Eval 1 - Integ, GU, Immune, Multi-System Flashcards
Most important functional mobility abilities for older adults (4)
- Walk 1/4 mile without stopping.
- Cross street on time.
- Climb stairs.
- Rise from floor.
Integumentary: self report measures
Diabetes Impact Measurement Scale (DIMS)
Falls Efficacy Scale (FES)
Integumentary: important meds to screen for (4) and why
- Steroids - inhibits epidermis regeneration & collagen synthesis.
- NSAIDs - decreases epithelialization & slows inflammatory healing process.
- Immunosuppressants - higher risk of infections.
- Aspirin/Anti-Coagulants - impedes blood clotting.
Integumentary: nutrition requirements for older adult with wounds
Protein = 1-1.5 g/kgBW per day.
Total Caloric Intake = 35-40 kcal/kgBW per day.
Integumentary: tests & measures
Sensation: sharp/dull best option; should be in dermotome pattern.
Gait: if foot wounds.
ABI
Ipswich Touch Test*
Integumentary: what monofilmant size tests for protective sensation?
0.05
Ipswich Touch Test
Purpose: protective sensation in diabetic foot, determines risk of ulcer.
Pt position: supine, eyes closed, feet off edge.
Procedure: gently touch tip of toes 1, 3, and 5 & dorsal aspect of hallux (both feet). Pt says “yes” when touch felt.
(+) = cannot feel 2 or more spots, indicates neuropathy.
Genitourinary: incontinence red flags (5)
Sudden onset.
After surgery or after new meds.
Burning or blood in urine or stool.
Any large or unexpected amount.
LBP + difficulty initiating.
Genitourinary: important meds to screen for (3) and why
- Benzodiazepines - relaxes urethra.
- Anti-HTNs (Anti-Cholinergic or Beta-Blockers) - may cause retention.
- Opioids/Narcotics - puts stress on bladder.
Genitourinary: tests & measures
Strength: glutes, abs, PFM.
Balance: esp eyes closed, bc getting up in night to pee.
Internal/External Pelvic Exam: palpation, sensation.
Sacral Reflex.
Immune: what conditions are we mostly screening for? (2)
RA
Cancer
Immune: important meds to screen for (2) and why
- Chemo - neuropathy, inner ear dysfunction, vision changes, fatigue.
- Steroids for RA flare - affects what we can/cant do with manual therapy.
Immune: tests & measures
Sensation: neuropathy from chemo/cancer.
Balance: vestibular effects from chemo.
Endurance/Aerobic Capacity: fatigue.
Anthropometrics if lymphedema.
Balance/Falls: 40-50% higher risk w/in 1-2yrs of dx.
Multi-System: important eval components for falls
Kyphosis: weight is more forward.
Fwd head: can mess with vestib.
DF ROM: need 8deg for ankle strategy.
Glut Max strength: predicts fallers vs non-fallers.
Multi-System: Hopkins Falls Grading Scale
Grade 1 (near fall): did not fall to ground or lower surface.
Grade 2 (fall): fell to ground or lower surface, but no med attention needed.
Grade 3 (fall): received med attention, but no hospital admission.
Grade 4 (fall): admitted to hospital.