The Older Patient

Question 1

What kind of temperature responses are “normal” in the elderly?

Answer 1

Hypothermic–also not that it is v. unusual to see an elderly individual with a v. high fever (this is a significant red flag)

Question 2

What are some of the normal changes in vital signs seen in the elderly esp. related to the cardiovascular system?

Answer 2

• Systolic HTN (150 mm/Hg is OK)
• Widened pulse pressure
• Orthostatic HTN

*****Note that there is a stiffening of the aorta & large arteries that underlies these changes

Question 3

What is the most common dysrhythmia seen in the elderly?

Answer 3

A-fib

**Don’t immediately try to convert this unless it is acute and symptomatic.

Question 4

What is presbycusis?

Answer 4

Age-related hearing loss

Question 5

What do you need to remember about the mouth & teeth of an elderly patient?

Answer 5

Decreased salivary production that leads to:

• Dysphagia
• Increased likelihood of aspiration
• Decreased taste & olfaction

Question 6

What are elderly patients at risk for that is esp. important post-op?

Answer 6

Increased risk of atelectasis & pneumonia

Question 7

You are able to hear a bruit in a patient’s jugular arteries with auscultation. What does this mean?

Answer 7

At least 70% occlusion of the vessel–warrants work-up

Question 8

What are some of the major psychosocial issues that you need to ask about with elderly patients?

Answer 8

1) How are they paying for meds
2) Can they pay heating & cooling bills
3) Transportation
4) Advance directives