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PAR3012 - Extended Care > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What are some clues to disorders in older patients in relation to Skin?

A

Skin

  • itching
  • -> allergic reaction/cancer/dry skin/hyperthyroidism/jaundice
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2
Q

What are some clues to disorders in older patients in relation to Head?

A

Head

  • Headache
  • -> anxiety/cervical osteoarthiritis/depression/subdural haematomas
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3
Q

What are some clues to disorders in older patients in relation to Eyes?

A

Eyes

  • Glare of lights at night
  • -> Cataracts/glaucome
  • Loss of central vision
  • -> macular degeneration
  • Loss of near vision
  • -> decreased accommodation of the lens
  • Loss of peripheral vision
  • -> retinal detachment/stroke
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4
Q

What are some clues to disorders in older patients in relation to Ears?

A

Ears

  • Hearing loss
  • Loss of high frequency range
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5
Q

What are some clues to disorders in older patients in relation to Mouth?

A

Burning mouth
- Pernicious anemia/stomatitius

Denture pain
- poor dentures/oral cancer

Dry mouth
- autoimmune disporders/dehydration/drugs

Limited tongue motion
- oral cancer/stroke/neuro-degenerative

Loss of taste
- Adrenal insufficiency/drugs/infection of mouth or nose

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6
Q

What are some clues to disorders in older patients in relation to Throat?

A

Dysphagia
- Anxiety/cancer/esophageal stricture/foreign body

Voice changes
- Hypothyroidism/vocal chord tumour

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7
Q

What are some clues to disorders in older patients in relation to Neck?

A

Pain

- cervical arthritits/carotid or vertebral artery dissection

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8
Q

What are some clues to disorders in older patients in relation to Chest?

A

Dyspnea during exertion
- Cancer/COPD/functional decline/heart failure/infection

Paroxysmal nocturnal dyspnea
- Gastroesophageal reflux/heart failure

Pain
- Angina pectoris/anxiety/aortic dissection

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9
Q

What are some clues to disorders in older patients in relation to GI?

A

Constipation with no othber symptoms
- Colorectal cancer/dehydration/drugs/hypercalaemia/hypokalaemia

Constipation with pain, vomiting and intermittent diarrhea
- Fecal impaction

Fecal incompetence
- Cerebral dysfunction/fecal impaction/ rectal cancer

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10
Q

What are some clues to disorders in older patients in relation to Musculoskeletal?

A

Back pain
- Abdominal aortic aneurysm/compression fracrtures/infection

Proximal muscle pain
- Myopathies/polymyalgia rhumatica

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11
Q

What are some clues to disorders in older patients in relation to Neurological?

A

Change in mental status with fever
- Delirium, encephalitis, meningitis, sepsis

Change in mental status without fever
- Acute illness, cognitive dysfunction, constipation (if severe), depression, paranoia, urinary retention

Clumsiness in tasks requiring fine motor coordination (eg, buttoning shirt)
- Arthritis, parkinsonism, spondyloticcervical myelopathy, intention tremor

Excessive sweating during meals
- Autonomic neuropathy

Fall without loss of consciousness
- Bradycardia, drop attack, neuropathy, orthostatic hypotension, postural instability, tachycardia, transient ischemic attack, vision impairment

Hesitant gait with intention tremor
- Parkinson disease

Numbness with tingling in fingers
- Carpal tunnel syndrome, peripheral neuropathy, spondyloticcervical myelopathy

Sleep disturbances
- Anxiety, circadian rhythm disturbances, depression, drugs, pain, parkinsonism, periodic limb movement disorder, sleep apnea, urinary frequency

Syncope
- Aortic stenosis, cardiac arrhythmia, hypoglycemia, orthostatic hypotension (especially drug-related), seizure

Transient interference with speech, muscle strength, sensation, or vision
- Transient ischemic attack, aphasia

Tremor
- Alcohol abuse, CNS disorder (eg, cerebellar disorders, poststroke), essential tremor, hyperthyroidism, parkinsonism

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12
Q

What are the changes to skin with age?

A
  • Thinner
  • Less elastic
  • Drier
  • Finely wrinkled
  • Less regular in pigmentation
  • Bruises more easily
  • Tears more easily
  • Slower to heal
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13
Q

How do you manage skin tears imt he elderly?

A
  • Gently cleanse the skin with saline
  • Allow the area to air-dry or pat carefully to dry
  • Replace the skin tear flap/tissue, if present, as closely as possible
  • Secure non-adherent moist dressings with gauze bandage
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14
Q

What are sime causes of malnutrition in the elderly?

A
  • Loss of appetite
  • Financial
  • Independence
  • Lack of transport access
  • Decreased functioning:
  • -> Food prep & cooking
  • -> Dementia or memory loss
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15
Q

WHat influences chest infection associated with age?

A

–Decreased cough & gag reflexes
–Loss of cilia in airways
–Increased chest wall stiffening
–Weakening of respiratory muscles

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16
Q

WHat influences Renal infection associated with age?

A

–Decreased renal function and ability to metabolise and excrete

17
Q

What does the ECP management of Infections include?

A 
Diagnosis
– Chest auscultation
– Chest percussion
– Mobile CXR
– Urine analysis
– POC Lactate Test (Sepsis)

Treatment
– Fluids, GP Consult, Antibiotics & Follow up R/V

18
Q

What is the best predictor of falling?

A

Previous history of falls

19
Q

What factors interacts to cause falls in elderly?

A

–Intrinsic factors (age-related decline in function, disorders, and adverse drug effects)

–Extrinsic factors (environmental hazards)

–Situational factors (related to the activity being done, eg, rushing to the bathroom)

20
Q

What some consequences of falls in elderly?

A

Injuries:
–Head (Superficial => Subdural)
–Fractures: #NOF, long bones, ribs
–Skin tears, bruises

Loss of:
–Loss of Function
–Loss of Independence
–Loss of Confidence
–Loss of Social contact

Longer Term:
–Loss muscle mass, strength etc.
–More at risk infections
–Depression

21
Q

What are the Biophysical factors related to ageing?

A
  • genetic influences
  • Blood pressure
  • Lung function
  • Medication use
22
Q

What are the Psychosocial factors related to ageing?

A
  • Cognition
  • Anxiety
  • Depression
  • Percieved stress
23
Q

What are the social factors related to ageing?

A
  • SES
  • Family background
  • Social support
  • Resources
24
Q

What are some referral considerations for ECP’s with the elderly?

A

–GP, Specialists, Dental
–Home and Community Care (HACC) with the Royal District Nursing Service (RDNS), Personal Alert Victoria (PAV)
–Physiotherapy, Occupation Therapy
–Other Community Services:

PAR3012 - Extended Care (12 decks)

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