Term
| people ages 85 and up tend to be in __________ ___________ and use more _________ |
|
Definition
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Term
|
Definition
heart disease
malignant neoplasm
cerebrovascular disease
lower respiratory diseases
alzheimer's
DM
flu and pneumonia |
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Term
| most common chronic conditions |
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Definition
HTN 53.3%
arthritic symptoms 49.5%
heart disease 30.9%
cancer 21.1%
diabetes 18% |
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Term
| problems with chronic conditions |
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Definition
contribute to decreased functional ability
quality of life
housing choices and ability to remain in the community |
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Term
| how many older adults fall each year? |
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Definition
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Term
| what is the leading cause of death from injury in older adults? |
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Definition
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Term
| How do 74% of people over 65 rate their health? |
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Definition
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Term
| stochastic theory of aging |
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Definition
ramdom changes
accumulation of effects over time |
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Term
| nonstochastic theories of aging |
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Definition
predetermined onset and sequence of changes
could be based on number of cell divisions possible |
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Term
|
Definition
stochastic
ex: football, multiple childbirth, hard labor |
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Term
|
Definition
stochastic
proteins bind wrong and become dysfuctional |
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Term
|
Definition
stochastic
free radicals cause cell damage |
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Term
|
Definition
non-stochastic
boilogical clock= aging |
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Term
|
Definition
non-stochastic
change in t and b cells and responsivness |
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Term
|
Definition
non-stochastic
hormones are pacesetters |
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Term
| sociologic theory of aging |
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Definition
| non-biologic considerations: role, activity, disengagement, continuity, social exchange |
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Term
| age-related changes rule of thirds |
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Definition
1/3 due to disease
1/3 due to inactivity
1/3 due to aging itself
BUT EACH PERSON IS UNIQUE |
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Term
| body structure changes of aging |
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Definition
less subq fat
truncal obesity
height and bone mass loss |
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Term
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Definition
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Term
|
Definition
conduction speed decreases
bones are less sturdy
joints less stable
less muscle tone and reflex speed |
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Term
|
Definition
joint changes
ligament and tendons stiffen |
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Term
|
Definition
slower nerve conduction=slow reflexes
light accomodation changes
slower recall
slower learning |
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Term
|
Definition
smaller lung volume
smaller cardiac reserve
slower metabolism
smaller bladder volume |
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Term
| biphosphonates: action, SE |
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Definition
fosamax
remineralize bones
esophageal ulcers--watch for dysphagia, heartburn |
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Term
|
Definition
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Term
| what to do about 4th heart sound |
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Definition
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Term
| which murmurs are a problem? why? |
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Definition
| diastolic indicate backflow |
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Term
| with age, arteries become.... |
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Definition
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Term
| with age, how do veins change? |
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Definition
incompetent peripheral valves increase risk of DVT
thrombophlebitis
varicose veins |
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Term
| if you auscultate rales... |
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Definition
| have pt cough then listen again |
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Term
|
Definition
loss of elastic recoil
stiffening of chest wall
PO2 decreases
pH and PCO2 unchanged |
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Term
|
Definition
T3
aldosterone
renin
calicitonin
vasopressin
growth hormone |
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Term
|
Definition
norepi
parathyroid hormone
atrial natruiretic peptide
glucagon |
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Term
|
Definition
smaller in size
reduced flow
function unaltered |
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Term
| with age, cholesterol levels |
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Definition
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Term
|
Definition
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Term
| what is responsible for subdural hematoma risk? |
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Definition
| decreased adherence of dura mater to skull |
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Term
| what is the hallmark sign of alzheimer's? |
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Definition
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Term
|
Definition
diminished acuity
altered color discrimination (yellowing of lens)
more light needed
sensitivity to glare |
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Term
|
Definition
| farsightedness (can't see up close) |
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Term
|
Definition
opacity in lens
small print = problems
glare problems |
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Term
|
Definition
retina damage
abml proliferation of blood vessels damages macula
vision poor in front |
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Term
| what fraction of older adults are hard of hearing |
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Definition
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Term
|
Definition
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Term
| what is usually responsible for ED? |
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Definition
| medical problems: diabetes, cardiac problems, meds |
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Term
| reasons for predisposition to illness in older adults |
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Definition
functional changes (reduced cilia)
decrease in T cell function
reduced febrile response |
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Term
|
Definition
confusion
also...fatigue, loss of appetite, increased HR |
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Term
| stages of losing a spouse |
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Definition
1. reactionary
2. withdrawl
3. recuperation (6-12mos)
4. exploration (second year)
5. integration (5th year) |
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Term
|
Definition
subjective
objective
assessment
plan
intervene
evaluate
reassess/revise |
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Term
|
Definition
fluids
aeration
nutrition
communication
activity pain
elimination
socialization |
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Term
|
Definition
sleep disorders
probs with eating
incontinence
confusion
evidence of falls
skin breakdown |
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Term
|
Definition
| ongoing assessment that directs care plans |
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Term
|
Definition
| assesses basic activities and dependency |
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Term
|
Definition
| a little further left than normal |
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Term
| which pulse may be impossible to palpate? |
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Definition
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Term
| which drugs commonly cause tinnitis? |
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Definition
lasix
aspirin
aminoglycosides |
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Term
|
Definition
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Term
|
Definition
| cardiac and fluid overload, CHF |
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Term
|
Definition
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Term
|
Definition
| how many pillows do you use to prop up? |
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Term
| what causes varicose veins? |
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Definition
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Term
|
Definition
geriatric depression scale
beck depression inventory
zung depression scale
cornell depression scale |
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Term
| interventions for bowel obstruction |
|
Definition
good IV line (x2)
NG to suction
pain meds |
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Term
| ESR may be slightly _________ in older adults |
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Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| drop in BP, tachycardia, mental status change |
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Term
|
Definition
| poor skin turgor, dry membranes, mental status changes |
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Term
|
Definition
| muscle weakness, fatigue, cramps, constipation, hyporeflexia, tetany |
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Term
|
Definition
| weakness, cramps, increased GI motility, bradycardia, cardiac arrest |
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Term
| uric acid levels _____________ with age |
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Definition
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Term
| alkaline phosphatase levels |
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Definition
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Term
|
Definition
| lasix, aspirin, corticosterouds, thiazides, abx |
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Term
|
Definition
| reduced protein intake = reduced BUN |
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Term
| creatinine reduces b/c of |
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Definition
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Term
| creatinine may increase due to |
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Definition
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|
Term
| monitor creatinine if giving... |
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Definition
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Term
|
Definition
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Term
| any symptom in an elderly patient should be considered... |
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Definition
| a drug se unless proved otherwise |
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Term
| why are meds problematic in elderly? |
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Definition
body comp changes
multp. meds
mult diseases and symptoms
compliance |
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Term
| factors affecting elimination of drugs |
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Definition
decreased renal blood flow
decreased glomerular filteration rate
decreased turular secretory fx |
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Term
| factors affecting biotransformation |
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Definition
decreased hepatic mass
decreased hepatic blood flow
decreased enzyme activity
decreased enzyme inductibility |
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Term
| factors affecting drug absorption |
|
Definition
increased gastric ph
decreased absorbic surface
decreased splanchnic blood flow
decreased gastrointestinal activity |
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Term
| factors affecting drug distribution |
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Definition
decreased CO
decreased body water and lean mass
increased body fat
decreased albumin and protein binding |
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Term
| drug half life is _________ in elderly |
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Definition
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Term
| general rules of prescribing |
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Definition
specific reason for each
start one, stop one
start low, go slow |
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Term
| reasons for poor adherence |
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Definition
lack of understanding
sensory impairments
interferes with daily activities
comples regimen
expense |
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Term
| if you have _________ meds, you have a significant risk of at least one adverse rx |
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Definition
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|
Term
| confusion, depression, delirium, insomnia, incontinence, weakness, no appetite, falls, changes in speech |
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Definition
| adverse drug reaction symptoms |
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Term
| common anticholinergic symptoms |
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Definition
| decreased secretions, pupil dilation/blurred vision, tachycardia, urinary retention, decreased GI motility, constipation, decreased memory and concentration |
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Term
| signs of too much serotonin |
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Definition
| mental status changes, agitation, myoclonus, hyperreflexia, fever, diaphoresis, shivering, tremor, euphoria, drowsiness, sustained rapid eye mvt., diarrhea, incoordination, restlessness, tachycardia |
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Term
| most common anti-depressant type |
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Definition
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|
Term
Desyrel Demerol
Duspar Ultam
effexor Depakote
MAOIs Imitrex
St. John's Wort Remeron
Cocaine |
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Definition
| drugs linked to Serotonin Syndrome |
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Term
| which lab needs to be monitored with Digitalis? |
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Definition
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|
Term
| What do you assess before giving digitalis? |
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Definition
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Term
| side effects of digitalis |
|
Definition
| loss of appetite, nausea, diarrhea, wt loss, vision changes (yellowed lens), brady/tachycardia, dysrhythmias |
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Term
|
Definition
| fever, sweating, tachypnea, tachycardia, labile blood pressure |
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Term
| muscle rigidity, dysautonomia and fluctuating level of consciousness could indicate... |
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Definition
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Term
|
Definition
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Term
|
Definition
| fluctuates, often worse at night |
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Term
|
Definition
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Term
|
Definition
| often incoherent, slow or rapid, may call out or repeat same phrase |
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Term
|
Definition
| variable but may look disturbed |
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Term
|
Definition
| indisious, slow, over years |
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Term
|
Definition
| stable, may see changes with stress |
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Term
|
Definition
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Term
|
Definition
| often impaired, may make up answers, but tries to answer |
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Term
|
Definition
| difficulty finding word, perseveration |
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Term
|
Definition
| slowed response, may be labile |
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Term
|
Definition
drug use
electrolyte & physiologic abnormalities
lack of drugs
infection
reduced sensory input
intracranial probs
urinary retention and fecal impaction
myocardial problems |
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Term
| risk factors for delirium in elderly |
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Definition
mult, severe med conds
low albumin
dementia
polypharmacy
metabolic disturbances
advanced age
infection
fractures
hypothermia
psychoactive drugs
visual impairment |
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Term
|
Definition
| O2, hydration, pain control, med management, environment, communication |
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Term
| Confusion Assessment Method (CAM) |
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Definition
1. Acute change in mental status
2. Fluctuate
3. Inattention
PLUS
4. Altered LOC
OR
5. Disorganized thinking |
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Term
| 4 tenets of dementia care |
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Definition
know person
recognize abilities
keep environment safe
relate well |
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Term
| most common cause of dementia |
|
Definition
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|
Term
| characteristics of alzheiner's |
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Definition
| amnesia, agnosia, apraxia, aphasia |
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Term
|
Definition
| impaired ability to recognize people or things |
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Term
| early stage of alzheimers |
|
Definition
| disoriented, a little lost |
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Term
| middle stage of alzheimer's |
|
Definition
personal care probs
some incontinence
more supervision needed |
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Term
| late stage of alzheimer's |
|
Definition
cannot perform self care
needs constant supervision
gradually can't speak, walk, swallow |
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Term
|
Definition
| cholinesterase reuptake inhibitor, for Alzheimers |
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Term
|
Definition
| Exelon, patch form of AD tx |
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Term
|
Definition
|
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Term
|
Definition
| Namenda, AD treatment, late phase, works on glutamate metabolism |
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Term
|
Definition
maintain independence
promote wellness and comfort
promote safety
modify distressing behavior
support family |
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Term
|
Definition
| eosinophilic intracytoplasmic neuronal inclusions in cortex |
|
|
Term
| symptoms of dementia with lewy bodies (DLBD) |
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Definition
paranoia, delusions, hallucinations (strange dreams)
Parkinsonian symptoms |
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Term
| What affect may antipsychotics have on DLBD? |
|
Definition
ACUTE deterioration due to eps
and NMS
NO Haldol, abilify |
|
|
Term
|
Definition
prevent falls
avoid antipsychotics
comfort for hallucinations
recognize and treat depression |
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|
Term
| frontotemporal dementia--names |
|
Definition
Picks Disease
Cortical Dementia
depends on where lesions are located |
|
|
Term
| frontotemporal dementia characteristics |
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Definition
more rapid progression than AD
behavioral disturbances (inhibitions are impaired) |
|
|
Term
| nsg for frontotemporal dememtia |
|
Definition
| address hygiene, lack of social tact, sexual disinhibition, oral exploration of objects, inappropriate touching, apathy/depression |
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|
Term
| vascular dementia results from... |
|
Definition
|
|
Term
| vascular dementia characteristics |
|
Definition
abrupt onset
deterioration
fluctuating course
nocturnal confusion
preservation of personalitly
depression
somatic complaints
emotional lability
HTN
atherosclerosis |
|
|
Term
| most important nursing approach to vascular dementia |
|
Definition
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|
