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DNURS 832--Principles--OTHER > Geriatric Anesthesia - Quiz 8 > Flashcards

Geriatric Anesthesia - Quiz 8 Flashcards

1
Q

What CV Decreases are seen in Geriatrics?

A

↓Artery Elasticity

↓HR @ Rest & Max

↓Baroreceptor Response

↓Adrenergic Activity

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2
Q

What CV Increases are seen in Geriatrics?

A

↑Afterload

↑SBP

LV Hypertrophy

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3
Q

What are common Geriatric CV Problems?

A

Aortic Stenosis

HTN

CAD

CHF

Arrythmias

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4
Q

How does HR change after the age of 50?

A

Decreases by 1 bpm per year after 50

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5
Q

Why are the chances of arrythmias higher in the elderly?

A

Fibrosis of Conduction System & Loss of SA Node Cells

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6
Q

What is the concern regarding Atrial Enlargement in Geriatrics?

A

More risk of SVT & A-Fib

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7
Q

What is Eccentric Hypertrophy?

A

Ventricular dilation w/ normal Sarcomere Lengths - wall thickness proportional to chamber radius

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8
Q

What is Concentric Hypertrophy?

A

Wall thickness greatly increases, while chamber radius stays the same d/t newly added Sarcomeres from Chronic Pressure Overload

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9
Q

Why is there such a profound drop in BP during induction with Geriatrics?

A

Autonomic Dysfunction

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10
Q

How does Slow Circulation in Geriatrics affect Induction?

A

Slows IV Drugs, but Speeds Gas Induction

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11
Q

What CV Reponses are Blunted in regards to Beta Receptors?

A

↓Max HR

&

↓Peak EF

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12
Q

How does the elderly patient increase their Cardiac Output?

A

Elderly Cardiac Output is more dependent on End-Diastolic Volume rather than Heart Rate

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13
Q

Why is the Geriatric patient more prone to CHF when receiving large volume of fluids?

A

Anesthetic-induced Myocardial Depression & Hypotension + they can’t really increase their HR much.

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14
Q

What Decreases are seen in the Geriatric Respiratory System?

A

↓Lung Elasticity

↓Alveolar Surface Area

↓Cough

↓Response to Hypercapnea & Hypoxia

↓Max Breathing Capacity

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15
Q

What Increases are seen in the Geriatric Respiratory System?

A

↑Residual Volume

↑Chest Wall Rigidity

↑Closing Capacity & Volume

↑Alveoli Over Distention

↑Collapsed Small Airways

↑Dead Space

↑FRC

V/Q Mismatch

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16
Q

What are common Geriatric Respiratory problems?

A

Lung CA

Pneumonia

Emphysema

Chronic Bronchitis

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17
Q

How is Mask Ventilating & Intubating affected by Geriatrics?

A

Mouth Opening & Cervical Spine Arthritis

No teeth = Difficult Masking, but better view

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18
Q

Why are the elderly more at risk for aspiration?

A

Decreased Airway Reflexes

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19
Q

What is the Post-Op concern for Geriatrics?

A

Shallow Breathers - use narcotics judiciously, may require re-intubation

20
Q

How does age affect Vital Capacity?

A

Significantly decreases by 25 mL per year after 20 years old

21
Q

What are the GI changes in Geriatrics?

A

↑Gastric pH

↓Gastric Emptying

↓Stomach Volume

22
Q

Elderly patients have ______ Heat Production & _____ Heat Loss d/t a decreased Metabolic Rate & Thermoregulation

A

Elderly patients have LESS Heat Production & MORE Heat Loss d/t a decreased Metabolic Rate & Thermoregulation

23
Q

What are the Renal Changes in Geriatrics?

A

Decreased GFR, Renal Blood Flow, Renal Mass, and all normal Functions

24
Q

What are common Renal Problems in Geriatrics?

A

Prostatic Obstruction

Hypertensive Nephropathy

Diabetic Nephropathy

25
Q

What causes a decline in Renal Function in Elderly Patients?

A

Renal Cortex replaced w/ Fat & Fibrotic Tissue

26
Q

How much does BUN increase per year?

A

0.2% mg/dL per year

27
Q

What is the most specific test of Renal Failure?

A

24 hr Serum Creatinine Clearance

28
Q

Which part of the Nervous System decreases in Geriatrics?

A

↓CBF & Brain Mass

↓Neurotransmitters & Receptors

29
Q

How does physical activity affect Cognitive Function?

A

More Physical Activity = Preservation of Cognitive Function

30
Q

What causes Muscle Atrophy in the Elderly?

A

Degeneration of Peripheral Nerves that slows Conduction & Reaction

31
Q

What Nervous System thresholds increase in the Geriatric Patient?

A

Touch

Temp

Pain

Propioception

Hearing & Vision

32
Q

Geriatric patients require ______ Local & General Anesthetics

A

Geriatric patients require LESS Local & General Anesthetics

33
Q

Epidural Anesthetics tend to spread which way for Geriatric Patients?

A

More Cephalad

34
Q

For Geriatrics, Analgesia & Motor anesthetics have a ______ duration and need ____ time to recover Cognitively from General Anesthetics

A

For Geriatrics, Analgesia & Motor anesthetics have a SHORTER duration and need MORE time to recover Cognitively from General Anesthetics

35
Q

How do Anticholinergics like Scopolamine & Atropine affect the Elderly?

A

Hypersensitive to Anticholinergics

36
Q

The relationship b/t Drug Dosage & Plasma concentration is known as what?

A

Pharmacokinetics

37
Q

What is Pharmacodynamics?

A

Relationship b/t Plasma Concentrations & Clinical Effect

38
Q

How does the Decreased Total Body Water in Geriatrics affects drugs given?

A

Affects Water-Soluble Drugs & can lead to Higher Plasma Concentrations

39
Q

How does the increase in Body Fat in the Elderly affect Lipid Soluble Drugs?

A

More Volume Distribution, which can lower Plasma Concentrations

40
Q

How much does MAC decrease per decade after 40?

A

4% per Decade after 40

41
Q

Why would Geriatric Patients take longer to wake up even though they maintained normothermia?

A

Increased Body Fat

Decreased Hepatic Function

Decreased Pulm. Gas Exchange

42
Q

Older patients need less Opioids, Benzos, and Barbs, but how do Muscle Relaxors affect them?

A

No change in NMB effect, but prolonged renal excretion

43
Q

How does protein binding change in Geriatrics?

A

Older patients have more Alpha-1 Glycoprotein, which binds to Local Anesthetics & Opioids

44
Q

What is Hutchinson-Gilford Progeria?

A

Premature aging that becomes apparent after 6 months of age w/ an average lifespan of 13 years

45
Q

What comobidities are often associated w/ Progeria?

A

Ischemic Heart Disease

HTN

Cerebrovascular Disease

OA

DM

46
Q

What might make intubating a Progeria patient difficult?

A

Mandibular Hypoplasia

Micrognathia

Narrow Glottic Opening

47
Q

What are the general anesthetic considerations when working w/ Geriatrics?

A

Consider Regional > GA

Give B-Blockers

Give Abx

Avoid Hypothermia

DNURS 832--Principles--OTHER (5 decks)

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