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n3 gero > lect 4: ch 7 > Flashcards

lect 4: ch 7 Flashcards

1
Q

what are the types of assessments included for older adults?

A

1) physical
2) functional
3) cognition
4) mood
5) balance

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2
Q

what are hindering factors to collecting information for health history?

A

1) visual and auditory acuity
2) manual dexterity
3) language and health fluency
4) adequacy of translated materials
5) availability of trained interpreter
6) cognitive ability and reading level

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3
Q

what are the data needed for a health history?

A

1) demographic info
2) past medical Hx
3) current medications/ dietary supplements
4) functional status
5) social Hx

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4
Q

what does social Hx include?

A

people who will support the patient physically, provide transportation, and are involved in decisions regarding health

living arrangements

resources

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5
Q

which part of social Hx is usually incomplete?

A

advanced directives

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6
Q

what is the beginning of the assessment of the older adult?

A

health Hx

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7
Q

what is the end of the assessment?

A

review of systems (or person’s report of symptoms)

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8
Q

which type of person can speak or make decisions for the older adult with permission?

A

healthcare proxy or surrogate

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9
Q

what are the instruments used for a physical assessment?

A

FANCAPES and SPICES

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10
Q

FANCAPES

A

Fluid
Aeration
Nutrition
Communication
Activity
Pain
Elimination
Social skills

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11
Q

what is the most important part of the lung that needs to be auscultated?

A

lateral aspects of lower lobes

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12
Q

which two systems are assessed simultaneously?

A

cardiovascular and pulmonary

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13
Q

what does “activity” assess?

A

safe ambulation

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14
Q

why are elimination problems more common with older adults who live in institutional systems?

A

they are dependent on others for assistance to address incontinence

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15
Q

SPICES

A

Sleep disorders
Problems with eating
Incontinence
Confusion
Evidence of falls
Skin breakdown

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16
Q

tools for functional assessment

A

1) Katz
2) Lawton

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17
Q

Katz Index

A

measures ability to perform ADLs on a scale of 0-1

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18
Q

Lawton IADL Scale

A

determines level of function on a scale of 0-8

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19
Q

how is information acquired for Lawton?

A

through self-report, proxy, or observation

20
Q

tools for cognition assessment

A

1) MMSE (mini mental state examination)
2) CDT
3) Mini-Cog

21
Q

what does MMSE test?

A

orientation
short-term memory
attention
calculation ability
language
visuospatial construction

22
Q

what do the cognition assessment tools mainly screen for?

A

dementia

23
Q

how many items are there in MMSE?

A

30

24
Q

what is an alternative to MMSE?

A

SLUMS

25
Q

what is CDT more effective in screening for?

A

constructional aphasia (which is an indicator for dementia)

26
Q

what is CDT not appropriate for?

A

1) visually impaired patients
2) those who have tremors (Parkinson’s)
3) Hx of stroke
4) severe arthritis

27
Q

what does CDT test?

A

manual dexterity and visual acuity

28
Q

what direction is indicated for CDT?

A

“draw a clock reading 10 after 11”

29
Q

a score of 3 or more in CDT represents a cognitive deficit

A

true

30
Q

which test is believed to be more sensitive to dementia?

A

Mini-Cog

31
Q

what does Mini-Cog test for?

A

short-term memory and executive function

32
Q

how long does a Mini-Cog take to administer?

A

3-5 minutes

33
Q

what kind of skills does Mini-Cog require?

A

number fluency
visual and auditory acuity
ability to hold a pencil
experience with analog clocks

34
Q

directions for a Mini-Cog

A

1) repeat three unrelated words clearly, one second each
2) draw a clock (as it is in CDT)
3) then recall the three words

35
Q

what are the tools to assess mood?

A

1) Geriatric depression scale
2) Centers for Epidemiologic Studies Depression Scale
3) Cornell State for Depression in Dementia

36
Q

how does untreated depression affect older adults?

A

further functional impairment, prolonged hospitalizations, decreased quality of life, increased morbidity

37
Q

how many items is the Geriatric Depression Scale?

A

30

38
Q

what does a score of 5 or greater indicate in GDS?

A

potential major depressive disorder

39
Q

what makes GDS extremely successful?

A

it deemphasizes physical complaints, libido, and appetite

40
Q

tool for comprehensive geriatric assessment

A

OARS (Older Americans Resources and Services)

41
Q

range for OARS

A

6 (most capable)
30 (total disability)

42
Q

what are the subscales of OARS?

A

1) social resources
2) economic resources
3) mental health
4) physical health
5) ADLs

43
Q

tools to assess fall risk, balance, and gait

A

1) Hendrich II
2) Tinetti Balance and Gait

44
Q

Hendrich II

A

Get Up and Go

45
Q

Tinetti

A

assesses balance (scale of 16)

46
Q

things to consider regarding cultural etiquette

A

1) past experiences in the health care setting
2) ask if there needs to be another person with them during the exam
3) respect communication style
4) do not invade personal space without permission
5) determine general health orientation beforehand
6) ask what they want to be called
7) ask if touch is acceptable
8) ask about their gender

n3 gero (19 decks)

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