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EMRG 1305 > Week 11- Geriatrics > Flashcards

Week 11- Geriatrics Flashcards

1
Q

What happens to the respiratory system in geriatrics?

A

decrease in elasticity of the lungs and in size and strength

vital capacity decreases

residual volume increases

air flow deteriorates

resp rate increases

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2
Q

What happened to the PaO2 in older patients?

A

declines!!!!!!!
respiratory drive becomes dulled

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3
Q

What happens to the musculoskeletal changes that affect the resp system?

A

Kyphosis, the thoracic cage becomes increasingly stiff

chest expansion becomes limited by decreased pulmonary muscle strength/mass

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4
Q

What happens to the cardiovascular system in geriatrics?

A

there is increase in peripheral vascular resistance (after load) which decreases cardiac output and make them more prone to CHF

increase in cholesterol deposits as well as internal thickening of arteries, more prone to MI and HTN

arrhythmias are common and all come with their own risk

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5
Q

Overall decreases of the hearts efficiency causes what?

A

heart hypertrophies (works harder to pump)

cardiac output declines

arteriosclerosis

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6
Q

What happens the electrical activity in the heart when getting older?

A

the number of pacemaker cells in the SA node decreases causing bradycardia

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7
Q

What can severe renal disease lead to in geriatric patients??

A

Hyperkalemia! and cardiac arrest if untreated

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8
Q

When renal blood flow declines, which DECREASES renal function, this can cause……………

A

DECREASED clearance of toxins and prescription drugs as well as increased fluid retention causing peripheral edema

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9
Q

Incontinence is a normal part of aging- T or F?

A

false !! when renal problems arise, that is when that happens!

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10
Q

What cerebral vascular change happens in the body’s nervous system?

A

blood vessels get HARDER and more more to occlusions (STROKESSSS)

decrease in PAIN receptors sensitivity, pain threshold is higher

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11
Q

What happens to the BONES in geriatrics?

A

they become brittle and break more easily
cartilage in joints decreases
decrease in height as a person ages
joints lose flexibility and may be further immobilized by arthritic changes

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12
Q

What happens to muscles in a geriatric patient?

A

tendons and ligaments lose elasticity

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13
Q

What digestive changes happen?

A

MOUTH:
- decreases in appetite from diminished sense of taste and smell

  • reduction in the volume of saliva
  • dental loss is not a normal result of normal aging process

Gastric Secretions:
- enough acid remains to produce ULCERS under certain conditions

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14
Q

What happens to the SKIN in geriatric patients?

A

skin becomes thinner, drier (sweat gland activity decreases), less elastic, and more fragile

subcutaneous fat becomes thinner

bruising becomes more common

elastin and collagen decrease and thinner skin means tears more easily

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15
Q

In the liver, when a pt is prescribed numerous medications, the risk of what…. increases?

A

hepatic damage or medication toxicity increases

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16
Q

Why do the elderly fear hospitalization?

A

Fear of believing “they will never get out” as well as financial implication

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17
Q

What are some GOOD questions to ask during your geriatric assessment?

A

DNR?
Medications?
Past Med hx?
Are they ambulatory?
Hearing aids?
Cognitive function? Dentures?
Assess their living situation? Medical care?
Goals of care?
Family life?

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18
Q

What are common medical conditions in the elderly?

A

MI/Arrhythmia
CHF/COPD/Pneumonia/PE
UTI/Urosepsis
Diabetes
Arthritis/osteoarthritis
GI disturbances/bleeds
CVA

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19
Q

What are the 5 defenses our body has against infection??

A

Skin

Mucous membranes

Lysozymes

GI tract secretions

Immune response: B and T cells

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20
Q

What are the ways of transmission of communicable diseases?

A

Spread from person to person by several specific mechanisms:
- Airborne transmission
- Droplet transmission
- Contact transmission
- Vehicle transmission
- Vector-borne transmission

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21
Q

What are the FOUR influencing factors of disease infection?

A

Dosage of the organism

Virulence of the organism (severity or harmfulness of the disease)

Mode of entry

Host resistance

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22
Q

What are types of organisms that can infect a host?

A

Bacteria
Viruses
Fungi
Parasites
Protozoa
Helminths

23
Q

Definition: host resistance?

A

the ability to fight off infection

24
Q

Definition: incubation?

A

period between exposure to the organism and the first symptoms of illness

25
Q

Definition: communicable period?

A

period during which a person can transmit the illness to someone else

26
Q

Definition: contamination?

A

an object that has microorganisms on it or in it

27
Q

Definition: carriers?

A

infected individuals with no symptoms who are able to pass the disease on to others

28
Q

Definition: Reservoir?

A

a place where organisms may live and multiply, such as air-conditioning systems

29
Q

What is measles?
- other name for it
- how it is transmitted
- signs/ symptoms

A
  • rubeola, hard or red measles
  • HIIIIGH AIRBORNE transmission, droplets or direct contact with the nasal or pharyngeal secretions
  • fever, conjunctivits snd coryza, coughing, blotchy red rash, grey spots
30
Q

What is rubella?
- other name for it
- how it is transmitted
- signs/ symptoms

A
  • german measles
  • DIRECT contact transmission by direct contact wth nasal secretions of an infected person, droplet spread or touching pts or articles freshly contaminated
  • deafness, cataracts, mental retardation, heart defects

(often during winter and spring)

31
Q

What is mumps?
- other name for it
- how it is transmitted
- signs/ symptoms

A
  • mumps
  • droplet spread or direct contact of saliva in infected person
  • fever, swelling, and tendereness of one of the salivary glands
32
Q

What is chickenpox?
- other name for it
- how it is transmitted
- signs/ symptoms

A

-varicella
- direct contact or droplet spread of respiratory secretions in patients with chicken pox
- highly contagious, produces a slight fever, photosensitivity and a vesicular rash that gradually crusts over leaving and series of scabs

33
Q

What is pertussis (whooping cough)?
- other name for it
- how it is transmitted
- signs/ symptoms

A
  • transmitted by direct contact with discharges from mucous membranes and or airborne droplets
  • irritating cough that becomes paroxysmal in approx.1-2 wks may last up to 1-2 months
34
Q

What is meningitis?
- how it is transmitted
- signs/ symptoms

A

inflammation of the membranes that cover the brain and spinal cord
- two types: bacterial and viral

Signs and symptoms (same for viral and bacterial) include sudden-onset fever, severe headache, stiff neck, Kernig sign, Brudzinski sign, photosensitivity, and a pink rash that becomes purple.
– Changes in mental status, ranging from apathy to delirium
– Projectile vomiting is common.

35
Q

Which type of meningitis is communicable?

A

BACTERIAL, viral is NOT.

36
Q

What is tuberculosis?

A

Signs and symptoms include a persistent cough for more than 3 weeks plus one or more of the following:

Night sweats
Headache
Fever
Fatigue
Weight loss
Hemoptysis
Hoarseness
Chest pain
Transmission by airborne droplets

Communicable only when an active lesion develops in the lungs and bacteria are expelled into the air by coughing

37
Q

What is the difference between TB infection and TB disease?

A

TB infection (latent TB)-The individual has tested positive for exposure to TB but does not have, and may never develop, active disease.

TB disease-The individual has active disease

38
Q

What is PNEUMONIA?

A

Inflammation of the lungs

Triggered by bacteria, viruses, fungi, or other organisms

39
Q

What are symptoms of RSV and how is it transmitted?

A

Sneezing,
runny nose,
nasal congestion,
cough,
fever

Transmissions is by direct contact or indirect contact (contaminated hands or items!!!!!!)

40
Q

Who is most likely to develop RSV?

A

infants, older adults, and immunocompromised individuals

41
Q

What are symptoms of influenza ? How is influenza transmitted?

A

Systemic fever;
shaking chills;
headache;
muscle pain;
malaise;
loss of appetite;
dry, often protracted coughing;
hoarseness;
nasal discharge

droplets tranmissions

42
Q

What are scabies? What are symptoms?

A

Transmission occurs via direct skin-to-skin contact (wrestling; sexual contact; sharing undergarments, towels, and linens)

symptoms include nocturnal itching and the presence of a rash involving the hands, flexor aspects of the wrists, axillary folds, ankles, toes, genital areas, buttocks, and abdomen.

43
Q

What is lice?

A

Small insects that live in hair and feed on blood through the skin

All types of lice are acquired through direct contact with a person with an infestation.
Head and body lice can be acquired from objects such as hats, combs, or clothes infested with lice.

Pubic or crab lice transmitted through intimate physical or sexual contact.

Communicable period ends when all lice and eggs are destroyed.

44
Q

What is hepatitis?

A

inflammation of the liver caused by a virus

there is 6 forms viral hepatitis (A, B, and C accounting for 90% of acute infections)

all types present of the same signs and symptoms

45
Q

What is gastroenteritis?

A

Stomach flu
Comprises many types of infections and irritations of GI tract

Causes nausea and vomiting, fever, abdominal cramps, diarrhea

46
Q

What is HIV? And how is it transmitted?

A

Human immunodeficiency virus!!!!

it is blood borne transmitted from mother to infant in the birthing process and donated blood (or sexually transmitted)

pathogen envelops infected cells and attacks the immune system and other body organs.

Communicable period is unknown

Believed to span from the onset of infection possibly throughout life

47
Q

What is AIDS? (acquired immunodeficiency syndrome)

A

patients are extremely vulnerable to numerous bacterial, viral, and fungal infections.

Opportunistic infections include pneumonia in infants or people with compromised immune systems, loss of vision due to cytomegalovirus, reddish/purple skin lesions, atypical TB, and cryptococcal meningitis.

Communicable period is presumed to last as long as the patient is seropositive, even before clinically apparent AIDS develops.
New antiretroviral medications offer protection from transmission through treatment.

48
Q

What is Tetanus?

A

vaccine preventable disease

Tetanus bacillus found in the intestines of horses and other animals; transmission when tetanus spores enter the body by two means:

A puncture wound contaminated with animal feces, street dust, or soil

Contaminated street drugs
Incubation period is approximately 14 days; can be as short as 3 days.

49
Q

What are s/s of Tetanus?

A

Painful muscle contractions or rigidity (tetany) in the neck, face, jaw, and trunk muscles; abdominal rigidity (key sign, particularly in children); dysphagia, hydrophobia, drooling, and respiratory distress may also occur.

50
Q

What is antibiotic resistant organism?

A

overuse or misuse of antibiotics has led to some pathogens to develop resistance to the antibiotic drugs commonly prescribed

51
Q

What is Methicillin-Resistant Staphylococcus aureus (MRSA)?

A

Resistant to penicillin and other antibiotics

transmitted from patient to patient via unwashed hands

S/S: Localized skin abscesses and cellulitis, empyemas, and endocarditis; secondary infections such as osteomyelitis and septic arthritis

52
Q

What is Vancomycin-Resistant Enterococci (VRE)?

A

Normal organism of the GI tract, urinary tract and genitourinary tract.

transmission by direct contact with contaminated surfaces or equipment

53
Q

What are viral hemorrhagic fevers??

A

Ebola, Rift Valley, Hantavirus, Crimean-Congo, and Marburg

Spread to others via direct contact with blood and body fluids

Symptoms- Fever, headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain, and lack of appetite

Progresses to unexplained bleeding or bruising, hence the term “hemorrhagic”

EMRG 1305 (10 decks)

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