Failure to Thrive in the Geriatric Patient Flashcards Preview

Geriatrics FINAL > Failure to Thrive in the Geriatric Patient > Flashcards

Flashcards in Failure to Thrive in the Geriatric Patient Deck (18):
1

geriatric failure to thrive

Defined as:
-Ongoing State of Decline
-Multifactorial
-Chronic Concurrent Diseases
-Functional Disarray (Declining Activities of Daily Living, Impaired Instrumental Activities of Daily Living)

2

costs of failure to thrive

o Prevalence Increases with Age
o High Morbidity and Mortality
o Cost of Medical Care of Patients who are Failing to Thrive Escalates

3

How many elders are failing to thrive

o Community 5-35%
o Nursing Home 25-40%
o Hospital 50-60%

4

Institute of medicine nutrition criteria for failure to thrive

o Weight Loss >5% of Baseline
o Anorexia
o Poor Oral Intake
o Consequences: Inactivity, Pressure Ulcers, Impaired Immunity, Increased Surgical Mortality

5

contributing factors for failure to thrive

o Impaired Activities of Daily Living: Ambulation, Bathing, Eating, Dressing, Toileting
o Instrumental Activities of Daily Living
o Falls

6

underlying physical issues

o Chronic Heart Disease
o Chronic Lung Disease
o Dysphagia
o GI: Reflux, Constipation
o CANCER

7

underlying neurological disease

o Parkinson’s
o Stroke
o Multiple Sclerosis
o ALS

8

psychological factors

o DEPRESSION
o Dementia
o Delirium
o Chronic Mental Illness: Schizophrenia, Bipolar Disorder, Paranoid Disorders

9

medications for failure to thrive

o Any Rx can cause Failure to Thrive
o Major Culprits: Psychotropics: Anticholinergics: Antidepressants
o Over the counter
o Alternative nutritional supplements

10

failure to thrive work up

o Complete, comprehensive history and physical examination
o Mental Status Screening
o Depression Screening
o Functional Status Screening
o Medication Review: Prescription, Nonprescription

11

Tests for failure to thrive

-CBC = Anemia, Infection
-CMP = Malnutrition, Renal Failure, Dehydration
-ESR, C-Reactive Protein = Inflammation
-CXR = Infection, Neoplasm, TB
-PPD = TB

12

acute onset of failure to thrive

o Infections: Urinary Tract Infection, Pneumonia, HIV, Tuberculosis
o New Medication
o Unable to Afford Rx
o Elder Abuse/Neglect

13

acute onset underlying chronic disease

o Change of Status: Diabetes, COPD, Bowel “Problems”, Dehydration, Electrolyte Disturbance

14

frailty requirements

Frailty: Three of Five
-Weight Loss (unintentional)
-Self-reported Exhaustion
-Weakness (Decreased Grip Strength)
-Slow Walking Speed
-Low Physical Activity

15

failure to thrive chronic disease

o Anemia
o Cirrhosis
o Impaired Renal Function
o Congestive Heart Failure
o Chronic Obstructive Pulmonary Disease
o Thyroid Disease
o Arthritis

16

failure to thrive: cancer

o Before Diagnosis: “Dwindles”, “Poorly”, “Weak”, “Wind out of my sails”
o Beware anger if cancer diagnosis is delayed
o Treatment Induced Failure to Thrive: Chemotherapy, Radiation, Alternate Therapies
o Interventions: Psychological, Dietitian, Spiritual

17

failure to thrive and dementia

o Anticipated or Additional Disease?
o Health Care Decision Making: POLST, Ethics Committee, The “Solo” Elderly

18

failure to thrive and dementia interventions

-Treat underlying depression
-Appetite stimulants
-Support “slow eating”
-Nutritional supplements
-Tube Feeding