Age and Complex Health Examinations Flashcards
Stroke Assessment
Airway: open?
Breathing: brief resp exam and O2 stats
Circulation: brief CV exam, BP, carotid bruits, irregular pulse
Disability: GCS, blood glucose, temperature
Exposure and everything else: neuro/ cranial nerve exam, bamford classification, stroke severity (NIHSS), gait, speech and swallowing assessment
Investigations:
- CT brain
- ECG
- Bloods - clotting, hypoglycaemia, infection, hypercholesterolaemia
Comprehensive Geriatric Assessment
Physical Health
- PMH and comorbidities
- Medication list and review
- Nutritional status
- Skin integrity
- Falls screening
- Urinary and faecal incontinence
Mental health conditions
- Cognitive assessment + delirium assessment
- Mood and anxiety
- Fears
Social circumstances
- Care packages
- Statutory care and eligibility
- Finances
Functional abilities
- mobility and transfers
- ADLs
Environment
- Housing
- Equipment and adaptations
- Telecare
- Transport
- Accessibility
Nutritional Assessment
Feed/ shop/ cook themselves?
Change in weight/ appetite?
Problems with dentition/ swallowing
Usual dietary intake?
MUST - Malnutrition Universal Screening Toll
- BMI (<20 = 1, <18.5 = 2)
- Weight loss (5-10% = 1, >10% = 2 in last 3-6 months)
- Acutely unwell/ no nutrition >5 days (2)
Risk
- 0 low risk
- 1 medium risk - observe
- 2+ high risk - treat
Delirium Assessment
PINCH ME
- Pain
- Infection
- Nutrition
- Constipation
- Hydration
- Medication
- Environment
CAM 1. acute onset and fluctuating \+ 2. Inattention \+ 3. Disorganised thinking OR 4. Altered level of consciousness
4AT 1. Alertness - 0: normal - 4: hypo/ hyper 2. AMT4 (age, DoB, birthplace/ current location, current year) - 0: no mistakes - 1: 1 mistake - 2: 2+ mistakes 3. Attention (months backwards) - 0: 7+ - 1: <7 or does not attempt - 2: untestable 4. Acute and fluctuating - 0: no -4: yes Overall - 0: unlikely - 1-3: possible cognitive impairment - 4+: possible delirium +/- cognitive impairment
