Term
| Why is gerontology more important now than ever? |
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Definition
| In 2011, the first baby boomers turn 65. By 2030 71.5 million ppl >65, 20% of US Pop |
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| Which group tends to be in poorer health and use more services? |
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| In 1900 there were only 100,000 ppl >___; in 2050 there will be 21 million. |
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Definition
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Term
| What are the 3 highest chronic conditions in old people? |
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Definition
HTN
Arthritic Sx
Heart disease |
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Term
| The living arrangements for what population of elderly changed dramatically? |
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Definition
| Women, more were living with other relatives than before |
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Term
| Top Causes of death of elderly (2004) |
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Definition
Heart Disease
Malignant Neoplasm
Cerebrovascular Disease
Chronic Lower Respiratory
Alzheimer's
DM
Flu/Pneumonia |
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Term
| A third of the population >85 has what as a major reason to go to assisted living? |
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Definition
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| 74% of people >65 rate their health as what? |
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Definition
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| ___% over 65 are disabled. |
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| 1/3 of older adults ____ each year. This is the reason for 40% of SNF admissions every year. |
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| ____ is the leading cause of death from injury in older adults. |
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Woman age 80 or older
Lives alone or with abuser
Physically disabled
Mentally or cognitively disabled
Dependent on abuser
are vulnerable to what? |
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Definition
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Term
| If you have “reason to believe” that abuse has occurred (or is occuring), you must report it to ________. |
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Definition
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| 42% >___ have ADL limitations or live in a SNF. |
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Definition
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Term
| Theory of aging with random changes and accumulation of effects over time. |
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| Predetermined onset and sequence of changes in aging. |
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| Non-functional protein stochastic theory of aging. |
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| Antioxidant curable stochastic theory of aging. |
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Definition
Wear & Tear
Free Radical
Cross Linkage |
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Definition
Programmed
Immunity
Neuroendocrine (Pacemaker) |
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Definition
1/3 due to result of functional decline r/t disease
1/3 due to inactivity or disuse
1/3 due to aging itself |
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Term
| Elderly have a decrease in ___ layer. |
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Definition
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| Between ages 20 and 70 most of us will lose __ in of height. |
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Definition
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| Dowager's hump that decreases lung function. Think osteoporosis |
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Definition
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| Elderly have increase in _____ obesity |
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| Center of gravity shift ____ in the body. |
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| In elderly less muscle strength, changes in peripheral nerve conduction to muscles, bones are less ______, joints are less _____ and skin is ______. |
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Definition
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| Abnormal dryness of skin or mucous membranes. |
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Definition
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| Older adults are at risk of generalized hypothermia if their home is < ___ degrees. |
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Definition
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Term
| Proportion of water in body mass _______. |
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Definition
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Term
| Older adults have ________ lung volume, cardiac reserve, urinary bladder volume. |
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Definition
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Term
| Older adults have _____ nerve conduction velocity, responses to stimuli, reflexes, adaptation to changes in light, recall of information, learning and metabolism. |
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Definition
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Term
| ___% of men have male pattern baldness. |
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Definition
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| ________ happens before osteoporosis. |
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Definition
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Term
| This drug class for osteoporosis can cause esophageal ulcers. |
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Definition
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Term
| S3 is _______; S4 is ________. |
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Definition
| Pathological, physiological |
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Term
| Systolic murmurs are _______; Diastolic murmurs are __________. |
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Definition
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| Systolic pressures in elderly may increase due to arterial stiffening, but they should not exceed _____. |
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Definition
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| The decreased competency of peripheral valves can cause ______. |
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Definition
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| _____ in elderly are less elastic and muscular leading to ortho HoTN and decreased compensation abilities. |
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Definition
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| ____ ABG value in elderly decrease. |
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Definition
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| Elderly lungs have loss of _____ ____ and stiffening of the chest wall. |
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Definition
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| In kidney they have reduced blood flow, loss of nephrons and reduced ______. |
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Definition
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| Is elderly incontinence is ______, and increased frequency is _______. |
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Definition
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| _____ in elderly is abnormal, but decreased gastric motility and secretions is normal. |
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Definition
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Term
| Altered balance, slowed recovery and increased fall risk are because of what? |
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Definition
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Term
| 18% of elderly have decreased vision even ___ _______. |
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Definition
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| Altered color discrimination and sensitivity to ______ is common. |
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Definition
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| Altered color discrimination and _______ of the lens is common. |
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Definition
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| Increased ICP in Ant. chamber |
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Definition
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| Opacities that make elderly hate to drive at night |
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Definition
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Term
| Degenerative disease of retina |
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Definition
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Term
| Ppl c macular degernation can see at the ______, but not in the _____. |
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Definition
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| Cataracts are worse in ppl c _____ eyes and in ppl in UV light w/o protection. |
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Definition
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| Abnormal proliferation of blood vessels that damages the retina. Worst. |
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Definition
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Term
| High frequency hearing loss |
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Definition
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| Easily curable cause of hearing difficulty |
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Definition
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| _____ is regulated by the vestibular system. |
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| About a fourth of ppl >65 have no _____. |
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| ______ necessary for taste perception rises, # taste buds decreases, taste may be altered by disease or medication. |
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Definition
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| Elderly can have impaired smell sensitivity r/t history of ____ and chronic nasal ______. |
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Definition
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Term
| Due to reduced number of peripheral nerve endings, elderly can have altered perception of these 4 things. |
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Definition
Temperature
Pressure
Vibration
Pain |
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Term
| Reproductive issues affecting elderly men |
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Definition
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| Reduced cilia in lungs and decreased T cell function impair the ______ system. |
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Definition
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| Older adults have reduced _____ response and a normally lower temp. |
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Definition
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Term
| #1 Sign of infection in adults. |
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Definition
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Term
| Erickson developmental task in elderly |
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Definition
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Term
| Due to our changing society, many grandparents are having to help raise their grandchildren. This can lead to a _______ burden. |
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Definition
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Term
| Older men have increased risk of _____ after loss of spouse. |
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Definition
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| Adjusting to loss of spouse 5 stages |
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Definition
Reactionary (first few wks)
Withdrawal (first few months)
Recuperation (2nd 6 months)
Exploration (2nd year)
Integration (5th year) |
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Term
| SOAPIER assessment acronym |
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Definition
Subjective data
Objective data
Assessment
Plan
Intervene
Evaluate
Reassess |
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Term
| ____ _______ may take a long time in elderly |
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Definition
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| Interview with family member ONLY if older adult gives ________. |
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Definition
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Definition
Sleep disorders
Problems eating
Incontinence
Confusion
Evidence of falls
Skin breakdown |
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Term
| ____ pulses in elderly may be hard to find. |
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Definition
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Term
| _____ in adults may not be elevated in infection. |
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Definition
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Term
| _____ the brachial pulse and choose correct cuff size. |
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Definition
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| Apical pulse is at __ ICS and a little more to L than usual. |
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Definition
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| If hear crackles/rales ask pt to ____ and check again. |
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Definition
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| Ask about ___ on inspiration, expiration or at rest. |
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| Orthostatic & Post-prandial |
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| _&_ will be artifically high if pt is dehydrated |
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Definition
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| ____ lab value may not be increased in infection. |
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Definition
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| Meds cause __ imbalances as #1 electrolyte problem. |
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Definition
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| Lasix, aspirin, corticosteroids and thiazides can increase _____. |
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Definition
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| Reduced muscle mass leads to reduced ___ whereas reduced renal excretion leads to increased ___. |
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Definition
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| What must you monitor if give nephrotroxic drugs? |
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| ((140-Age)x wt (kg))/ (72 x serum creatinine) |
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Term
| To get a females CrCl, multiply the # by __. |
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Definition
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| The _____-______ equation is used to calculate CrCl. |
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Definition
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| PT level >____ panic level. |
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Definition
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Definition
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| Monitor ____ for Heparin. |
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Definition
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Term
| Any symptom in an elderly patient should be considered a _____ ______ ______ until proved otherwise. |
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Definition
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Term
| Low serum albumin causes higher levels of _____ drug. |
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Definition
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Term
| Digitoxin, furosemide, warfarin and phenytoin are all highly _____-bound drugs and can compete. |
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Definition
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| This type of assessment can be done on elderly to find out about their meds. |
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Definition
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Term
Multiple diseases
Multiple providers
Legal implications
Patient self-prescription & experimentation
Medication collecting
Search for total therapy
Patient/health care provider communication
all contribute to __________. |
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Definition
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Term
| Two good rules for prescription. |
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Definition
Start one, stop one.
Start low, go slow. |
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Term
| If you are on 4 or more medications, you have a significant risk of experiencing at least one _______ ____. |
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Definition
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Term
| Meds can interact with other ____, _____ and ______. |
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Definition
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Term
Decreased salivary & bronchial secretions
Decreased sweating
Pupil dilation, increased outflow resistance
Tachycardia
Inhibition of voiding & urinary retention
Decreased GI motility and tone, constipation
Decreased gastric secretions
Decreased memory and concentration
are all side effects of ____-________ |
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Definition
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Term
| Anticholinergics should NEVER be given to people with _____ or ___. |
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Definition
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Term
Autonomic hyperactivity
Mental status changes
Neuromuscular abnormalities
are signs of _______ __________. |
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Definition
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Term
| Hyperreflexia, jaw/ankle muscle relaxation and contraction, euphoria, diarrhea, dizziness are signs of _____ _____ and not ______ ________ . |
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Definition
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Term
esyrel
Buspar
Effexor
MAO inhibitors
St. John’s Wort
Cocaine
Dextromorphan
Demerol
Ultram
Depakote
Imitrex
Remeron
SSRIs are linked to _________ _________. |
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Definition
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Term
| _______ is an electrolyte Side effect of Dig. |
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Definition
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Term
| Loss of appetite, nausea, diarrhea and halo vision are SFX of what? |
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Definition
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Term
| Rigidity, Dysautonomia (Sweating), and AMS (agitation, lethargy and coma) are the clinical triad of what? |
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Definition
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Term
| Major difference between NMS & SS. |
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Definition
SS - muscle twitching/hyperreflexia
NMS - Muscle rigidity |
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Term
| Hyperpyrexia, sweating, tachypnea, tachycardia, dyshpagia, and labile BP are sings of what? |
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Definition
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Term
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Definition
Tardive dyskinesia
Akathisia
Parkinsonism |
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Term
| A clinical state characterized by an acute, fluctuating change in mental status, with inattention and altered levels of consciousness that occurs in at least 40% of hospitalized elderly. |
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Definition
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Term
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Definition
Drug Use
Electrolyte & physiologic abnormalities
Lack of drugs
Infection
Reduced sensory input
Intracranial problems
Urinary retention and fecal impaction
Myocardial problems |
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Term
Overstimulation
“Tubes”
Metabolic/fluid abnormalities
Physical restraints
Polypharmacy
Postoperative states
Sleep deprivation
are potential causes of what? |
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Definition
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Term
| Sudden _____ and _____ of confusion in a patient are signs of delirium. |
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Definition
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Term
| Confusion Assessment Method (CAM) |
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Definition
Acute change in mental status
Symptoms that fluctuate over minutes or hours
Inattention
Altered level of consciousness
Disorganized thinking
(1, 2, 3 must be present plus either 4 or 5) |
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Term
Physicians fail to recognize
32-67% of cases of delirium
in hospitalized patients |
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Definition
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Term
| A deterioration of intellectual function and other cognitive skills leading to a decline in the ability to perform activities of daily living |
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Definition
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Term
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Definition
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Term
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Definition
Dementia with Lewy Bodies
Frontotemporal Dementia
Vascular Dementia
Normal Pressure Hydrocephalus |
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Term
| shuffling, broadbased gait, new onset incontinence, confusion are Sx of what kind of dementia? |
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Definition
| Normal pressure hydrocephalus |
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Term
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Definition
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Term
| Impaired ability to recognize people or things |
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Definition
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Term
| Inability to carry out a task |
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Definition
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Term
| Impaired ability to speak, write or name objects |
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Definition
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Term
| Brain findings in ppl with Alzheimers |
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Definition
| Amyloid plaques and neurofibrillary tangles |
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Term
| Rx Alzheimer's not used anymore r/t liver toxicity |
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Definition
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Term
| Ach agonists used for Alzheimer's in early/middle stages. (3) |
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Definition
Donepezil
Rivastigmine
Galantamine |
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Term
| End stage Alzheimer's medication (NMDA, glutamate agonist) |
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Definition
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Term
| In this type of dementia psychological symptoms are more prominent than in Alzheimer's. Mild parkinsonism may be present. |
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Definition
| Diffuse Lewy Body Disease (DLBD) |
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Term
Psychological
Paranoia, delusions, visual hallucinations
Parkinsonian
Bradykinesia, muscular rigidity, loss of postural reflexes, low frequency/amplitude tremor
are Sx of what type of dementia? |
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Definition
| Diffuse Lewy Body Dementia |
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Term
| Use of what drug class can lead to acute deterioration in DLBD r/t adverse EPS and NMS? |
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Definition
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Term
| Little lies told to pt's with dementia to increase comfort |
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Definition
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Term
| #1 drug to NOT give a pt with DLBD |
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Definition
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Term
| This type of dementia has a rapid progression and is early onset and includes Pick's Disease & Cortical Dementia |
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Definition
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Term
| Sexual disinhibition, lack of social tact and oral exploration and hallmark signs of what type of dementia? |
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Definition
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Term
| This type of dementia has abrupt onset of symptoms, relative preservation of personality, multiple small strokes. |
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Definition
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Term
| What is a different approach you can use with Vascular dementia? |
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Definition
| Decrease HTN, DM and smoking. |
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Term
| 3 useful communication strategies w/dementia |
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Definition
Simplification
Facilitation
Supportive |
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Term
Failure-free
Self-care
Privacy
Calmness
Simplicity
Safety
are good "care themes" for people with _______. |
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Definition
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Term
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Definition
Never assume
Never leap to conclusions.
Slow down
Probe for the most information possible
Listen, listen, listen
And always keep an open mind, because surprises happen. |
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