Week 4 Flashcards

1
Q

what are types of bone diseases in geriatricts?

A
  • Osteoporosis (women > men)
  • Osteoarthritis
  • Scoliosis
  • Kyphosis
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2
Q

WHat are considerations of geriatricts and the CNS with trauma?

A

Cognitive impairment
• Cause trauma
• Subtle sign & symptoms

More susceptible to shearing forces, axonal injuries, subdural/epidural hematoma
• ↓ elasticity of the bridging veins lining the meninges
• ↓ number of neurones and functions
• Brain Mass↓
• ↑ Relative intracranial space

Reduced pain perception
• ↓ intensity and quality of pain

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3
Q

What happens with skin and ageing?

A

Skin loses structural support of elastin fibres and atrophy of all skin layers
• Skin becomes more fragile
• Delayed wound healing
• ↑Risk for full-thickness injury

  • Difficulty maintaining body temperature
    • Trauma’s lethal triad?
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4
Q

what are some common antigoagulants and antiplatelet medications old people might be on?

A
  • Aspirin
  • Clopidogrel (Plavix)
  • Warfarin
  • Apixaban (Eliquis)
  • Dabigatran (Pradaxa)
  • Rivaroxaban (Xarelto)
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5
Q

what are some special considerations with geriatircts and their co-morbidities?

A
  • > 50% have underlying HTN*
  • > 30% have heart disease*
  • VSS could be falsely reassuring
  • Polypharmacy, PPM could confuse vital signs
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6
Q

what should you consider with the geriatric airway?

A
  • Partial plates, dentures could become foreign bodies if dislodged
  • Intact dentures could be crucial to good seal (during assisted ventilation)
  • Speech characteristics (e.g. garbled sound) might indicate FBAO
  • Pre-existing conditions might affects airway (e.g. COPD)
  • Bone disorders may alter normal alignment of head and neck
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7
Q

what should you consider with the geriatric breathing?

A
  • Less pulmonary reserve
    * Might requires oxygen to avoid hypoxia (in major trauma)
  • Muscle fatigue will occur more quickly
    * Frequent RSA?
  • Positioning
    * Spinal immobilisation might affects ventilation
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8
Q

what should you consider with the geriatric circulation?

A
  • Vulnerable to shock
  • Early signs could be subtle
  • Age-related and medication-related delay in compensatory response, false security
  • Altered conscious state due to poor perfusion
  • Large volume of fluid given too fast aren’t well tolerated by elderly
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9
Q

What is the best predictor for future falls in elderly?

A

> 2 falls within 12/12 is the best predictor of future fall risk

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10
Q

what can the pain of a rib fracture cause in elderly?

A
  • Hypoventilation, reluctant to cough
  • Atelectasis, retained bronchial secretions
  • Pneumonia and respiratory failure
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11
Q

what is most common fracture in geriatrics?

A

Hip and NOF

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12
Q

What is the second most fracture in geriatrics?

A

Collies - wrtist

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13
Q

What is the presentation of burns with elderly?

A

more likely to be deeper and wider surface area

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14
Q

what is primary and secondary head injuries?

A
  • Primary – initial focal injuries, such as contusion or haemorrhage
  • Secondary – poor cerebral circulation, hypoxia or oedema
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15
Q

What kind of spinal injuries are common with elderly?

A
  • C1 or C2 #
  • Even from simple fall
  • High cervical # are more common in elderly
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16
Q

What is central cord syndrome?

A
  • Complication of C-Spine injury
  • More likely in older trauma patient
  • Disproportionately greater motor impairment in upper extremities
  • Bladder dysfunction, urinary retention
  • Variable degree of sensory low below the level of injury
17
Q

what are some considerations with elderly and c-collars?

A

do NOT tolerate C-collars well (Not to spine-board neither)

  • Spinal immobilisation restricted respiration by an average of 15%*
  • More pronounced at extremes of age
  • OP and Kyphosis may complicate positioning
18
Q

why are epidural haematomas less likely in elderly?

A

because the dura becomes tighly adhered to the skull