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Semester 3 PM Exam 6 > Geriatric Assessment > Flashcards

Geriatric Assessment Flashcards

(79 cards)

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1
Q

Additional health status questions

A

Do you have visual problems
Do you have hearing difficulties
Have you been experiencing any light headedness
Have you fallen in the last year
Fear of falling
How many times have you left your home in the last year
Do you need assistance when you leave your home
Have you had a bone scan done recently

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2
Q

Additional questions - vision

A

Have you ever had eye surgery
Do you wear glasses
When was your last eye exam

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3
Q

Additional questions - hearing

A

Do you use a hearing aid

When was your last hearing exam

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4
Q

Additional questions - light headedness

A

Dizziness

Spinning or vertigo

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5
Q

Additional to systems review - musculoskeletal system

A

Height in typical standing posture
Height in erect standing
Height in conscious erect standing

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6
Q

Additional to systems review - genitourniary

A

Bladder - urinary freq, urgency, incontinence, color, difficulty
Bowel - changes in regularity

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7
Q

Red flags from history

A

Resting HR (more than 120 or less than 50)
Resting SBP (more than 200 or less than 90)
Resting DBP (more than 110)
Weight gain (more than 4-6 lbs a day)
Ankle edema
Acute angina
Acute dizziness

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8
Q

Choosing the best test

A

Should reflect a similar population
Should be easy to perform
Should have strong measurement properties

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9
Q

F words

A

Fun - Function - Frailty - Failure

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10
Q

Fun ages

A

until about 50, maybe 65

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11
Q

Function ages

A

50 or 65 until 75 or 85

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12
Q

Frailty ages

A

75 or 85 until 95 or 90

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13
Q

Failure ages

A

85 or 90 until 100

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14
Q

Functional Markers - Fun category

A

TUG (less than 8 sec)
FSST (less than 10 sec)
30 sec chair rise (more than 15)

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15
Q

Functional Markers - Function category

A

TUG (9-20 sec)
FSST (10-15 sec)
30 sec chair rise (9-14)

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16
Q

Functional Markers - Frail Category

A

TUG (more than 20 sec)
FSST (15-20 sec)
30 sec chair rise (less than or equal to 8)

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17
Q

Frailty defined as

A

a clinical syndrome in which 3 or more of the following are present:

  • Unintentional weight loss
  • Weakness
  • Slow walking speed
  • Low physical activity
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18
Q

Frailty definition - unintentional weight loss defined as

A

10 pounds in last year

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19
Q

Frailty definition - weakness defined as

A

Grip strength
less than 30 kg men
less than 18 kg women

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20
Q

Frailty definition - slow walking speed

A

Less than .65 m/s for 15 feet

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21
Q

Frailty definition - low physical activity

A

cal burned

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22
Q

The prevalence of frailty is

A

difficult to determine
5-8% of people over 65
33% of people over 85 - need assistance with at least one ADL

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23
Q

Functional Markers - Failure category

A

TUG (more than 20 sec)
FSST (more than 20 sec)
30 sec chair rise (0)

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24
Q

2 minute step test is associated with

A

the ability to perform lifestyle tasks like walking and climbing stairs
It is an alternate to the 6 min walk test

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25
2 minute step test - equipment required
Stopwatch Tally counter Tape measure or metric ruler Masking tape or whiteboard marker
26
2 minute step test - establishing knee lift height
Mark on the wall the height from ground to participants mid thigh (btw patella and iliac crest)
27
Where to stand with 6 minute walk test
off to side and a little behind | You do not want to set their pace for them
28
2 minute step test
Pretty high for geriatric population
29
Four Square Step Test - test of
dynamic balance that clinically assess the persons ability to change directions while stepping NOT good for visually impaired Looking at dynamic balance
30
Four square step test - what is it
pt instructed to stand in square 1 facing square 2 and then as fast as they can they step into 2, 3, 4, 1, 4, 3, 2, and 1
31
Four square step test - requires patient to step
forward, backward, and sideways to right and left
32
Four square step test - equipment
stopwatch and 4 canes
33
Cut point for fall risk - FSST
If it takes more than 15 seconds for them to do it
34
30 second chair rise provides a measurement of a persons
``` lower body (leg strength) Associated with the ability to perform lifestyle tasks like climbing stairs, getting in and out of vehicles ```
35
Equipment for 30 sec chair rise
Chair with a straight back and a seat at 43 cm | Stop watch
36
30 sec chair rise instructions for participant
``` Sit in middle of the chair Cross arms over chest Keep feet flat on floor Keep back straight On signal begin to rise to full stand and then sit back down ```
37
Cut point for 30 sec chair rise
less than 10 is an indication of poor leg strength | As yet, there is no fall risk for this test
38
Timed up and go test was developed as a
brief screen for mobility and fall risk | Has good test-retest reliability and Sn and Sp for falls
39
What is timed up and go measuring
Time it takes for an individual to stand up from a standard arm chair, walk 3 meters, turn, walk back to chair, sit down again No physical assistance Can use normal walking aid if their norm
40
Cut point for TUG
Vary depending on population studied | Generally more or equal to 14 seconds
41
Seated step test is a measure of
exercise tolerance, fitness for activity and endurance | Graded exercise test that's less intense than submax or max bike, treadmill testing
42
Seated step test is completed in
4 stages Pt seated in chair or wc and asked to alternately place each foot on edge of step or raised bar for period of time Each level is performed at inc level of exercise intensity
43
Stages for seated step test - Step 1
Alternate placement of heel on raised edge 6 in high at rate of 1 step per second (2.3 mph walking)
44
Stages for seated step test - Step 2
Alternate placement of heel on raised edge 12 in high at rate of 1 step per second (2.9 mph walking)
45
Stages for seated step test - Step 3
Alternate placement of heel on raised edge 18 in high at rate of 1 step per second (3.5 mph walking)
46
Stages for seated step test - Step 4
Alternate placement of heel on raised edge 24 in high at rate of 1 step per second (3.9 mph walking)
47
Seated step test - vitals
HR and BP monitored at two minutes and five minutes Vitals after every stage? HR under 75% of age predicted max at 5 min means you continue to next stage
48
Physical performance test
Measures several aspects of function ADL and AIDL Simple, inexpensive Takes about 10 minutes
49
Test for physical performance test
``` Write a sentence Simulate eating Lifting a book and place it on shelf Donning and doffing a jacket Picking up a penny from floor Turning 360 while standing Walking 50 feet ```
50
Gait Speed - to determine
``` gait speed while walking To evaluate mobility Need pathway of 3 meters - can do 4, 5, or 10 Allow 2 meters for acc and deceleration Good reliability ```
51
Gait speed - procedures
Instruct pt to walk at comfortable pace for trial run for entire distance Then test gait speed at comfortable pace Then instruct pt to walk at fast pace for trial run Then test gait speed at fast pace Give 2 trials Obtain the gait speed and divide by distance
52
Scores for Gait speed
0.5 m/s is sufficient for community ambulators Less than 1 m/s = well functioning people at high risk of health related outcomes 1.2 - 1.3 m/s usual adult walking
53
Functional status questionnaire can be used as a
self administered functional assessment for providing info on patients physical, psychological, social and role function
54
Functional status questionnaire - can be used as both
screen initially for problems | And to monitor patient over time
55
Sections of functional status questionnaire
``` Physical function in ADLs Psychological function Role function Social function Variety of performance measures ```
56
Cognitive tests - Mini mental
One of the most frequently used cognitive screens
57
Equipment for mini mental
Form | Pencil
58
Mini mental - tool consists of
two sections First verbal responses and addresses orientation, memory, and attention Second respond to verbal and written commands
59
Score for mini mental -
Out of 30 More than 24 = cognitively intact Less than 23 = cognitive impairment
60
Cognitive exam - MoCA
Rapid screen of cog abilites Best for Alz, dementia, stroke, parkinsons Looks at visuospatial, naming, memory, attention, language, abstraction, recall and orientation
61
Short portable mental status questionnaire (SPMSQ) - assess
Short reliable tool that assesses cognitive impairment
62
Short portable mental status questionnaire - measures
Orientation, memory function related self care, remote memory and capacity to perform mental operations
63
Scoring for Short portable mental status questionnaire
0-2 errors = normal mental functioning | 8 or more errors = severe cognitive impairment
64
Saint Louis Mental Status Exam
30 point screening questionnaire to identify people with mild cognitive disorder
65
Saint Louis Mental Status Exam - time and what it is testing
7 minutes | Orientation, verbal recall, calculation, naming, attention, executive function
66
Saint Louis Mental Status also takes what into consideration -
Education
67
Geriatric Depression Scale
Assesses depression and suicide ideation in elderly 30 item questionnaire Y or N questions Score of 11 or above indicated depression
68
Dyspnea Scale
``` 1 = light, barely noticeable 2 = moderate, bothersome 3 = moderately severe, very uncomfortable 4 = most severe or intense dyspnea ever experienced ```
69
RPE
6 - 20
70
Anginal scale
1 = lightly barely noticeable 2= moderate, bothersome 3 = severe, very uncomfortable 4 most severe pain ever experienced
71
Rib/Pelvis Distance - Less than 1 fingerbreadth Less than 2 fingerbreadths More than 2 fingerbreadths
Less than 1 fingerbreadth = fracture with high certainty less than 2 fingerbreadths = may need radiographs More then 2 fingerbreadths = rule out fracture with high degree of certainty
72
Strength test - arm curl test
To assess upper body strength required for household and other activities that involve carrying and lifting 5 lb women 8 lb male
73
Procedure for arm curl test
Have pt perform bicep curls using good form throughout | Count curls completed in 30 seconds
74
Grip strength
Measures strength of grip | Need dynamometer
75
Procedure for grip strength
Subject is seated with shoulder adducted, neutrally rotated, elbow flexed to 90 deg, forearm neutral, wrist btw 0 and 30 deg of DF Squeeze as hard as possible for 3 sec
76
Future older adults - higher levels of educational attainment =
lower mortality better health reduced poverty less likelihood of being alone
77
Before 2005 - what percent of adults had 4 or more children
35%
78
After 2005 - what percent have 4 or more children
11% | Need for formal care will increase
79
Future older adults - older adults can now expect to live
18.7 yrs on avg more than in 1980s and will continue to inc | Longer time in workforce - older women will have pensions now

Semester 3 PM Exam 6 (2 decks)

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