Lecture 4

Question 1

Adults over 65 purchase __% of all perscription medication

Answer 1

30%

Also older adults are more likely to experience adverse drug reactions

Question 2

The average older adult takes _ medications

The average nursing home resident takes _ medications

Answer 2

Older Adult: 5

Nursing home resident: 7

Question 3

Polypharmacy definition

Answer 3

Excessive/Inappropriate use of perscription medications

Question 4

____ of all old people take atleast one unnecessary drug

Answer 4

half

Question 5

How does aging effect drug absorption?

Answer 5

Decreased gastric acid

Decreased stomach emptying

Decreased gastric motility

Question 6

How does aging effect drug distribution

Answer 6

Decreased Body H20

^ Body fat

Decreased plasma proteins

Decreased lean body mass

Question 7

How does aging effect drug metabolism

Answer 7

Decreased liver mass

decreased bloodflow to liver

decreased enzymatic activity

Question 8

How does aging effect drug excretion

Answer 8

Decreased kidney mass

Decreased bloodflow to kidneys

Decreased nephron function

Question 9

What kind of medications are most commonly overperscribed

Answer 9

Laxatives

BP medication

Diuretics

Diabetes medication

Question 10

What is the common side effect of NSAIDS

Answer 10

GI symptoms

Question 11

What is the common side effect of opiods

Answer 11

sedation

Question 12

What is the common side effect of antidepressants/ analgesics/ lithium

Answer 12

Confusion

Question 13

What is the common side effect of barbiturates and antihypertensive medication

Answer 13

Depression

Question 14

What is the common side effect of antihypertensives

Answer 14

orthostatic hypotension

Question 15

What is the common side effect of Diuretics and glucocorticoids

Answer 15

Fatigue/weakness

Question 16

–% of adults 65+ report a fall once a year

Answer 16

29%

Question 17

Medical treatment for falls costs about ____ a year

Answer 17

50billion

Question 18

Fall risk factors

Answer 18

Besides the obvious:

Polypharmacy

Use of Assistive Device

Depression/Anxiety

Fear of falling

Recent hospitalization

Question 19

What is the 6th vital sign

Answer 19

Gaitspeed

Question 20

What is the cutoff for community ambulation

Answer 20

0.8m/s

Question 21

What is the cutoff gaitspeed for being dependent in ADLs AND more likely to be hospitalized

Answer 21

Under 0.6m/s

Question 22

Whats the gaitspeed cut off for being independent and less likely to be hospitalized

Answer 22

Over 1m/s

Question 23

What outcome measures are for balance

Answer 23

BERG balance scale

Sharpened romberg

4 square step test

functional reach test

MiniBEST

Question 24

What outcome measures are best for “Functional” measurement

Answer 24

5xSTS

30s STS

TUG

10mWT

Question 25

What tests are best for measuring endurance

Answer 25

6MWT 2min step test

Question 26

What outcome measures are considered self report

Answer 26

MFES fear of falling avoidance questionarre

Question 27

What is the cutoff in gaitspeed for being D/Ced to a skilled nursing home vs being D/Ced back home

Answer 27

0.1m/s

Question 28

What is the cutoff gaitspeed for needing intervention to reduce fall risk

Answer 28

1m/s

Question 29

Household walker gait speed

Answer 29

0.4 m/s

Question 30

limited community ambulator gait speed

Answer 30

0.4-0.8m/s

Question 31

community ambulator gaitspeed

Answer 31

0.8-1.2

Question 32

Cross street ambulator gait speed

Answer 32

1.2m/s+

Question 33

The sharpened romberg uses what 3 stances?

Answer 33

Feet together Semi tandem Tandem

Question 34

How far do you walk before you turn around in the TUG test?

Answer 34

3m

Question 35

What is the cutoff value for fall risk during a TUG test

Answer 35

13.5

Question 36

What is the cutoff fall risk for a 5xSTS?

Answer 36

11.4s

Question 37

What are the different categories of disability

Answer 37

Ambulation Cognitive Visual Hearing Medical

Question 38

What percent of people over 65 have atleast one disability

Answer 38

34%

Question 39

What percent of people over 65 have an ambulatory disability

Answer 39

21%

Question 40

What activities are ADLs

Answer 40

Bathing Dressing Toileting Transfering Eating

Question 41

what activities qualify as IADLs

Answer 41

Shopping Preparing meals Taking medications Housekeeping Using transportation Managing finances Using the phone

Question 42

Medicare is for

Answer 42

People over 65 or people with disabilities

Question 43

Medicaid is for

Answer 43

Low income Persons responsible for minor/pregnant Disability

Question 44

Requirements for independent community living

Answer 44

1.2m/s gait speed Ambulation distance 400m Carrying objects around 8lbs (gallon of milk) Ambulate varions terrain Stairs/curbs

Question 45

Inpatient rehab

Answer 45

3 hours of therapy per day (PT OT SP) high prior level of function Moderate complexity

Question 46

Skilled nursing facility

Answer 46

Unable to participate in 3 hours of therapy Moderate functional prognosis Variable level of prior function

Question 47

Long term acute care

Answer 47

Poor Prognosis High complexity of medical needs Less need for skilled therapy

Question 48

Hospice care

Answer 48

Life expectancy under 6 months

Question 49

MOLST/POLST

Answer 49

advanced care directives for physician to order life sustaining care

Question 50

DNR

Answer 50

Advanced care directive: do not resuscitate

Question 51

Adults lose __% of their strength between 60-90

Answer 51

40%

Question 52

Review this

Answer 52

K

Question 53

FITT recommendations for geriatric w/ osteoporosis

Answer 53

Aerobic 4-5 times a week, Moderate intensity Resistance. 1-2 nonconsecutive days. Adjust weight so last two repetitions are challenging. High intensity is beneficial if they can tolerate it. Flexibility 5-7 days a week, hold static stretch for 10-30 seconds, 2-4 repetitions

Question 54

Review this

Answer 54

K