lecture 1 Flashcards
(72 cards)
1
Q
aged, aging, elder, elderly, old
A
> /= 65
2
Q
young-old
A
65-74
3
Q
middle-old
A
75-84
4
Q
old-old
A
85+
5
Q
fastest growing segment of aging population?
A
85+, old-old
6
Q
elite-old, centernarians
A
100+
7
Q
ave life span for female infants
A
81.1
8
Q
ave life span for male infants
A
76.2
9
Q
frail
A
related to functional status, not age
10
Q
what % live in community?
A
95%
11
Q
what % live in CA FL NY PA TX OH IL MI
A
52%
12
Q
what % live in urban areas?
A
77%
13
Q
fastest growing group of elders
A
women 85+
14
Q
what % of those >65 live alone?
A
> 36%
15
Q
changes in elder pop? what we know
A
^ in absolute # of persons 65+ ^ in % of persons 65+ ^ life exp at birth & at age 65 dramatic changes in ethnic div major ^ in education achievement
16
Q
changes in elder pop? what we dont know
A
- implications of current lifestyle/behavior patterns on future health status
- availab/type of health care resources
- disease/tx response patterns for diff demograph groups
- implications of scientific/technical advances for health & quality of life
17
Q
top 10 causes of death in elders
A
heart disease cancer cerebrovascular diseases COPD and assoc conditions pneumonia/ flu diabetes accidents septicemia kidney disease alzheimers
18
Q
elder abuse
A
battering, verbal abuse, exploitation, denial of rights, forced confinement, neglected med needs, personal harm, usually at the hands of someone responsbile for assisting them in ADLs
19
Q
what happens as violence in society increases?
A
likely ^ in elder abuse
20
Q
how much abused/neglected elders are there each year?
A
> 2 mil
21
Q
how much elder abuse is under reported?
A
est 80%
22
Q
how much of abuse involves elders?
A
40%
23
Q
why are elders reluctant to report abuse?
A
fear worse/unsure situation if they get moved
24
Q
abuse is usually related to what?
A
limited resources of time, money, coping, help, substance abuse
25
what % is financial abuse?
46%
26
neglect by self
story about woman who didnt wanna abuse friendship with woman who drove her to tx.
most frequent type of mistx
27
largest # of elderly living at home alone
women 75+, can be subject to self neglect, abuse and exploitation by hired caregivers
28
what is related to long-standing problems in a relationship?
verbal abuse/ neglect
29
"better quicker"
philosophy in hospitals- pts sent home earlier with more sophisticated needs and more demands on the family for care.
30
why is the "better quicker" philosophy not good?
increases stress, fam can be resistant to care for pt. pt may get inadequate care, neglected
31
families/cg at home make up what % of care?
80%
32
why do families take care of pts?
mostly due to costs of institutional care
33
physical assessment
normal aging and comorbidities
| nutritional assessment
34
functional assessment
ADLs, InstumentalADLs, timed up and go, gait/balance
35
psychological assessment
cognitive/mental status assessment
| ie depression assessment, mental exams
36
social assessment
relationships and network size
37
spiritual assessment
doesnt have to be religion. do you have faith? something that can sustain you when youre sick?
38
normal aging changes
```
alterations at all levels
dec reserve/efficiency
-intracell
-cellular
-tissue
-organ
-system
```
39
cumulative effect of inc vulnerability
diff maintaining homeostasis
| diff responding to stress
40
top 10 chronic conditions
```
HTN
arthritis
heart disease
hearing impairment
cataracts
deformity/ortho impairment
chronic sinusitis
diabetes
tinnitus
visual impairment
```
41
functional evaluation
tell about typical day, ADLs, IADLs, performance measures
42
nutrition eval
nutrition screening ?aire, current wt, wt trend, BMI, Albumin, Cholesterol
43
underweight BMI
< 18.5 kg/m2
44
healthy weight BMI
18.5-24.9
45
overweight BMI
25-29.9
26- protective for immune system
46
obese BMI
> 30.0
47
albumin level
3.5-4 g/dL
48
less than 3.5 albumin means what
malnourishment
49
why use prealbumin?
actually see more quickly over time. Half life is 2 days vs. 12-18 days for albumin.
50
cholesterol
160-200
51
cognitive, mental status screening
remember 3 objects
mini mental status exam (MMSE)
Short portable mental status ?aire (SPMSQ) 10 items
clock drawing test
52
depression screening
GDS geri dep scale
53
full scale GDS
30 y/n ?s
54
short scale GDS
15 items
55
if pt has plan to kill themselves
get help right away
56
if pt just feeling depressed, say they dont wanna live
need to follow up, but not an emergency situation
57
assessment of SS
```
if something happens, who can help u?
how long do you see yourself being able to manage?
primary cg?
is cg burdened?
resources?
```
58
polypharm
know why each drug given.
know AE.
know interactions bw other drugs.
59
pharmacokinetics
how body acts on drugs, how drug moves on body. ADME
60
pharmacodynamics
actual effects, results. was there toxicity? was it efficacious?
61
what happens if someone is on digoxin while anemic?
drug wont be connected to proteins (albumin) and will stay in blood. There will be digoxin toxicity. will see halo/yellow spots, bradycardia, NV, HA
62
most drugs are metabolized thru the?
liver
63
most drugs are excreted thru the?
kidneys
64
Drug-receptor interactioin
inc BBB permeability and receptor sensitivity; CNS side effects common.
65
Circulation
dec HR/BP regulation stability; toxicity common
66
Metabolism
dec liver mass and hepatic BF; dec metab; enzyme changes may inc drug 1/2 life
67
Excretion
dec renal BF, GFR, # functional nephrons; renal excretion slowed, inc drug 1/2 life.
68
Absorption
gastric emptying, GI motility, dec efficient
69
Distribution
dec lean body mass, total h20 and plasma protein; inc risk of drug toxicity.
70
loop diuretics
low K causes digoxin toxicity. K enhances action of drug... can have arrythmias.
71
QSEN competencies
1. Patient-centered care
2. Teamwork/collab
3. EBP
4. Quality improvement
5. Safety
6. Informatics
72
patient centered care
to recognize the pt or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for pt's preferences, values, and needs.
