exam 2 Flashcards
(67 cards)
1
Q
bathing
A
ADL
2
Q
dressing
A
ADL
3
Q
toileting
A
ADL
4
Q
transferring
A
ADL
5
Q
continence
A
ADL
6
Q
feeding
A
ADL
7
Q
grooming
A
ADL
8
Q
walking
A
ADL
9
Q
handling finances
A
IADL
10
Q
use telephone
A
IADL
11
Q
cook
A
IADL
12
Q
laundry
A
IADL
13
Q
manage medications
A
IADL
14
Q
clean the house
A
IADL
15
Q
absrption
A
- decreased acidity
- delayed GI transit
- increased Tmax
- AUC does NOT change
16
Q
distribution
A
- increase in fat
- decreased albumin
- lipophilic meds: increased T1/2
- hydrophilic meds: decreased T1/2
17
Q
metabolism
A
- decreased hepatic blood flow
- decreased CYP3A4
- no change in phase II metabolism
- increased T1/2
- increased risk of metabolite accumulation
18
Q
elimination
A
- decreased GFR
- delayed elimination
- increased exposure to toxic metabolites
19
Q
adverse drug reaction
A
- a specific rxn usually related to the pharmacology of the drug
- pruritis caused by morphine
20
Q
adverse drug event
A
- any injury due to drug therapy. includes ADRs
- prescribing, dispensing, administration, adherence problems and therapeutic failures
21
Q
adverse event
A
- any adverse event not exclusive to medication therapy
- DVT following hip replacement
22
Q
adverse outcome
A
- any poor health outcome that may be related to med or other factors
- stroke due to poorly controlled HTN
23
Q
top 5 med classes leading to ED
A
- hematologic
- cardio
- endocrine
- CNS
- anti-infective
24
Q
activation of M1 & M2 are importatnt for
A
learning and memory
25
STARTcriteria
ACEI/ARB, bisphosphonates, anti-HTN, Ca +D
26
STOPP criteria
CNS and psychotropic drugs, GI, musculoskeletal, analgesic, duplicates
27
leading source on the safety of prescribing meds for older adults
BEERS criteris
28
functional age-related eye changes
presbyopia, decreased tear production, visual field constriction, decreased refractive power, decreased dark adaptation
29
structural age-related eye changes
rising intraocular pressure, rod cell loss, liquefaction of vitreous gel, decreased lens translucency
30
glaucoma treatment
- decrease aqueous
| - beta blocker or PG analog
31
most common cause of low vision in the US
cataracts
32
conductive causes of hearing impairment
- obstructive of auditory canal
- tympanic membrane impairment
- middle ear abnormalities
33
sensorineural causes of hearing impairement
- age related
- autoimmune disease
- noise trauma
- meds- AGs, loop diuretics, NSAIDs, salicylaes, macroldes, vanc
34
MMSE
assesses cognitive impairment
- 27-30: normal
- 21-26 mild
- 11-20 moderate
- 0-10 severe
35
low health literacy risk factors
lack of internet, older age, lack of health insurance,
36
signs of low health literacy
- poor eye contact when asked to read
- being defensive in conversation
- blaming lack of knowledge on sensory deficit
37
implications of low health literacty
- increased BP, poor glycemic control, low self- reported health, low patient satisfaction, higher rates of hospitalization, non-adherence
38
Geriatric syndrome definition
multifactorial common conditions in the geriatric population associated with morbidity and mortality
39
geriatric syndromes are problems that affect
- cognitive, sensory, motor, psychosocial
| - resulting in a loss of function
40
measurements of function of IADLs
- ability to use the phone, shopping, food preparation, housekeeping, laundry, transportation, med management, ability to handle finances
41
measurements of function of ADLs
bathing, dressing, self-feeding, hygiene, continence, transferring
42
oropharyngeal dysphagia
difficulty initiating swallowing or coordinating movement of food or liquid from the mouth to the upper esophagus
- most common form in older adults
- causes- stroke, PD
43
esophageal dysphagia
- difficulty transporting food or liquid through the esophagus into the stomach
- any med carries the risk of esophageal injury when administered improperly
- causes- dry swallowing, drug induced
44
non-crushable meds
donepezil 23mg, duloxetine, omeprazole, potassium, dabigatran, mirabegron
45
involuntary weight loss
significant weight loss of 5% over
46
strongest factors for falls
abnormalities in gait and balance
47
high risk factors for falls
- time frame of 1 month post hospital discharge
- suffered a fall w/in 12 months
- diagnosed as frail
- acute illness
- exacerbation of chronic illness
48
frailty characteristics
unintentional weight loss, exhaustion/fatigue, lower energy expenditure, slow gait speed/ slow performance, weak grip strength/ sarcopenia
- must have 3/5 to be considered frail
49
elements of informed consent
```
competence
disclosure
assurance of understanding
volunteriness
signed authorization
```
50
medicare eligiility
- those over 65
- under 65 with diabilities
- ESRD
51
medicare part D eligibility
- medicare A or B
- 65
- regardless of income or health
52
caregiver burden risk factors
female sex, low education , depression, cohabitation, financial stress, social isolation
53
types of elder abuse
financial exploitation, caregiver neglect, self-neglect, psychological/emotional, physical, sexual, abandonment
54
what are advance directives?
- written instructions about future medical care (end of life choices)
- include living will and medical power of attorney
55
what is a durable power of attorney?
- a legal form that states who you want to make medical decisions
- the person is authorized to speak for you ONLY if you are unable
56
what is a living will?
- a written legal document with your wishes about medical treatment
- right to accept or refuse treatment
- detailed end of life decisions
57
life-sustaining treatments
resuscitation, mechanical ventilation, tube feeding, dialysis
58
DNR
do not resuscitate
59
DNI
do not intubate
60
DNH
do not hospitalize
61
hospice care qualifications
- medicare part A benefit
- terminally ill
- must have
62
CII meds for hospice patients
may be faxed!
63
non-verbal signs of pain
facial expression, verbalizations, acting out, guarding, breathing, consolability, PAIN-AD
64
pain treatment
opiates first line
65
constipation management
- hydration, promote movement, fiber
- preventative: stool softeners, bulk-forming agents
- PRN- stimulants, MOM, osmotic laxatives
66
dyspnea management
- first line: opiates- decrease ventilatory drive (morphine or fentanyl)
- BZD: releive anxiety
- oxygen to correct hypoxia- for social functioning and discomfort
67
delirium management
- treat underlying cause
| - meds: haloperidol, BXD
