Exam 3 Flashcards by megan kaiser

ataxic

unsteady, uncoordinated, feet raised high while stepping and then dropped flat on floor; indicates cerebellar disease or intoxication

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Foot slapping

wide based, feet raised high while stepping and then slapped down against floor; no staggering or weaving; indicates a lower motor neuron disease, paralysis of pretibial and peroneal muscles

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Hemiplegic

unilateral foot drop and foot dragging, leg circumducted, arm flexed and held close to side; indicates unilateral upper motor neuron disease

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Parkinsoniam

trunk leans forward, slight flexion of hip and knees, no arm swinging while stepping, short and shuffling steps, starts slowly and then increases in speed; indicates PD

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Scissors

slow, short steps, legs cross while stepping. Spastic paraplegia, dementia, cerebral palsy

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Spastic

uncoordinated, jerking gait, legs stiff, toes drag; indicates spastic paraplegia, spinal cord tumor, or MS

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what is the leading cause of physical disability in older adults?

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mullein, marshmallow, eucalyptus, pine, lavendar, lemon and slippery elm

herbs that increase pulmonary secretions and sooth irritated lining.

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Do you recommend a patient with a respiratory condition eat spicy food?

yes! Spicy foods open passages

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confusion, muscle twitching, visual defects, perspiration, hypotension, circulatory failure, cerebral depression

signs of CO2 necrosis from too much o2

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What is the purpose of cupping and vibration?

drainage of pulmonary secretions

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red, frothy sputum

pulmonary edema or left-sided heart failure

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tenacious, translucent greyish white sputum

COPD

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purulent and foul smelling sputum

lung absess or bronchiectasis

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awakening with a dull HA, impaired memory, disorientation, confusion, epistaxis and slow tremor

symptoms of HTN=most prevalent cardiovascular disease in older adults

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What may be indicated if tactile fremitis is increased?

pneumonia or mass

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What may be indicated if tactile fremitis is decreased?

COPD, pneumothorax

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Measures to promote respiratory health in older adults?

inspiration: expiration = 1:3

smoking cessation

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increased RR with decreased appetite and decreased functioning, no chest pain, low grade fever

Pneumonia

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more frequent infections, hypoxia; manage by removing secretions and prevent airway obstruction, ensure adequate hydration and expectoration of secretions

Chronic Bronchitis

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require more effort jut for breathing, hypoxia, fatigue, anorexia, weight loss, weakness, symptoms slow in onset and can delay diagnosis and Tx; manage with postural drainage, give bronchodilators, avoid stress and extremely cold weather, safe med administration, recognize SOI, smoking cessation, pace activities

Emphysema

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leading cause of cancer deaths, rare under 40 yo, increase in incidence 60-70 yo; average age is 71. dyspnea, coughing, chest pain, fatigue, anorexia, wheezing, recurrent URI’s

Lung CA

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Why is the HR typically slower in older adults?

fibrous tissue and fat deposits reduce HR

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Why are arrhythmias common in older adults?

heart fills more slowly–> arrhythmia

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hypotension, tachycardia, claudication, edema, loss of hear on extremities, tissue necrosis, dyspnea, increased RR, pallor, cool skin, cyanosis, decreased UO, delirium, restlessness, memory disturbance

indications of ineffective tissue perfusion

Nutrition for cardiovascular health

decrease fat and stimulants, increase fiber and exercise, manage stress

Statins Side effects

muscle pain, weakness, fatigue, ED, memory loss, burning or tingling in hands and feet

calcium supplements

to reduce cholesterol and platelet aggregation

selenium supplements

to reduce platelet aggregation

magnesium supplements

to dilate arteries, prevent calcification of vessels, decrease total cholesterol, increase HDL, inhibit platelet aggregation

What should you watch for if an older adult has a high carb diet?

A high carb diet can stimulate an abnormally high release of insulin in the older adult which leads to HYPOglycemia which may initially present as a confused state

What nutrients facilitate Calcium absorption in the older adult?

vit D and Mg

Too much of what results in calcium deposits in kidneys and arteries?

vit D

too much of what may contribute to blood clots?

vit K

too much of what may mask a vit B12 deifiency which is a cause of dementia?

folic acid

Too much of what may lead to renal calculi and an impaired ability to absorb other minerals

too much calcium (more than 2000/day)

dense masses of seeds, skins, and other fiber-containing components of plants that form in the stomach

bezoars-may be an adverse development r/t too much fiber and lower gastric acidity (n/v, fullness, and ABD pain)

goose bumps

vit B6 deficiency

purpura

vit C deficiency

brownish pigment

niacin deficiency

red scaly areas in folds around eyes and between nose and corner of mouth

riboflavin deficiency

dermatitis

zinc deficinecy

midarm muscle circumference

25.3 males, 23.2 females; MMC below 90% of the standard is considered undernutrition, below 60% is considered protein-calorie malnutrition

what vitamin deficiencies may result in depression?

vit B6, Mg, or niacin

What drug is least toxic to older adults to treat asthma

cromolyn sodium; may take weeks to become therapeutic

What is a great diagnostic tool to screen for MI?

C-Reactive Protein is a marker of inflammation that is a stronger indicator of cardiovascular disease than LDL. CRP>3 is bad. add LDL160 must be controlled by meds

Besides cardiovascular disease, what else might elevated CRP indicate?

lupus or endocarditis

Classes of Heart Failure

Class 1: no limitation on activity Class 2: symptoms with ordinary activities but only slight limitations Class 3: symptoms with less than ordinary activity and significant limitations Class 4: symptoms with ANY activity--> bedrest

dyspnea of exertion | confusion, insomnia, weakness, SOB, bilateral ankle edema, moist crackles on auscultation

CHF-skin is at risk for breakdown due to edema and build up of toxic chemicals

first indication may be only vague discomfort under sternum and often after larger meal. Syncope, cough, sweating w exertion, confusion Angina may be diffuse and less severe

CAD (ischemic heart disease)

How do you teach a pt to avoid angina?

avoid cold wind, emotional stress, strenuous activity, anemia, tachycardia, arrhythmias, hyperthyroidism

Classic sign is sudden onset of dyspnea often accompanied by anxiety and confusion, pain to left arm, entire chest, neck, jaw, and abdomen.

MI-older adult may have atypical symptoms and absence of pain

what is postprandial hypotension?

usually associated with taking anti-HTN meds before a meal; is a 20 mm Hg drop within one hour of eating DRINK CAFFEINE AFTER A MEAL TO REDUCE OCCURRENCE

How often should you remove antiembolism stockings and inspect skin?

remove antiembolism stockings for ten minutes q8h

What is the primary source of cardiac energy?

GLUCOSE! encourage regular intake of glucose in older adults

Walking can provide collateral circulation to naturally relieve what?

intermittent claudication

how do you treat resting pain?

analgesics

How does hawthorne berry aid in cardiovascular disease

dilates vessels, relieves arterial wall spasms, produces hypotension

how does garlic aid in cardiovascular disease?

dissolves clots

how does ginger aid in cardiovascular disease?

decreases cholesterol

how does gingko aid in cardiovascular disease?

increases circulation

herbs that stimulate bowel movements

CDRS | Cascara segrada, dandelion root, rhubarb, senna

buerger allen exercises for

ateriosclerosis

urinary frequency

caused by hypertrophy of the bladder muscle and thickening of the bladder which decreases the ability of the bladder to expand and reduces storage capacity

nocturia

nighttime frequency due to improved kidney circulation in recumbent position or age-related changes in cortical control of micturition or diuretics

most common cause in women is fecal impaction while most common cause in men is BPH

urine retention

Why is the increased renal threshold for glucose a major concern in older individuals?

older adult may be hyperglycemic without evidence of glycosuria

give estrogen or anticholinergics

to treat stress incontinence

strict toiletting schedule, kegel exercises, biofeedback, anticholinergics or sympthomimetics

treat urgency incontinence

toileting schedule, crede method, intermittent cath, meds (cholinergics)

treat overflow incontinence

painless hemturia is the primary sign of what?

bladder cancer-watch for complications manifesting as pelvic or back pain

how much calcium should you eat dialy?

1500mg or 1000mg if taking estrogen

methotrexate

treat RA

intellectual performance is preserved up to which age? | verbal skills are maintained until which age?

80/70

body mvmts affects by loss of dopamine producing cells in substantia nigra

parkinsons disease

tremor, rigidity, bradykinesia, postural instability

what dietary considerations should you make with a prescription for levodopa?

no foods with vit b6 (avocados, lentils, lima beans)

shuffling gait with leaning forward of trunk

decrease in lens elasticity

presbyopia

visual acuity declines

due to reduced pupil and opacification of lens and vitreous, loss of photoreceptor cells in retina

Exam 3 Flashcards

(80 cards)