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Gero > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

Early warning signs of cancer

A 
Change in bowel or bladder
sore doesn't heal
unusual bleeding
skin thickening
indigestion
nagging cough or hoarseness
painless enlarged lymph nodes
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2
Q

What are the benefits of doing a Comprehensive Geriatric Assessment?

A

improves functioning
enhances survival
decreases hospitalization

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3
Q

most important determinant of cancer

A

age

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4
Q

On what scale is cancer staged?

A

TNM system

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5
Q

What factors are used in the TNM system?

A

tumor size, location, degree of invasion

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6
Q

What are the first symptoms of lung cancer?

A

pleural pain
cough
hemoptysis
dyspnea

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7
Q

The patient with lung cancer with mediastinal involvement will present with what symptoms?

A

heart failure
arrhythmia
pleural effusion

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8
Q

Which organ cancer is considered clinically silent?

A

Lung cancer

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9
Q

Which type of lung cancer is the worst and most aggressive?

A

Small cell

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10
Q

Which type of lung cancer is the most treatable?

A

squamous

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11
Q

Clinical presentation of liver cancer

A

hepatomegaly
RUG and or epi pain
weight loss

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12
Q

Lab abnormalities seen in liver cancer

A

LFTs
hypercalcemia
hyperlipidemia
hypoglycemia

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13
Q

Clinical presentation of pancreatic cancer

A 
jaundice
vague abd or back pain
n/v
wt loss
generalized weakness
labile blood sugars
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14
Q

Tumor markers present in pacreatitis

A

CA 19-9

CEA

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15
Q

Surgery for pancreatic cancer

A

Whipple

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16
Q

Clinical manifestations of stomach cancer

A 
***vague***
anemia
weakness
fatigue
dizziness
epigastric fullness
constipation
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17
Q

DX of stomach cancer

A

endoscopy

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18
Q

Characteristics of nociceptive pain

A

responds to analgesics

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19
Q

neuropathic pain characteristics

A

burning, tingling, nerve pain

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20
Q

Which aging related change can cause orthostatic hypotension in the older adult?

A

decrease in baroreceptors

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21
Q

What are the first line medications for CHF?

A

ace inhibitors and diuretics

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22
Q

Which type of CHF medication will have poor short term outcomes but better long term outcomes?

A

beta blockers

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23
Q

What is the max dosage for dig?

A

0.125

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24
Q

Sodium limits for pt with CHF

A

2-3g/day

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25
Bronchitis and emphysema is characterized by
airway inflammation and hypertrophy and firbrosis
26
Clinical manifestations of emphysema
``` dyspnea increased a:p diameter hypoxia wt loss due to energy use crackles wheezes clubbing ```
27
Pt with emphysema are called...
pink puffers
28
Pt's with emphysema are most comfortable in what position?
tripod
29
Chronic bronchitis clinical manifestation
``` productive cough frequent resp infex dyspnea on exertion hypoxia hypercapnea polycythemia and cyanosis crackles tackycardia pedal edema wt gain ```
30
Chronic bronchitis is called..
blue bloater
31
Which atypical symptoms of pneumonia are commonly seen in the older adult?
confusion, dehydration, failure to thrive
32
Which antibiotic is the best choice to treat community acquired pneumonia?
Clarithromycin (macrolides)
33
Clinical manifestations of TB
low fever non productive cough chills atypical pneumonia
34
DX of TB
chest xray
35
TX of TB
INH and Rifampin x4mo
36
What is the treatment regimen for TB
4 meds x2 months
37
If TB is resistant, what is the tx regimen?
4 meds x 18-20 mo
38
Which sleep scale will show what interrupts the pt sleep?
Pittsburgh Sleep Quality Index
39
TX for sleep disorders
biofeedback
40
Andropause
dec in testosterone
41
somatopause
decrease in growth factor
42
Characteristics of metabolic disorder
BP > 129/84 Triglycerides >149 HDL 99
43
Mild hypoglycemia tx
15g of carb 4oz juice
44
Moderate hypoglycemia tx
15g carb repeated
45
Severe hypoglycemia tx
glucagon, IV glucose
46
DX of hyperthyroidism
TSH
47
Iodine induced hyperthyroidism is secondary to
amiodorone
48
Geriatric hyperthyroidism presentation
tachycardia, fatigue, tremors, nervousness
49
Subclinical hypothyroidism labs
TSH elevated | T4 norm
50
Hypothyroidism sx in the older adult
fatigue, cold intolerance, wt gain, muscle cramps, paresthesias, confusion
51
Common complication related to hypothyroidism tx
angina
52
Grading scale for Gero version of MAST for alcoholism
0-3 normal 5-9 80% chance alcoholism >10 100% chance
53
Alcohol withdrawal symptoms begin within
48-72 hours after last drink
54
Caffeine withdrawal symptoms begin within
12-24 hours after last
55
Which model is used when a pt is ready to change their substance use?
5 A's
56
What are the 5 A's
``` Ask about substance use Advise to quit Assess willingness to change Assist in quit attempt Arrange follow up ```
57
When a pt is reluctant to change, which model is used?
``` Relevance Risks of behavior to health Rewards of quitting Roadblocks to quitting Repitition ```
58
PT
11-12.5 sec
59
INR
2-3
60
Which lab value is to evaluate the effectiveness of warfarin?
PT | INR
61
Which lab value is to evaluate the effectiveness of heparin?
PTT
62
PTT
60-70 sec
63
Platelet count
150-400
64
Which drugs are Protein bound?
Furosemide Dilantin Warfarin
65
What are the limits when administering neuroleptic drugs?
No more than twice a day in 7 da period
66
At what grade level should drug education be written
5th
67
On the geriatric depression scale what score is suggestive of depression
>5
68
Which score on the GDS is always indicative of depression
>=10
69
Which drug class is the safest for depression tx
Ssri
70
Which four basic features distinguish between delirium and dementia
Acute onset In attention Disorganized thinking Altered level of consciousness
71
The nurse knows that which medication prevents reabsorption of serotonin
Zoloft
72
Normal hemoglobin
12-13
73
Micro cystic anemia is caused by which deficiency
Iron
74
DX of iron deficiency anemia
Serum ferritin
75
Tx of iron deficiency anemia
325 mg ferrous sulfate
76
Macrocyclic anemia is also called
B12 deficiency anemia
77
DX for macrocyclic anemia
Schilling test: parietal cells to check intrinsic factor
78
Macrocyclic anemia sx
Beefy red tongue Abd pain Paresthesia
79
Which toxic chemicals can cause hemolytic anemia
Lead Copper Arsenic
80
When transfusing blood, what gauge is used?
18

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