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Clinical Disciplines II-Exam #1 > Comprehensive Assessment > Flashcards

Flashcards in Comprehensive Assessment Deck (46)
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1

Define Functional Capacity

Person's ability to perform tasks that are required for living

2

What are the two key divisions of functional capacity?

1. Basic Activities of Daily Living (ADL's)
2. Instrumental Activities of Daily Living (IADL)

3

What Katz Index of Independence in ADL score would indicate a highly independent elder?

Score of 6

4

What Katz Index of Independence in ADL score would indicate a very dependent elder?

Score of 0

5

List the 5 Instrumental Activities of Daily Living (IADL)

1. Housework
2. Preparing meals
3. Taking medications properly
4. Managing finances
5. Using a telephone

6

What Scale would you use to assess IADL's?

Lawton Instrumental Activities of Daily Living Scale (9 Q's)

7

What are the 4 components of the comprehensive geriatric assessment?

1. Functional Capacity
2. Physical Health: Pharmacy
3. Cognition/Mental health
4. Socio-Environmental

8

What 5 topics does the physical health component cover?

1. Nutrition
2. Vision/Hearing
3. Balance and Fall prevention
4. Fecal and Urinary incontinence
5. Polypharmacy

9

What vitamins/minerals are elderly deficient in?

1. Vitamin A, C, D
2. B12
3. Calcium
4. Zinc
5. Iron

10

What does Nutritional Health Checklist of 0-2 mean? Recommendation?

Good nutrition
Re-check nutrition score in 6 months

11

What does Nutritional Health Checklist of 3-5 mean? Recommendation?

Moderate nutritional risk
Re-check nutrition score in 3 months
See what you can do to improve eating habits and lifestyle

12

What does Nutritional Health Checklist of 6+ mean? Recommendation?

High Nutritional Risk
Bring checklist to physician or dietician for help to improve nutritional status

13

What increased risks is low vision associated with?

1. Falls
2. Cognitive decline
3. Depression

14

Who should have a vision assessment?

1. Falls
2. Cognitive Declines
3. Functional impairment

15

What are common causes of vision impairment?

1. Presbyopia
2. Glaucoma
3. Diabetic Retinopathy
4. Cataracts
5. Age-Related Macular Degeneration

16

What is the 3rd MC ailment in elderly?

Hearing

17

At what age do we screen for hearing loss?

65+

18

What tests do we use to test for hearing loss?

1. Surveys
2. Whispered voice test
3. Audiometry

19

What is hearing loss associated with?

1. Cognitive decline
2. Functional impairment
3. Depression
4. Social Isolation
5. Poor self-esteem
6. Increased hospitalizations

20

What Hearing Handicap Inventory score is considered a No Handicap/No Referral

0-8= 13% probability of hearing impairment

21

What Hearing Handicap Inventory score is considered a mild-to-moderate handicap/referral?

10-24= 50% probability of hearing impairment

22

What Hearing Handicap Inventory score is considered a severe handicap/referral?

25-40= 84% probability of hearing impairment

23

When should you refer your patient to a otolaryngologist?

If they fail the screening test

24

What is the TOC in hearing loss?

Hearing Aids

25

What are the complications of urinary incontinence?

1. UTI's
2. Sepsis
3. Decubitus ulcers
4. Renal Failure
5. Increased mortality

26

What is the key deciding factor in urinary incontinence?

Nursing home placement

27

What is the leading cause of hospitalizations and injury-related death in 75+?

FALLS

28

What is a Normal Time for the Get up and Go test (Tinetti Balance & Gait Evaluation)

7-10 seconds

29

What is a Fairly Mobile time for the Get up and Go test

10-19 seconds

30

What is a Variable Mobile time for the Get up and Go test

20-29 seconds

31

What is a Functionally Dependent in Balance and. Mobility time for the Get up and Go test

30 seconds or more

32

How can older persons reduce their fall risk?

1. Exercise
2. Home Hazard Assessment
3. Remove Psychotrophic meds

33

What is the USPSTF osteoporosis screening recommendation in women?

Screen women 65+ with DEXA of femoral neck

34

Osteoporosis T-score

-2.5 or lower

35

Osteopenia T-score

-1 to -2.5

36

What percentage of hospital admission in older people is secondary to drug ADE's?

30%

37

How do older adults present with depression?

Atypical Presentation:
1. Somatic complaints
2. Cognitive/functional problems
3. Sleep disturbances
4. Fatigue

38

What screening can you use to easily identify pt's @ risk for depression?

Two Q screening
1. Bothered by feeling down, depressed, or hopeless?
2. Little interest or pleasure in doing things

39

If the patients has a positive screen to both Q's, what should you follow-up with?

7 additional Q's to complete Patient Health Questionnaire (PHQ-9)

40

PHQ-9 Score for Minimal Depression

1-4

41

PHQ-9 Score for Mild Depression

5-9

42

PHQ-9 Score for Moderate Depression

10-14

43

PHQ-9 Score for Moderately Severe Depression

15-19

44

PHQ-9 Score for Severe Depression

20-27

45

What is a quick initial screening you can use to assess for dementia?

Mini-Cognitive Assessment Instrument: 3 Q's
1. Repeat 3 unrelated words
2. Draw clock
3. Repeat 3 words from step 1

*One point for each item that is recalled correctly

46

What is the most widely used assessment for dementia?

Mini Mental Status Exam: 7-10 Q's