adult failure to thrive

Question 1

a syndrome of weight loss, decreased appetite and poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol.

Answer 1

adult failure to thrive

Question 2

malnutrition or weight loss and impaired physical function

Answer 2

frailty

Question 3

frailty is defined by meeting greater than or equal to 3 of these criteria:

Answer 3

• weight loss (> or equal to 5% of body weight in last year)
• exhaustion
• weakness (decreased grip strength)
• slow walking speed (> 6-7 seconds to walk 15 ft)
• decreased physical activity (men < 383 kcal/wk, women <270 kcal)

Question 4

SOF scale (study of osteoporotic fractures) 2 out of the 3 criteria need to be met.

Answer 4

• weight loss of > or equal to 5% over 2 years
• inability to stand from a chair 5x without using the arms to push up
• negative response to the question “do you feel full of energy?”

Question 5

what should the BMI goal be in older adults to decrease mortality and lessen functional decline?

Answer 5

24-29 kg/m2

Question 6

a catabolic state characterized by anorexia, weight loss, inflammation, and insulin resistance

Answer 6

cachexia

Question 7

loss of muscle mass that occurs with aging

Answer 7

sarcopenia

Question 8

difficulty or dependency in completing tasks essential for self-care and independent living

Answer 8

disability

Question 9

what are the 3 most common forms of neuropsychiatric impairment?

Answer 9

delirium, depression and dementia

Question 10

an acute cognitive decline, different from a patient’s baseline, that results from a number of factors

Answer 10

delirium

Question 11

on the geriatric depression scale, a score of 1-5 is normal, 5-10 is depressed and 10-15 is ?

Answer 11

very depressed

Question 12

when evaluating for elder abuse and neglect, what are some red flags to look out for ?

Answer 12

unexplained injuries, behavioral changes in the presence of the caregiver, limited social supports, substance abuse among caregivers, failing to fill medication prescriptions

Question 13

when diagnosis adult failure to thrive, there is a lack of standardization. The patient might have some or all of the following:

Answer 13

impaired functional status, malnutrition, depression, cognitive impairment, pressure ulcers, impaired quality of life, chronic pain, chronic illness, polypharmacy

Question 14

tube feeding has a survival benefit compared to hand feeding in those with severe cognitive impairment. T or F?

Answer 14

False

Question 15

what could happen if you treated a patient with AFTT with appetite stimulants such as megace or Marinol?

Answer 15

It could increase their mortality and morbidity especially if they have CHF, can cause significant sedation and fatigue. These drugs are not approved or recommended

Question 16

name the 4 evidence based treatments for fragility?

Answer 16

• most effective: EXERCISE (aerobic & resistance)
• calorie and protein support
• vitamin D supplementation
• reduction of polypharmacy

Question 17

Which medication is used to treat depression in elderly and is often used because it also increases appetite and weight gain?

Answer 17

Remeron (mirtazapine)

Question 18

AFTT is no longer a qualifying hospice diagnosis. T or F?

Answer 18

true