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Therapeutics III > Geriatric Diseases - Block 4 > Flashcards

Geriatric Diseases - Block 4 Flashcards

1
Q

What is a geriatric syndrome?

A

Multifactoral health conditions that leads to impairments rendering patient vulnerable

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2
Q

What are the series of I’s?

A
  1. Immobility
  2. Instability
  3. Incontinence
  4. Intellectual impairment
  5. Infection
  6. Impairment of vision and hearing
  7. Irritable colon
  8. Isolation
  9. Inanition
  10. Insomia
  11. Immune def
  12. Impotence
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3
Q

Outcomes of immobility?

A

Deconditioning -> regaining what was lost takes longer in older adults

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4
Q

Outcomes of immobilization?

A

Inability to obtain water -> decreased plasma volume -> syncope, falls and, fractures

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5
Q

Outcomes of sensory deprivation?

A

Delirium -> treated by restraints or antipsychotics

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6
Q

Outcomes of immobilization caused by tethers?

A

Neccessitate nursing assistance to bathorrm and delay -> incontinence, cathers, infections, pressure sores

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7
Q

Outcomes of prescribed diets or NPO?

A

Dehydration, malnutrition, insertion of feeding tubes, and aspiration pneumonia

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8
Q

What is a pressure ulcer?

A

Localized injury to the skin or tissue as a result of pressure

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9
Q

What are extrinsic RF for pressure ulcers?

A
  1. Lying on hard surfaces
  2. Nursing homes
  3. Poorly fitting prostheses
  4. Pooor skin hygiene
  5. Patient restraints
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10
Q

What are examples of intrinsic RF for pressure ulcers?

A
  1. Diabetes
  2. ANemia
  3. Smoking
  4. Malnutrition
  5. Immunosuppression
  6. Vascular dx
  7. Spinal cord injury/paralysis
  8. Contractures
  9. Prolonged immobility
  10. Advanced age
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11
Q

What is considered a high risk patient for pressure ulcers?

A
  1. Older
  2. Trauma
  3. SCI
  4. Fractured hip
  5. Long term care
  6. Acutely ill
  7. Diabetes
  8. Critical care
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12
Q

How can we prevent pressure ulcers?

A
  1. Repositioning and mobility (move 4H if sitting, 2H for lying down): support surfaces, medical devices
  2. Clean and dry skin
  3. Don’t massage skin
  4. Individualized continence management plan
  5. Barrier product
  6. SKin moisturize
  7. Adequate nutrition
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13
Q

Topical barriers for pressure ulcers?

A
  1. Occlusives
  2. Humectants
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14
Q

What is the difference between occlusive and humectant?

A

Occlusive: insoluable in water
Humectants: increase skin’s ability to hold water

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15
Q

What are the types of occlusives?

A
  1. Petroleum jelly
  2. Silicone/dimethicone
  3. Zinc oxide
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16
Q

What are types of humectants?

A
  1. Glycerin
  2. Sorbitol
  3. Urea
  4. Seaweed extract
  5. Hyaluronic acid
  6. Alpha-hydroxl acids
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17
Q

What are physical characteristics used to assess pressure ulcers?

A
  1. Location
  2. Stage
  3. Size
  4. Tissue type
  5. Color
  6. Periwound
  7. Wound edge
  8. Sinus tracts
  9. Undermining
  10. Tunneling
  11. Exudate
  12. Odor

Would cultures are only for infections

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18
Q

What are the classes of pressure ulcers?

A

Stage I: Nonblanchable Erythema
Stage II: Partial Thickness Skin Loss
Stage III: Full Thickness Skin Loss
Stage IV: Full Thickness Tissue Loss
Unstageable: Depth Unknown
Suspected Deep Tissue Injury: Depth Unknown

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19
Q

What is the tx for pressure ulcers?

A
  1. Pressure relief
  2. Infection control
  3. Debridement
  4. Dressing, topicals
  5. Patient optimization
  6. Control of contamination
  7. Surgery for reconstruction
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20
Q

What are the types of dressings?

A
  1. Alginate dressings
  2. Foam dressings
  3. Gauze dressings
  4. Honey dressings
  5. Hydrocolloid dressings
  6. Hydrogel dressings
  7. Silver dressings
  8. Transparent film dressing
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21
Q

Alginate dressing

Advantages, Disadvantages, Ideal wound

A

A: Absorbent, infrequnet changes
D: expensive
Ideal: Infected wounds

22
Q

Foam dressings

Advantages, Disadvantages, Ideal wound

A

A: Absorbent, provides padding
D: expensive
Ideal wound: Infected, fragil surrounding skin, Stage 1, prevention

23
Q

Gauze dressing

Advantages, Disadvantages, Ideal wound

A

A: Inexpensive, microdebridement
D: frequent changes
Ideal wound: Large complex wounds with exudate or biofilm

24
Q

Honey dressing

Advantages, Disadvantages, Ideal wound

A

A: Mild antibiotic
D: poor efficacy
Ideal wound: Stage II with mild infection

25
Q

Hydrocolloid dressings

Advantages, Disadvantages, Ideal wound

A

A: absorbent
D: expensive
Ideal wound: wounds with minimal discharge, Stage II and III

26
Q

Hydrogel dressing

Advantages, Disadvantages, Ideal wound

A

A: hydrating
D: moves easily
Ideal wound: Dry or dehydrated, uninfected granulating wounds

27
Q

Silve dressing

Advantages, Disadvantages, Ideal wound

A

A: Antibiotic
B: Prevents epitheliazation
Ideal wound: Infected wounds, remove once infection is cleared

28
Q

Transparent film dressing

Advantages, Disadvantages, Ideal wound

A

A: Barrier from bodily fluids, infrequent changes
D: Not porous, can rip skip on removal
Ideal wound: Stage I, Stage II without exudate

*Must be dry, fentanyl patch

29
Q

How do we decide on what dressing to use?

A
30
Q

Describe the mechanism for swallowing?

A
31
Q

How does the ability to swallow affected by aging?

A

ALteration in olfaction and gustatory sensation -> affecting appetite, diet, and amount of intake

Lower salivary flow rate

32
Q

What is sarcopenia?

A

Decreased muscle mass and quality with advancing age

33
Q

What are the types of dysphagia?

A

Oral, Pharyngeal, esophageal

34
Q

What med can reduce attention and oral praxis?

A

Sedatives neuroleptics

35
Q

What meds cause xerostoma?

A

Anticholinergics, TCA

36
Q

What meds cause weakness in the tongue and mouth strength?

A

Steroids

37
Q

What are med that impair pharyngeal phase?

A

Antipsychotics

38
Q

What meds impair esophageal phase?

A

Bisphosphonates

39
Q

Drugs that are common causes of pill esophagitis?

A
  1. Tetracycline
  2. KCl
  3. NSAIDs
  4. ALendronate
  5. Quinidine
  6. Metformin
40
Q

What are drugs used for dysphagia?

A
  1. Botulinum toxin type A
  2. Diltiazem
  3. Nitrates
  4. Glucagon
41
Q

Define Compression of morbidity?

A

Limiting morbidity to a shorterr period closer to the natural end of life

42
Q

Define health span?

A

The period of life free of major chronic clinical dx and disability

43
Q

What are the phases of a health span?

A
  1. Period of healthy aging
  2. Period of disease and disability
44
Q

What are biological implications of longevity?

A

Increase health span by slowing the biological process of aging

45
Q

What are the Psychological and social implications of aging?

A
  1. Ageism
  2. Negative attitudes aboout one’s own aging
46
Q

What are the factors that affect preventative health?

A

Prevalence of problem and likelihoos of an effective intervention
* must focus on the QOL rather than mortality

47
Q

What are type of preventative activities?

A

Primary: Makes the patient more resistant or the environment less harmfull
Secondary: to screen or not to scfree
Tertiary: delay dx progression

48
Q

What are examples of primary activities?

A
  • Immunizations
  • Blood pressure
  • Smoking
  • Exercise
  • Diet/sodium restriction
  • Cholesterol
  • Social support
  • Home improvements
  • Seat belts
  • Medication review
  • Oral Care
49
Q

What are types of secondary activities?

A

Cancer screening

50
Q

What are types of tertiary activites?

A
  • Proactive primary care
  • Comprehensive geriatric assessment
  • Foot care
  • Dental care
  • Toileting efforts
  • Rehabilitation/exercise
  • Dietary protein
51
Q

What are the preventative health guidelines?

A
  1. U.S. Preventative Services Task Force
  2. My health finder
  3. HealthyPeople.gov
52
Q

What is Healthy People 2030?

A

Sets data-driven national objectives to improve health and well-being over the next decade

Therapeutics III (40 decks)

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