The older patient

Question 1

Changes in physiolgoic reserve are influenced by what four things?

Answer 1

1. Periods of stress
2. Fluctuating temps
3. Dehydration
4. Shock

Question 2

What happens to the aorta and large arteries as we age? What does this cause?

Answer 2

Stiffening

Systolic HTN with a widened pulse pressure

Question 3

What happens to HR as we age?

Answer 3

Decreases

Question 4

What happens to our temperature control as we age?

Answer 4

Decreases –susceptibility to hypothermia

Question 5

What is age related hearing loss called?

Answer 5

Presbycusis

Question 6

What happens to saliva as we age? Consequences?

Answer 6

Decreased output, causing decrease in taste, olfaction, possible choking

Question 7

What happens to the thorax and lungs as we age?

Answer 7

Chest wall becomes stiffer, increased risk for atelectasis, pneumonia, and kyphosis

Question 8

S3 = what pathology?

Answer 8

Heart failure

Question 9

S4 = what pathology?

Answer 9

impaired ventricular filling

Question 10

What happens to abdominal pain as we age?

Answer 10

Not as significantly felt

Question 11

What two specific peripheral vascular diseases are more common as we age?

Answer 11

AAA

Temporal areritis

Question 12

Bruit in a neck = ?

Answer 12

Temporal arteritis

Question 13

What are the big tip offs for abuse?

Answer 13

Eye contact
Facial expressions
Tone
Who’s asking the questions

Question 14

Which CA should you be particularly concerned about in the elderly?

Answer 14

Colon CA

Question 15

What are the ADLs? (6)

Answer 15

1. Bathing
2. Dressing
3. Toileting
4. Transferring
5. Continence
6. Feedings

Question 16

What are the “instrumental activities”? (7)

Answer 16

Using the phone
Shopping
Food prep
Housekeeping
Laundry
Transport
Meds
Money

Question 17

What is the functional status of a pt?

Answer 17

Ability to perform tasks and fulfill social roles associated with daily living

Question 18

True or false: ALL of your visits with older patients are about helping to promote the pts independence and optimal level of functioning

Answer 18

True

Question 19

What is the “general survey” of the older pts PE?

Answer 19

Apparent state of health and hygiene

Question 20

What is the most common cause of hearing loss in the elderly?

Answer 20

Cerumen

Question 21

What are the heart signs to look for in the geriatric pt? (5)

Answer 21

1. JVD
2. Carotids
3. PMI
4. heart sounds
5. Pulses

Question 22

What are the keys items to look for on a geriatric abdominal exam? (2)

Answer 22

Aortic bruit

Renal or femoral bruit

Question 23

Disjointed speech can be indicative of what?

Answer 23

Dementia

Question 24

What happens to the skin as we age?

Answer 24

Loss of collagen= thinning

Question 25

What are the key things to look for in the thorax in the elderly?

Answer 25

chest diameter or pulmonary function change

Question 26

What are the key cardio problems to look for in the elderly?

Answer 26

JVDs, murmurs

Question 27

What are the breast/axillary things to look for in the elderly?

Answer 27

Lumps/masses

Question 28

What are the specific abdominal signs to look for the in elderly?

Answer 28

AAA

Bruit

Question 29

What are the 8 minimal geriatric competencies?

Answer 29

1. Med management
2. Cognitive and behavioral disorders
3. Self care capacity
4. Falls
5. health planning
6. Atypical presentation
7. Palliative care
8. hospital care for elders