Week 11- Geriatrics Flashcards
What happens to the respiratory system in geriatrics?
decrease in elasticity of the lungs and in size and strength
vital capacity decreases
residual volume increases
air flow deteriorates
resp rate increases
What happened to the PaO2 in older patients?
declines!!!!!!!
respiratory drive becomes dulled
What happens to the musculoskeletal changes that affect the resp system?
Kyphosis, the thoracic cage becomes increasingly stiff
chest expansion becomes limited by decreased pulmonary muscle strength/mass
What happens to the cardiovascular system in geriatrics?
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
Overall decreases of the hearts efficiency causes what?
heart hypertrophies (works harder to pump)
cardiac output declines
arteriosclerosis
What happens the electrical activity in the heart when getting older?
the number of pacemaker cells in the SA node decreases causing bradycardia
What can severe renal disease lead to in geriatric patients??
Hyperkalemia! and cardiac arrest if untreated
When renal blood flow declines, which DECREASES renal function, this can cause……………
DECREASED clearance of toxins and prescription drugs as well as increased fluid retention causing peripheral edema
Incontinence is a normal part of aging- T or F?
false !! when renal problems arise, that is when that happens!
What cerebral vascular change happens in the body’s nervous system?
blood vessels get HARDER and more more to occlusions (STROKESSSS)
decrease in PAIN receptors sensitivity, pain threshold is higher
What happens to the BONES in geriatrics?
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
What happens to muscles in a geriatric patient?
tendons and ligaments lose elasticity
What digestive changes happen?
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
What happens to the SKIN in geriatric patients?
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
In the liver, when a pt is prescribed numerous medications, the risk of what…. increases?
hepatic damage or medication toxicity increases
Why do the elderly fear hospitalization?
Fear of believing “they will never get out” as well as financial implication
What are some GOOD questions to ask during your geriatric assessment?
DNR?
Medications?
Past Med hx?
Are they ambulatory?
Hearing aids?
Cognitive function? Dentures?
Assess their living situation? Medical care?
Goals of care?
Family life?
What are common medical conditions in the elderly?
MI/Arrhythmia
CHF/COPD/Pneumonia/PE
UTI/Urosepsis
Diabetes
Arthritis/osteoarthritis
GI disturbances/bleeds
CVA
What are the 5 defenses our body has against infection??
Skin
Mucous membranes
Lysozymes
GI tract secretions
Immune response: B and T cells
What are the ways of transmission of communicable diseases?
Spread from person to person by several specific mechanisms:
- Airborne transmission
- Droplet transmission
- Contact transmission
- Vehicle transmission
- Vector-borne transmission
What are the FOUR influencing factors of disease infection?
Dosage of the organism
Virulence of the organism (severity or harmfulness of the disease)
Mode of entry
Host resistance
What are types of organisms that can infect a host?
Bacteria
Viruses
Fungi
Parasites
Protozoa
Helminths
Definition: host resistance?
the ability to fight off infection
Definition: incubation?
period between exposure to the organism and the first symptoms of illness
Definition: communicable period?
period during which a person can transmit the illness to someone else
Definition: contamination?
an object that has microorganisms on it or in it
Definition: carriers?
infected individuals with no symptoms who are able to pass the disease on to others
Definition: Reservoir?
a place where organisms may live and multiply, such as air-conditioning systems
What is measles?
- other name for it
- how it is transmitted
- signs/ symptoms
- 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
What is rubella?
- other name for it
- how it is transmitted
- signs/ symptoms
- 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)
What is mumps?
- other name for it
- how it is transmitted
- signs/ symptoms
- mumps
- droplet spread or direct contact of saliva in infected person
- fever, swelling, and tendereness of one of the salivary glands
What is chickenpox?
- other name for it
- how it is transmitted
- signs/ symptoms
-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
What is pertussis (whooping cough)?
- other name for it
- how it is transmitted
- signs/ symptoms
- 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
What is meningitis?
- how it is transmitted
- signs/ symptoms
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.
Which type of meningitis is communicable?
BACTERIAL, viral is NOT.
What is tuberculosis?
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
What is the difference between TB infection and TB disease?
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
What is PNEUMONIA?
Inflammation of the lungs
Triggered by bacteria, viruses, fungi, or other organisms
What are symptoms of RSV and how is it transmitted?
Sneezing,
runny nose,
nasal congestion,
cough,
fever
Transmissions is by direct contact or indirect contact (contaminated hands or items!!!!!!)
Who is most likely to develop RSV?
infants, older adults, and immunocompromised individuals
What are symptoms of influenza ? How is influenza transmitted?
Systemic fever;
shaking chills;
headache;
muscle pain;
malaise;
loss of appetite;
dry, often protracted coughing;
hoarseness;
nasal discharge
droplets tranmissions
What are scabies? What are symptoms?
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.
What is lice?
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.
What is hepatitis?
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
What is gastroenteritis?
Stomach flu
Comprises many types of infections and irritations of GI tract
Causes nausea and vomiting, fever, abdominal cramps, diarrhea
What is HIV? And how is it transmitted?
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
What is AIDS? (acquired immunodeficiency syndrome)
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.
What is Tetanus?
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.
What are s/s of Tetanus?
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.
What is antibiotic resistant organism?
overuse or misuse of antibiotics has led to some pathogens to develop resistance to the antibiotic drugs commonly prescribed
What is Methicillin-Resistant Staphylococcus aureus (MRSA)?
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
What is Vancomycin-Resistant Enterococci (VRE)?
Normal organism of the GI tract, urinary tract and genitourinary tract.
transmission by direct contact with contaminated surfaces or equipment
What are viral hemorrhagic fevers??
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”
