Geri Rupp Flashcards
(63 cards)
Geriatric population ___ fold increase of intra-op death
3
Elevated CV changes in geri
Elevated afterload,
elevated systolic pressure,
Left ventricular hypertrophy
Decreased CV changes
decrease in elasticity of arteries,
adrenergic activity decreases,
decreased heart rate both rest and max,
decreased baroreceptor response
Commonly on H&P
Aortic stenosis, Hx of arrhythmias, CHF, HTN, CAD
Heart rate declines __ _____ per minute per year over the age of ____
1 beat,
50
_____ enlargement puts them at risk for ____ and very common A-____
Atrial,
SVT,
A-fib
COnduction system fibroses and loss of ___ node cells increase chances of _____
SA node,
arrhythmias
Left ventricular wall ______ by _____ the cavity
thickens,
decreasing
Eccentric hypertrophy
ventricular dilation while maintaining normal sarcomere lengths-the heart can expand to receive a greater volume of blood. The wall thickness normally increases in proportion to the increase in chamber radius
Concentric hypertrophy
In the case of CHRONIC pressure overload (as through anaerobic exercise, which increases resistance to blood flow by compressing the arteries), the chamber radius may not change; however, the wall thickness greatly increases as new sarcomeres are added in-parallel to existing sarcomeres
what causes drops in BP during induction with geriatrics?
decreases in their cv system-autonomic responses that maintain homeostasis progressively decline-autonomic dysfuntion
circulation time IV vs inhalation
slow IV drugs but speeds induction with inhalation agents
What are two cardiovascular responses that are altered to blunted B-receptor response?
decreased maximal heart rate and decreased peak ejection fraction (board question)
The elderly patient is more dependent on an _____ in ___-_____ volume than an ________ in heart rate to produce an _____ in CO.
increase, end-diastolic, increase, increase. These factors make the geri patient more prone to CHF when large volumes of IV fluids are administered in the presence of anesthetic-induced myocardial depression and hypotension.
Respiratory decrease changes
decrease in elasticity of lungs,
decrease in alveolar surface area,
decreased cough,
blunted response to hypercapnia and hypoxia,
decreased max breathing capacity,
vital capacity significantly decreases-25mL/yr starting at age 20,
total lung capacity decreases
respiratory changes increase
increased residual volume, vent/perf mismatch, increased chest wall rigidity, increased closing capacity and closing volume, dead space increases, FRC increases slightly
Lung H&P
Lung CA,
Pneumonia,
Emphysema,
Chronic bronchitis
Respiratory general
see an over distention of alveoli,
collapse of small airways,
this pts difficult to mask vent-edentulous,
arthritis in mouth opening and cervical spine,
no teeth does make for a better view,
increase risk of aspiration r/t decrease in airway reflexes,
shallow breathers in recovery room-Question to leave intubated with a pre-exisiting respiratory disease.
elderly have signs of both ____ and obstructive disease
restrictive
does Vd/Vt ratio increase or decrease with age
Bohr equation, increase?
150mL/450mL=0.33%
200mL/400mL=0.5%?
Elderly gastric
gastric pH rise,
Gastric emptying slows,
Some elderly patients have smaller stomach volumes than younger patients
Temperature regulation
Heat production decreases,
Heat loss increases,
Three things that put them at risk-decreased metabolic rate, decreased heat production, deficient thermostat control
Renal changes
decreased blood flow, GFR, renal mass, concentration, dilution, drug excretion, renin-aldosterone response.
Impaired sodium handling, fluid handling, and potassium excretion
Renal H&P
Prostatic obstruction, CHF, Hypertensive nephropathy, diabetic nephropathy
