Concurrent Illness

Question 1

Atypical presentation

Answer 1

Signs and symptoms of a disease are different or absent from what would be expected

Common in elderly and can make identifying the underlying cause challenging
Esp in 85 year old and have cognitive impairment

Question 2

The older patient

Answer 2

Many factors differentiate older person from other patient

The older adults commonly has more chronic acute episodes that need management

Question 3

Factors effecting elderly

Answer 3

Commorbidities
Atypical presention
Geriatric syndromes
Frailty

Question 4

Geriatric syndromes

Answer 4

Describes a syndrome with high prevalence in older adults

Gs will have a significant negative effect and are commonly associated with a poorer quality of life

Question 5

Types of geriatric syndromes

Answer 5

Falls 
Frailty 
Malnutrition 
Incontinence
Pressure wound
Delirium

Question 6

Common health problems of old age

Answer 6

Musculoskeletal skeletal conditions 
Heart disease 
Visual and hearing deterioration 
Diabetes 
Cancer 
Hypo/hyperthermia

Question 7

Care ppanning for elderly includes

Answer 7

Health promotion 
Knowledge of risks
Prevention of disease
Management of chronic disease
Patients values Andrew wishes

Question 8

Health assessment

Answer 8

Assessment

Information

Question 9

Assessment

Answer 9

First step of the nursing process 
Collect verify
Organize
Interpret
Document

Question 10

Information can be

Answer 10

Subjective

Objective

Question 11

Cognition as a vital sign

Answer 11

Cannot answer question
Overly sleepy
Disorganised thinking
Easily distracted 
Agitated

Question 12

Airway

Answer 12

Upper airway changes with calcification of cartilage
Alveoli larger and have thinner walls
Difficult to hyperextend 
Foreign objects- teeth
Diminished gag reflex

Question 13

Breathing

Answer 13

Chest wall stiffness
Alterations in lung volumes and airflow
Long exposure to resp hazard

Question 14

Circulation

Answer 14

General colour
Feel quality of pulses
Listen for heart failure
Remember alterations of baroflex mechanism means there is bluntening of compensation

Question 15

Disability (neuro)

Answer 15

Know your patient and what their level of normal
Don’t presume they are old they are confused
Pupil response
Do they have a hearing or vision deficit

Question 16

Exposure

Answer 16

Expose patient and have a look for bruises, marks, chest wall deformity, tubes, paradoxical movement

But be quick , keepcolder patient warm

Question 17

Examples of specific assessment

Answer 17

Mna - mini nutritional assessment 
Braden ax
Abbey pain scale
Mmse - mini mental state exam
Geriatric depression scale
Cam - detects delirium

Question 18

Plan

Answer 18

Involves goal setting with patient
Relates to nmba standards 5
Involve other professionals

Question 19

Beware if the myths about elderly people

Answer 19

Some staff may assume that a change in cognition in elder is normal
Managing illness treatment does not focus on addressing tge problem but the symptoms

Good discharge planning for acute facilities is essential to maintain wellness

Question 20

Focus on the whole person

Answer 20

Successful planning
Personal relationships develops around mutual trust
Establish rapport, introduce yourself, explain purpose
Be aware of the prior history
Gain understanding of yours patients wishes

Question 21

Facilitating person- centredness

Answer 21

Be attentive and open with older person
Be non-judgemental
Make a concerted effort to understand their perspective, priorities and issues
Clarify what is understood and get agreement on the plan forward