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Flashcards in Intro. to Geriatrics Deck (39):
1

T/F: Old age or being a geriatric is defined as 60 years and over.

False; 65 years old!

2

When does medical care dramatically rise amongst all age groups? (Hint it's in the geriatric range)

75 years old

3

T/F: Women outlive men

True

4

By 2050, the percent of white elders will ______ by 20% and Asians & Hispanic percent rate will _______ by 300%.

Drop; Increase

5

As we get older, we get obese and unhealthy. Womp womp womp. Why?

We are overfed and undernourished!

6

The percentage of income that Social Security provides differs from total income depending upon income level.

And in modern times, less elders are in the low-income/poverty level. And the high income groups have increased.

7

T/F: Better healthcare is extending lives

False! This change is due to changes in public health.

- Cleaner Water
- Better nutrition
- Less poverty
- Improved Prenatal Care
- Childhood Immunizations
- Smoking Less
- Safety Measures

8

On a very basic level, what is the cause of human aging?

Disruption of homeostasis

9

Factors of aging:

- Gender
- Genetics
- Lifestyle

10

Common causes of death since the 1940s

- CVD
- CA
- CVA
- DM

11

Common Sensory Impairments due to Aging

- Presbycusis (50%)
- Presbyopia (20%)
- Memory Impairment (10%)
- No natural teeth (33%)

12

Common Geriatric Syndromes

- Falls
- Urinary Incontinence
- Confusion
- Immobility
- Sleep Disorders
- Fatigue
- Weight Loss

13

T/F: Generally, minority group members die later in life from preventable causes

False; They die earlier

14

Goal of geriatrics:

Older adults will maintain full function and live active lives in their homes and communities

15

Two foundations of Geriatric Medicine

1. Ethical Decision Making (can vs. should)
2. Patient-Centered Care

16

What to consider with Patient-Centered Care? (FIFE)

F- Feelings (hopes and fears)
I- Ideas about what's going on
F- Function (How is the illness affecting their life?)
E- Expectations

17

When assessing the older adult, what should we focus on?

***Healthy or successful aging -- Quality of Life

- Understand and mobilize family, social, and community supports
- Important of skill directed to functional assessment
- Opportunities for promoting older adult's long-term health and safety

18

Geriatric/Aging Changes of Blood Pressure

Widened Pulse Pressure

19

Geriatric/Aging Changes of Heart Rate and Rhythm

Rhythms Change in multiple ways!
Maximum Rate decreased!

20

Geriatric/Aging Changes of Respiratory Rate and Temperature

RR Unchanged
Basal Temp lowered

21

Geriatric/Aging Changes of Integumentary System

- Think Skin
- Grey Hair
- Thick Nails
- Sun Damage starts catching up

22

Geriatric/Aging Changes of Eyes

- Increased incidence of degenerative diseases
- Presbyopia

23

Geriatric/Aging Changes of Ears

- Presbycusis

24

Geriatric/Aging Changes of Thorax and Resp System

- Increased Chest Wall Stiffness
- Osteoporosis and Kyphosis can reduce the thoracic capacity
- Osteoporosis, kyphosis, and alveolar stiffness leads to "senile emphysema" with FEV1/FVC < 70% of the predicted for age and gender.

25

Respiratory Problems are associated with all cause mortality and specifically with:

- CVD
- COPD
- Lung Cancer

26

Geriatric/Aging Changes of the CV System

- Reduced Cardiac Output
- Increased BP
- Increased Peripheral Vascular Resistance

27

Geriatric/Aging Changes of Male and Female Genitalia

- Female: Menopause between aged 48-55
- Male: ED - common after 4th decade -- important marker for CVD
- Prostate: BPH

28

Geriatric/Aging Changes of MSK

- Loss of height
- Loss of Muscle Mass
- Osteoarthritis
- Osteoporosis
- Increased risk for fracture

29

Geriatric/Aging Changes of Neuro

- Neuronal loss is normal in the aging brain but ability to learn remains generally unchanged
- Recall memory declines
- Increased incidence of dementias

30

Geriatric/Aging Changes of Renal System

- Decreased renal mass and size
- Mostly loss of renal cortex - 40% less glomeruli by age 80
- Reduced Renal Blood Flow (dec 10% reduction per decade after 20)
- Less Urine Concentration

31

Geriatric/Aging Changes of GI

- Decreased Global Functions (secretion/absorption)

32

Geriatric/Aging Changes of Endocrine

- Hypothyroidism
- DM has an increased incidence
- Vitamin D absorption - Parathyroid Issues
- Androgen/Estrogen lessens

33

Geriatric/Aging Changes of Immune System

- Global Decrease in immune function and response to antigens

34

Things to think about when treating the elderly

- They can undergo most surgeries that younger patients can
- Treat infections AGGRESSIVELY
- Mental Status Changes, you should think urgent/emergent disease

35

ADLs

- Bathing
- Dressing
- Toileting
- Transferring
- Continence
- Feeding

36

IADLs

- Using Telephone
- Shopping
- Preparing Food
- Housekeeping
- Laundry
- Transportation
- Taking Medications

37

Health Promotions and Counseling

- Encourage regular health screening exams
- Assess vision and hearing
- Encourage immunizations (flu- annually, pneumococcal single does)
- Encourage household safety
- Encourage cancer screening
- Assess for depression
- Assess for dementia and mild cognitive impairment
- Assess for elder mistreatment

38

Things older patients should do, that you should advocate for with every visit:

1. Exercise! Some is better than none! We need to maintain maximal muscle mass
2. Maintain Careful Hydration
3. Maintain Nutritional Status
4. Avoid excess weight gain, but protect weight loss unless morbidly obese.

39

A drop in LDL, TG, and/or albumin are red flags for?

Senescence and decline