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n3 gero > Exam 2 - chronic illness > Flashcards

Exam 2 - chronic illness Flashcards

1
Q

characteristics of acute illness

A

occurs suddenly and often without warning

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2
Q

characteristics of chronic illness

A
  • needs lifetime adaptation through management
  • no cure
  • may not always be manifested
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3
Q

examples of acute illness

A
  • stroke
  • MI
  • hip fracture
  • infection
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4
Q

what are the most common chronic conditions for older adults (≥ 65 years old)?

A
  • HTN
  • increased cholesterol
  • arthritis
  • ischemic heart disease
  • diabetes
  • CKD
  • HF
  • depression
  • Alzheimer’s / Dementia
  • COPD
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5
Q

what are the phases of chronic illness trajectory?

A
  • preventive
  • definitive
  • crisis
  • acute
  • stable
  • unstable
  • downward
  • dying
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6
Q

what is the nursing goal for a patient in the acute phase of their illness?

A
  • stabilize the condition
  • promote recovery
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7
Q

what is most important in managing chronic illness?

A

maintaining the patient in their stable phase

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8
Q

define frailty

A

the body is unable to compensate for several geriatric conditions

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9
Q

manifestations of frailty

A
  • unintentional weight loss
  • self-reported exhaustion
  • weak grip strength
  • slow walking speed
  • low activity
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10
Q

formal diagnosis of frailty will need at least 3 manifestations

A

true

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11
Q

what are significant factors that contribute to frailty?

A
  • diet
  • physical activity
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12
Q

what is the best intervention for HTN?

A

weight loss

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13
Q

what is an acceptable parameter for BP in adults ≥ 60 years old?

A

< 150/90

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14
Q

what is the most common cause for hospitalization?

A

HF

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15
Q

etiology for HF

A
  • enlarged and dilated ventricles
  • weaker heart muscles
  • hypercardiomyopathy
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16
Q

what are the nursing interventions for patients with HF?

A
  • DO NOT give calcium channel blockers
  • daily weights (AM)
  • low sodium diet
  • fluid restriction
  • pacing & tolerance
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17
Q

what is the Frank-Starling Law of the heart?

A

the greater the filling pressure in ventricle, the greater the cardiac output

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18
Q

what is systolic CHF?

A

decreased contractility of the heart

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19
Q

what is diastolic CHF?

A

decreased filing of the heart

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20
Q

what are the medications used for CV diseases?

A
  • ACEs & ARBs
  • diuretics
  • beta blockers
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21
Q

Parkinson’s disease is more common in women than men

A

true

22
Q

etiology of Parkinson’s disease (PD)

A

loss of dopamine neurons

23
Q

how is dopamine related to the development of PD?

A

dopamine is responsible for motor function

24
Q

what are s/s of PD?

A
  • cogwheel rigidity
  • bradykinesia
  • tremors
  • autonomic dysfunction
  • cognitive impairment
25
Q

what is cogwheel rigidity?

A
  • jerking muscle movements
  • muscle rigidity
26
Q

what is bradykinesia?

A
  • shuffling
  • freezing
  • difficulty coordinating movements
27
Q

how do tremors manifest in PD?

A
  • pill rolling
  • small handwriting
  • low monotone voice
28
Q

when do tremors disappear?

A

during sleep & purposeful movements

29
Q

what are some important motor symptoms of a patient with PD?

A
  • involuntary flexion of head & neck
  • stooped posture
  • postural instability
30
Q

what is the first line of medication for PD?

A

levodopa

31
Q

levodopa is usually added with carbidopa

A

true

32
Q

what kind of drugs is Carbidopa-Levidopa contraindicated with?

A

SSRIs

33
Q

how does autonomic dysfunction manifest in patients with PD?

A
  • seborrhea dermatitis on the scalp
  • hyperhydrosis (face and neck)
  • heat intolerance
  • postural hypotension
  • constipation
34
Q

how does cognitive dysfunction manifest in patients with PD?

A
  • dementia
  • memory loss
  • anxiety
  • depression
  • sleep / wake reversal
  • visual disturbances
  • psychosis
35
Q

nursing interventions for patients with Parkinson’s disease

A
  • medications
  • ablation
  • deep brain stimulation
  • stem cell transplantation
36
Q

in what part of the brain is dopamine synthesized?

A

substantia nigra

37
Q

manifestations of Parkinsonian crisis

A
  • severe tremors, rigidity, & bradykinesia
  • anxiety
  • sweating
  • tachycardia
  • hyperpnea
38
Q

what are the interventions for Parkinsonian crisis?

A
  • respiratory / cardiac support
  • non-stimulating environment
  • psychological supports
  • restarting medications
39
Q

patient education for those with Parkinson’s disease

A
  • lift toes while walking
  • widen legs while walking
  • small steps
  • look forward
  • take wide turns (avoid bumping into corners)
  • swing arms for better balance
  • read aloud
  • speak slow
  • facial exercises
40
Q

what are the types of medications for Parkinson’s disease?

A
  • Dopamine precursor
  • Glutamine antagonist
  • MAOB inhibitor
  • Dopamine agonist
  • COMT inhibitors
  • Anticholinergics
41
Q

what are the therapeutic effects of Levodopa?

A

improves manifestations of motor function

42
Q

what is the MOA of Carbidopa?

A

prevents conversion of dopamine in peripheral tissues

keeps dopamine at desired levels throughout the body

43
Q

what is the MOA of Amantadine?

A

increases the response of CNS to dopamine

^ dopamine recognition = ^ dopamine use

44
Q

what are the side effects of anti-Parkinsonian drugs?

A
  • NVD
  • blurred vision
  • arrhythmia
  • dark urine & sweat
  • dyskinesia
  • orthostasis
  • hallucinations
45
Q

client education regarding Dopamine precursors and Glutamine antagonist drugs

A
  • it takes weeks / months to take into effect
  • decreased protein intake is essential
  • avoid food with pyridoxine (pork, beef, avocado, beans, oatmeal)
  • administer antiemetics
46
Q

what is the role of COMT in the body?

A

breaks down dopamine

47
Q

which type of drug do COMT inhibitors adversely interact with?

A

warfarin

48
Q

which lab values need to be monitored when patient is taking COMT inhibitors & warfarin?

A

INR levels

49
Q

examples of COMT inhibitors

A
  • Tolcapone
  • Entacapone
50
Q

which organ are COMT inhibitors most affected by?

A

liver

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