Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ME 536- Patient Care II > Older Adult > Flashcards

Older Adult Flashcards

(118 cards)

Start Studying
1
Q

Older people have a higher rate of ______

A

chronic illnesses (often multiple)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Wide variation in _______ and ______ status

A

physical, functional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Individuals who do not have debilitating disease live healthy lives into their

A

80s and 90s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Assessing the older adult is not simple a

A

disease oriented approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Focus is on healthy or ________ aging

A

successful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lifespan wish for elder adult

A

simple happiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Focus on older adult

A

understand supports
functional assessment
promote long term health and safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Not just maximize life span, but maximize ______ span

A

health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Goals of care for older adult

A

maintain function
fulfilling, active lives
promote healthy aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Primary aging

A

changes in physiologic reserve that occur over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Primary aging is _________ of changes induced by _______

A

independent, disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Changes in vital signs in older adults: BP

A

Systolic HTN with widened pulse pressure (vessels stiffen), auscultatory gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Changes in vital signs in older adults: Heart Rate and Rhythm

A

decline in function of pacemaker cells, affects response to physiologic stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Changes in vital signs in older adults: Respiratory rate

A

unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Changes in vital signs in older adults: temperature

A

changes in temperature regulation leads to susceptibility to hypothermia/hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Changes in physiology in older adults: skin

A

fragile, loose, transparent (esp hands/forearms) “onion skin”
actinic (solar or senile) purpura
Loss of subcutaneous fat/tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Changes in physiology in older adults: nails

A

lose luster, yellow, thicken, especially toenails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Changes in physiology in older adults: hair

A

loses pigment
hair recedes
loss of hair elsewhere (trunk, pubic, axilla, limbs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Changes in physiology in older adults: Eyes

A

fat around eye atrophies
cornea lose luster
smaller pupils
dry eye common
presbyopia (age related vision loss)
increased risk glaucoma, macular degeneration, cataracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Changes in physiology in older adults: Ears

A

deceased hearing (presbycusis)- lose higher tones
increased cerumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Presbycusis

A

deceased hearing (especially lose higher tones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Changes in physiology in older adults: mouth

A

decreased secretions
decreased sense of taste (d/t meds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Changes in physiology in older adults: thorax and lungs

A

decrease in exercise capacity (d/t cardiac +- pulmonary)
increased work to move joints/contract muscles
chest wall stiffens (increased work of breathing)
kyphosis d/t OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Changes in physiology in older adults: cardiovascular- VESSELS

A

Bruits (vessels in neck): partial material obstruction from atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Changes in physiology in older adults: Cardiovascular HEART
Extra heart sounds S3 after age 40 (suggests heart failure) S4 (can he healthy but suggests decreased ventricular compliance/impaired filling) Scarring in SA node
26
Changes in physiology in older adults: cardiovascular murmurs
systolic aortic murmurs are common aortic stenosis (fibrosis and calcification) Aortic stenosis (leaflets become calcified and immobile, impede outflow)
27
Aortic stenosis and aortic sclerosis increase risk of
cardiovascular morbidity and mortality
28
Changes in physiology in older adults: breasts
diminish in size (glandular tissue atrophies, replaced by fat) ducts surrounding nipples become more palpable and firm/stringy strands (calcification deposits)
29
Changes in physiology in older adults: abdomen
fat accumulates in lower abdomen and near hips signs of acute abdominal disease is blunted
30
Pair and fever in older adults
Pain is less severe Fever is less pronounced
31
Changes in physiology in older adults: Male GU SEX
sexual interest intact frequency declines erection more dependent on tactile stimulation ED in 1/2 of men
32
Changes in physiology in older adults: Male GU PROSTATE
Benign prostatic hyperplasia (BPH) proliferation of prostate epithelial and stratal tissue 30s-70s half of men with BPH have sx
33
Changes in physiology in older adults: female GU Menopause
Menopause usually around 48-55 Hot flashes up to 5 years (maybe longer) vaginal dryness urge incontinence dyspareunia Within 10 years ovaries are usually no longer palpable Loss of estrogen tone
34
Changes in physiology in older adults: MSK
shortening (loss of height in trunk from thinning intervertebral discs, vertebral bodies shorten OA) Skeletal muscle decrease in bulk/power ROM diminishes from OA
35
Changes in physiology in older adults: Neurologic
difficult to distinguish changes of moral aging from disease "benign forgetfulness" can occur at any age
36
Consider more than disease in elderly (4 others)
Functional Economic Psychosocial Environmental
37
Geriatric syndromes
common health conditions in older adults not distinct organ based category multifactorial cause functional decline and dependence
38
Examples of geriatric syndromes
cognitive impairment incontinence MALNUTRITION Falls SLEEP DISORDERS sensory deficit DEPRESSION
39
Aortic stenosis presents with
exertional fatigue
40
Risk factors in older adults
increased age cognitive impairment functional impairment impaired mobility
41
Examples of multidimensional problems
hearing vision polypharmacy mobility
42
Younger vs. older adults
younger adults (look for unifying diagnosis) older adults (multifactorial, geriatric syndromes)
43
Approach to the patient: older adults
demeanor: respect, patience, cultural awareness Pay close attention to: adjusting office environment, content and pace of visit
44
When an older adult spikes a fever you are concerned because
it is their bodies last resort
45
Approach to the patient: office modifications
well-lit, moderately warm room minimal background noise safe chairs make sure glasses/HA/dentures in
46
Approach to the patient: older adults Interview
adjust pace, content ALLOW TIME FOR OPEN ENDED QUESTIONS AND REMINISCING Include family and caregivers ensure written instructions are in large print and easy to read
47
Special areas to assess older adult
functional status polypharmacy fall risk cognitive problems mood/depression nutrition incontinence vision/hearing social supports financial concerns goals of care
48
Approach to the patient: older adults Functional status
absolutely vital to assess!!! ADLs IADL (instrumental activities of daily living)
49
estrogen sets the _____
tone
50
Assessments to functional status in older adults
Katz Index of Independence in activities of daily living Lawton-Brody IADL
51
Content of Katz independence in activities of daily living questionnaire
bathing dressing toileting transferring continence feeding
52
Content of Lawton-Brody IADL questionnaire
ability to use telephone shopping laundry mode of transportation food preparation responsibility of medications housekeeping ability to handle finances
53
Polypharmacy definition
use of multiple medications
54
Average amount of meds for a patient discharged to a skilled nursing facility
14 medications
55
Risk of adverse reaction in older adults on multiple medications
increase with number of meds 13% 2 meds 58% 5 meds 82% 7 or more
56
Risks with polypharmacy
drug-drug interactions Independent risk factor for hip fractures (use of drugs affecting CNS) Issues with med adherence prescribing cascade
57
Definition of prescribing cascade
adverse drug reaction is misinterpreted as a new medical condition, and so a new medication is prescribed
58
How to avoid polypharmacy
Start low and go slow Thorough medication history (all meds, including OTC, why are they taking it?)
59
BEERS criteria
Used to assess inappropriate drug prescribing in older adults List of medications considered potentially inappropriate for use in older patients, mostly due to high risk for adverse events
60
5 categories of BEERs criteria
Drugs that are potentially inappropriate in older adults Drugs that should be avoided in older adults with certain conditions Drugs to use with caution Drug-drug interactions Drug dose adjustment based on renal function
61
Falls are associated with
decline in functional status increased chance of nursing home placement increased risk of death greater use of medical services MEDICATION USE
62
What is the most modifiable risk factor for falls in older adults
medication use
63
Biological factors in falls in older adults
leg weakness mobility problems problems with balance poor vision
64
Behavioral factors in falls in older adults
psychoactive meds 4+ medications risky behavior inactivity
65
Environmental factors in falls in older adults
clutter/tripping hazards no stair railings or grab bars poor lighting
66
Fall screening/risk assessment older adults
have you fallen in the last year? (# times, injury) do you feel unsteady when standing/walking? are you worried about falling?
67
If an elder adult answers yes to a fall screening question you should
evaluate gait, strength and balance Timed Get up and go trial
68
How to do a Timed Up and Go (TUG)
Patients wear regular footwear and can use a waling aid Sit in a standard aim chair and identify a line 3 meters/10 feet away 1. stand up from chair 2. walk to the line on the floor at your normal place 3. turn 4. walk back to the chair at your normal pace 5. sit down again
69
Cognitive issues in older adults SCREENING TOOLS
assess memory complaints from patient or concerns from caregivers MOCA MMSE Mini-Cog
70
When do you use a MOCA with an older adult
best in early decline, not effective late
71
When do you use MMSE in older adults
used for monitoring screening NOT status exam
72
When do you use Mini-Cog in older adults
Yes/no for further screening or suspected dementia
73
Is depression a normal part of aging?
Depression is NOT a normal part of aging
74
Older adults attempt suicide less but are
more successful in completion
75
Most older adults who complete suicide
were in their first episode of depression and had seen a physician in the last month of life
76
Screening tools for mood/depression in older adults
PQI2 1. In the past month have you been bothered by feeling down, depressed or homeless? 2. During the past month, have you been bothered by little interest or pleasure in doing things?
77
Nutrition in older adults
Malnutrition associated with increased mortality
78
Weight loss in the elderly can predict
mortality
79
Hospitalized older patients are at higher risk for
nutritional risk or are malnourished
80
Nutrition screening for older adults
serial measurement of body weight
81
Urinary incontinence for older adults
major cause of social and emotional distress (can place a role in nursing home placement)
82
causes for urinary incontinence in older adults
increased risk in diabetes, usually multifactorial
83
Is incontinence more common in older men or women
women
84
Fecal incontinence in older adults more common in men or women
slightly more in women
85
What is the cause of fecal incontinence in older adults
multifactorial decreased strength of external sphincter increased rectal compliance medications lactose intolerance poor mobility
86
Prevention in older adults
physical activity tobacco cessation alcohol screening ASA to prevent CV disease
87
What screening tool does American Geriatric Society suggest for alcohol screening
CAGE
88
Immunizations in older adults
TD Q 10 (1 dose TDAP if never received) annual flu shot Zoster (age 50) Pneumococcal
89
A lot of polypharmacy comes from
specialty care
90
Zoster immunizations in older adults
Start at age 50
91
Shingrix is a
recombinant vaccine for zoster
92
Zostavax is a
live attenuated zoster vaccine
93
What are the three different vaccines for pneumococcal
PCV15 (1 dose) PCV20 (1 dose PPSV23 1 year later) PPSV23
94
What are do people get pneumococcal vaccine
65 or older
95
What are the current recommendations for pneumococcal vaccine in older adults
PCV20 OR PCV15 and PPSV23 1 dose 1 year later
96
Why would a younger person get pneumococcal vaccine
certain underlying medical conditions or risk factors (heart, lung, liver, diabetes, ETOH, smoker)
97
Older adult: What age does USPSTF suggest to screen for colorectal cancer
45-75
98
Older adult: What age does USPSTF suggest to screen for breast cancer
biennial mammography age 50-74
99
Older adult: What age does USPSTF suggest to screen for lung cancer
55-80, 30 pack years, current smoker or quit in past 15 years
100
Older adult: What age does USPSTF suggest to screen for prostate cancer
individual discussion with patient
101
Older adult: What age does USPSTF suggest to screen for cervical cancer
can stop at age 65 if previous screening was adequate and negative
102
Older adult blood pressure screening
annually
103
Older adult statin screening ages
40-75
104
Older adult diabetes screening
40-70 with increased BMI
105
Older adult osteoporosis screenings
postmenopausal women <65 higher risk all women age 65 and older
106
Older adult elder abuse screening
ask patients, direct, specific questions
107
Older adult AAA screening
men 65-75 who have ever smoked
108
Older adult colorectal screening tests
gFOBT: guaiac fecal occult blood (3 specimens, 2 samples/specimen) FIT: fecal immunochemical test for hemoglobin FIT-DNA: cologuard Flexible sigmoidoscopy: Flex-sig (goes to splenic flexure) Colonoscopy CT colonography
109
What colon cancer screenings are stool based
FOBT (yearly) FIT (yearly) FIT-DNA (1-3 years)
110
What are the benefits of stool based colon cancer screenings?
No bowel prep
111
What are visual based colon cancer screenings
Colonoscopy (Q10) CT colonography (Q5) Sigmoidoscopy (Q5)
112
What is the best test for colorectal cancer screening?
The one that the patient will do
113
When should advanced care planning be done?
all ages, not just older adults
114
What is the importance of advanced care planning
ensure the patients get care that is consistent with their own goals, values, preferences
115
What are the benefits of advanced care planning
provider/family will comply with patient's wishes deceased hospitalization at end of life increased use of hospice higher satisfaction with quality of care
116
Advance directives are done:
when a patient can still make decisions
117
When are advanced directives acted on?
ONLY if the patient loses the ability to make decisions for themselves
118
What are the main types of advance directives?
DPOA Living will POLST DNR/DNI

ME 536- Patient Care II (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions