Exam I Flashcards by Claire Mitchell

Domains of the Geriatric Comprehensive Assessment

Functional
Physical
Cognitive
Psychological
Social
Spiritual
(and other....)

(Fun Physical Conga-lines Psych-out Social Scaredy-cats)

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The cognitive assessment focuses on which five categories?

Attention
Memory
Language
Visual-spatial skills
Executive capacity

(Alma Mar Loves Vampire Erections)

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Tools for assessing ADLs and IADLs

Katz index (ADLs)
Barthel index (ADLs)
Lawton IADLs

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Tools for assessing cognition

Mini Mental Status Exam (MMSE)

Montreal Cognitive Assessment (MoCA)

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Tools for assessing psychological domains

Discussion around “successful aging” (QOL)

Geriatric Depression Scale (GDS)

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Tools for social assessment

Lubben Social Network Scale

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Tools for spiritual assessment

FICA Spirituality Assessment

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Tools for assessing sleep

The Pittsburgh Sleep Quality Index

Insomnia Severity Index

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Tools for assessing confusion/delirium

Nursing Delirium Symptom Checklist (NuDeSC)

Confusion Assessment Method

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Tools for assessing mobility

Get Up and Go

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Benefits of the Comprehensive Geriatric Assessment

Less likely to die during hospitalization
Less likely to experience deconditioning
More likely to live at home 6 mo post-discharge

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Three areas to focus on during nutritional assessment

Caloric intake
Liquid intake
Calcium intake

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Poor outcomes associated with geriatric syndromes

Disability
Dependence
Decreased QOL
Need for nursing home
Death

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SPICES

Sleep problems
Problems with eating/feeding
Incontinence
Confusion
Evidence for falls
Skin breakdown

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What is SPICES used as?

A framework for assessing older adults. Focuses on six common “marker conditions” of geriatric syndromes.

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Risk factors for developing a geriatric syndrome

Older age
Functional impairment
Cognitive impairment
Impaired mobility
DM
Malnutrition and low weight

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What is the #1 nursing intervention for geriatric syndromes?

PREVENTION

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Three common sleep problems

Insomnia
Sleep apnea
Restless leg syndrome

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Two markers of malnutrition

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Sarcopenia (overall loss of muscle tissue)

Cachexia (wasting away of body, usually associated with terminal illness)

Complications associated with malnutrition

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Delayed healing
Increased risk for pressure ulcer development
Functional and cognitive decline
Deterioration in QOL

Four types of chronic urinary incontinence

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Stress UI (leakage w/ increased IAP)
Urge UI (sudden abrupt need)
Overflow UI (incomplete emptying)
Functional UI (environmental)

Cardinal signs of delirium

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Sudden onset
Cognition fluctuates throughout day
Incoherent, disorganized speech
Reduced focus, attention
Insomnia
Medical emergency

Cardinal signs of dementia

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Gradual onset
Normal attention
Clear cognition
Sun downing and reversed sleep
Short term memory deficit

Three types of delirium

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Hypoactive (lethargy, apathy, slowed speech)
Hyperactive (irritability, restlessness, agitation)
Mixed

What stage pressure ulcers are considered a "near miss event?"

Stage III & Stage IV

Stage I Pressure Ulcer

Non-blanchable erythema, intact skin

Stage II Pressure Ulcer

Partial-thickness kin loss with exposed dermis | May present as blisters

Stage III Pressure Ulcer

Full-thickness skin loss | Adipose, rolled edges, slough/eschar?, tunneling?, undermining?

Stage IV Pressure Ulcer

``` Full-thickness skin and tissue loss Exposed bone, fascia, muscle, tendon, ligament, cartilage, bone Slough/eschar Rolled edges Tunneling/undermining ```

Atypical presentations of MI

``` Decreased functional status Confusion/anxiety Fatigue Dyspnea and SOB INSTEAD OF PAIN Nausea ```

Atypical presentations of HF

Decreased functional status Confusion/anxiety Weakness TYPICAL ASSESSMENT FINDINGS: Crackles Weight gain Peripheral edema

Atypical presentations of infection

Decreased functional status Confusion/falls Decreased appetite Lack of fever

Atypical presentations of pneumonia

Confusion/delirium Weakness Decreased appetite TYPICAL ASSESSMENT FINDINGS: Tachypnea Tachycardia Dullness in percussion over lung fields -often leads to hypoxemia and sepsis-

Atypical presentations of UTI

Decreased functional status Confusion/delirium Falls Sudden onset urinary incontinence -often leads to sepsis and shock-

Atypical presentations of acute abdominal concerns

``` Confusion Agitation Lethargy Mild discomfort Constipation Absent/vague pain ```

Atypical presentations of depression

Lack of sadness Appetite changes Sleep disturbances Preoccupation with somatic symptoms

Outcomes of atypical presentations

``` Delayed treatment Delayed diagnosis Severe outcomes Increased length of stay Decreased QOL Missed diagnoses ```

What are cataracts?

Clouding of the normally clear lens of the eye

S/S of cataracts

Blurry vision Changes in color Glare Decreased vision

Risk factors of cataracts

Age DM Smoking Sun damage

What is glaucoma?

Blocked drainage leading to increased optic pressure that damages the optic nerve

S/S of glaucoma

Loss of peripheral vision | Elevated pressure in eye

Risk factors of glaucoma

``` Age Infection Tumor DM Hereditary ```

What is retinal detachment?

A painless separation of the retina, causing sudden loss of vision. NOT NORMAL AGING

S/S of retinal detachment

Curtain over visual field and sudden vision loss

Medications that affect hearing

``` NSAIDS Aspirin IV Abx IV Loop Diuretics Quinine Chemo ```

Exam I Flashcards

(46 cards)