cargiver
- ___-neglect
a. Non-attention to one’s own physical being: possible
mental health problems
i) Poor hygiene
ii) Untreated medical conditions
iii) Poorly kept home environment
Self
Elder Abuse Risk Factors
1. Lack of close _____ ties
family
Elder Abuse Risk Factors
2. Increasing ____
age
Elder Abuse Risk Factors
- Physical or ____ impairment
a. Caregiver stress
b. Unsafe housing
c. Poverty or financial distress
mental
Elder Abuse Risk Factors
4. Identifying and reporting elder abuse
a. The ____ _____mandates that hospitals
have procedures and training for reporting elder
abuse:
Joint Commission
Elder Abuse Risk Factors
4. Identifying and reporting elder abuse
a. The Joint Commission:
i) Collection, retention, and ______ of
evidence pertaining to elder abuse and
notification of proper authorities
safeguard
Elder Abuse Risk Factors
a. The Joint Commission mandates:
ii) Medical record includes:
a) Documentation of ______
b) Treatment given
c) Any referrals made to medical professionals
or community agencies
d) List of private and public community
agencies for evaluation and elder abuse
care
exam
Elderly Abuse Risk Factors:
5. Questioning a potential victim
a. Frame questions in a _______, non-judgmental
manner.
non-threatening
Elderly Abuse Risk Factors:
- Questioning a potential victim
b. Note any signs of ________
defensiveness.
Elderly Abuse Risk Factors:
- Questioning a potential victim
c. Has anyone tried to ___ you?
hurt
Elderly Abuse Risk Factors:
- Questioning a potential victim
d. Have you any recent ______?
injuries
Elderly Abuse Risk Factors:
- Questioning a potential victim
e. How did that injury (mark, ______ eye, burn, etc.) get there?
black
Elderly Abuse Risk Factors:
- Questioning a potential victim
f. Is there ____ where you live?
stress
Elderly Abuse Risk Factors:
- Questioning a potential victim
g. ____ me about your caregiver.
Tell
Elderly Abuse Risk Factors:
- Questioning a potential victim
h. How is your _____ being handled?
money
Elderly Abuse Risk Factors:
- Questioning a potential victim
i. Is anyone making you do anything you do not ____ to
do?
want
Elderly Abuse Risk Factors:
6. Physical examination
a. Injuries
i) Burns
ii) Bite marks
iii) Lesions from improper restraint use
iv) \_\_\_\_\_\_\_\_\_
v) Lacerations
b. Malnutrition
c. Personal hygiene
d. Appropriate dress
e. Dehydration
f. Pressure ulcers
g. Pain
h. Mobility and range of movement problems
i. Genital/rectal
i) Bleeding
ii) Discharge
iii) Infections
iv) Irritation
v) Injury
vi) Scarring
vii) Sexaully transmitted disease
j. Serum levels of medicationsHematomas
Elderly Abuse Risk Factors:
- Psychological assessment
a. Screen for depression
b. ______
c. Mental disorders
d. Dementia
e. Delirium
f. Evaluate for behavior
g. Mood
h. Affect
Anxiety
Elderly Abuse Risk Factors:
8.Evaluate, refer, and report
a. Most states have mandatory statutes for reporting.
b. All states have protection for those who report from
civil and criminal liability.
c. Penalties for not reporting include
i) Fines
ii) Damages
iii) \_\_\_\_\_ terms
iv) Loss of professional licenses Prison
Elderly Abuse Risk Factors:
8.Evaluate, refer, and report
a. Most states have mandatory statutes for reporting.
b. All states have protection for those who report from
civil and criminal liability.
c. Penalties for not reporting include
i) Fines
ii) Damages
iii) \_\_\_\_\_ terms
iv) Loss of professional licenses Prison
Sleep Disorders
General Comments:
1. More than ___-____ of all older adults report at least one recurring sleep complaint.
one-half
