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Developmental Concepts > Week 11- Geriatrics 2 > Flashcards

Week 11- Geriatrics 2 Flashcards

1
Q

True or false: Older adults consume a disproportionately large number of medications relative to younger people

A

True

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2
Q

The excessive or inappropriate use of medications

A

Polypharmacy

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3
Q

Adults over age 65 purchase over ____% of all prescription medications

A

30%

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4
Q

Older adults are more likely to experience _________

A

Adverse drug reactions (ADR’s)

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5
Q

Half of older people take at least _______ unnecessary drug

A

One

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6
Q

Average older adult takes _____ medications

A

5

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7
Q

Average nursing home resident takes _____ medications

A

7

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8
Q

Characteristics of polypharmacy in older adults

A

-Use of medications for no apparent reason
-Use of duplicate medications
-Concurrent use of interacting medications
-Use of contraindicated medications
-Use of inappropriate dosage
-Use of therapy to treat adverse drug reactions

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9
Q

Affects of aging on absorption

A

-Decreased gastric acid
-Decreased stomach emptying
-Decreased gastric motility

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10
Q

Affects of aging on distribution

A

-Decreased body H2O
-Increased body fat
-Decreased plasma proteins
-Decreased lean body mass

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11
Q

Affects of aging on metabolism

A

-Decreased liver mass
-Decreased blood flow to liver
-Decreased enzyme activity

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12
Q

Affects of aging on excretion

A

-Decreased kidney mass
-Decreased blood flow to kidneys
-Decreased nephron function

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13
Q

Medications most commonly overprescribed

A

-Laxatives
-BP meds
-Diuretics
-DM meds

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14
Q

Common side effects

A

-GI symptoms
-Sedation
-Confusion
-Depression
-Orthostatic hypotension
-Fatigue/weakness

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15
Q

Drug that causes GI symptoms

A

NSAIDS

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16
Q

Drug that causes sedation

A

Opioids

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17
Q

Drug that causes confusion

A

-Antidepressants
-Analgesics
-Lithium

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18
Q

Drug that causes depression

A

-Barbiturates, antihypertensives

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19
Q

Drug that causes orthostatic hypotension

A

-Antihypertensives

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20
Q

Drug that causes fatigue/weakness

A

-Diuretics
-Glucocorticoids

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21
Q

When reviewing a patient’s medication list, you should…

A

-Look for any possible adverse drug reactions
-Does their medication list make sense with their comorbidities?
-Think about how medications with affect PT
-Provide patient education

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22
Q

____% of people over age 65 reported at last one fall in a year

A

29

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23
Q

True or false: Medical treatment for falls costs less than $50 billion each year

A

False

(costs more)

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24
Q

True or false: Falls can occur with or without injury

A

True

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25
Q

True or false: Falls are the leading cause of death or hospitalization from injury in older adults

A

True

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26
Q

Falls are associated with…

A

-Pain
-Loss of confidence
-Functional decline
-Institutionalization

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27
Q

Risk factors of falls

A

-Prior falling
-Age over 65
-Polypharmacy
-Fear of falling
-Use of an assistive device
-CVA or neuro diagnosis
-Recent hospitalization
-Impaired balance, gait
-Incontinence
-Poor sensation
-LE weakness (STS: must use hands)
-Depression or anxiety
-Pain
-Frailty
-Foot problems
-Difficulty with ADLs
-Orthostatic hypotension
-Cog impairment
-Certain medications (benzodiazepine, diuretics, sedatives)

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28
Q

Environmental risk factors for falls

A

-Slippery/uneven surfaces
-Rugs
-Poor lighting
-Obstacles in path (ex: cords, clutter)
-Lack of grab bars or handrails
-Poorly arranged furniture

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29
Q

This is also known as the 6th vital sign

A

Gait speed

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30
Q

Gait speed is correlated with multiple outcomes such as…

A

-Re hospitalization
-ADL performance
-Number of medications
-Depressive symptoms
-Discharge location from hospital
-History of multiple falls

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31
Q

Cut off for community ambulation is ____ m/s

A

0.8

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32
Q

Cut off speed for fall risk

A

1 m/s

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33
Q

Interventions for fall prevention

A

-Balance training
-Cardiovascular endurance training
-Assistive Device Training
-Home environment modification

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34
Q

Balance training consists of training…

A

Somatosensory, vestibular, and visual systems

35
Q

Aspects of balance training

A

-Dynamic and static balance training
-Lower extremity strengthening and endurance training
-Coordination
-Flexibility and ROM

36
Q

The Sharpened Romberg is this type of test

A

Balance

37
Q

The TUG is a screening for __________ and is this type of test

A

-Fall risk
-Functional

38
Q

The BERG is this type of test

A

Balance

39
Q

5xSTS is this type of test

A

Functional

40
Q

Cut offs for fall risk:

TUG- ______
5xSTS - ______
BERG - ______

A

TUG - 13.5s (greater than 8.5s indicated high risk of falls in community dwelling adults)

5xSTS- 11.4s

BERG- 45/56

41
Q

A mental or physical impairment that limits major activities in one or more ways

A

Disability

42
Q

Types of disabilities

A

-Ambulation
-Cognitive
-Visual
-Hearing
-Medical

43
Q

-Age 65 or older OR people with disabilities
-Part A: IP, SNF, HH, Hospice
-Part B: OP, DME

A

Medicare

44
Q

-Low income
-Pregnant or responsible for a minor
-People with disabilities

A

Medicaid

45
Q

Ambulation distance for independent living/community

A

400m

46
Q

Gait speed for independent living/community

A

1.2 m/s

47
Q

Carrying object requirement for independent living/community

A

One gallon of milk is around 8 lbs

48
Q

True or false: You do not have to be able to ambulate on variable terrains

A

False

(ex: carpet, grass, uneven surfaces)

49
Q

True or false: You must be able to encounter obstacles (ex: stairs, curbs, doors, elevators) in independent living/community

A

True

50
Q

Other requirements for independent living/community include…

A

-Postural transitions
-Head orientation
-Stop/start
-Backing up
-Side stepping

51
Q

PT setting:

-3 hours of therapy per day (PT, OT, SLP)
-High prior level of function
-Not safe to go home
-Moderate complexity of medical needs

A

Inpatient rehab

52
Q

PT setting:

-Unable to participate in 3 hours of PT per day
-Moderate functional prognosis
-Variable prior level of function

A

Skilled Nursing Facility

53
Q

PT setting:

-High prior level of function
-Stable complexity of medical needs
-Must be able to travel through community to OP facility

A

Outpatient

54
Q

PT setting:

-Limited ambulation for community
-Safe to go home
-Good functional prognosis

A

Home health

55
Q

PT setting:

-High complexity of medical needs
-Poorer prognosis
-Less need for skilled therapy

A

Long term acute care

56
Q

PT setting:

-Typically for patients with chronic and serious illnesses
-Aims to treat pain and suffering
-Addresses psychological, social, and spiritual problems

A

Palliative care

57
Q

PT setting:

-End of life care (terminal illnesses)
-Expectation: 6 months or less to live
-Aims to manage pain and other symptoms
-Can take place at home or a facility

A

Hospice

58
Q

Allows individuals to identify their preferences for care when they are unable to do so themselves

A

Advanced care directives

59
Q

General indication of preferences, recommended for all adults

A

Living wills

60
Q

Do not resuscitate

A

DNR

61
Q

Medical/Physician orders for life sustaining treatment

A

MOLST/POLST

62
Q

Appoints an individual to make decisions on one’s behalf

A

Power Attorney

63
Q

__________ is the most powerful intervention for maintaining well-being

A

Exercise

64
Q

True or false: Some exercise is better than nothing

A

True

65
Q

Ways to help patients exercise:

A

-Make it attainable for the patient
-Encourage them to meet their goals
-Consider family support and what is available in their community
-Make it something that patients can do on their own eventually

66
Q

Types PT interventions for geriatrics

A

-Group exercise
-Resistance exercise
-Aquatic exercise
-Balance training
-Power

67
Q

Added benefit of socialization, supervision, and peer support

A

Group exercise

68
Q

Resistance exercise is important because adults lose as much as ____% of their strength between 60-90

A

40

69
Q

Good option for aerobic and strength training for patients who cannot tolerate weight bearing on land

A

Aquatic exercise

70
Q

Training that reduces fall risk

A

Balance training

71
Q

__________ is a better indicator than strength for functional activities such as stair climbing, sit to stands, and gait

A

Power training

72
Q

Power training for beginners

A

Frequency: 1-2 days
Loading: Low; low-to-moderate; moderate
Volume (sets): 1-2
Rest intervals: 60-120

73
Q

Power training for trained

A

Frequency: 3 or more days
Loading: Low; low-to-moderate; moderate; high
Volume (sets): 3 or more

74
Q

Low loading

A

20% of RPE

75
Q

Moderate loading

A

50% of RPE

76
Q

High loading

A

80% of RPE

77
Q

True or false: Underdosing of osteoporosis is a problem

A

True

78
Q

__________ exercises are important when combating osteoporosis

A

Loading

79
Q

True or false: If a patient as osteoporosis, they must strengthen bones in a safe environment

A

True

80
Q

PT interventions for patients with loss of visual acuity

A

-Use large print books and computer software
-Color: use bright, warm colors, avoid pastels, avoid monotones
-Depth perception: avoid patterned floor surfaces, use warm colors to highlight handrails and steps
-Contrast: use bright details on dark backgrounds

81
Q

PT interventions for patients with hearing loss

A

-Minimize background music
-Say the person’s name before beginning the conversation
-Try rephrasing if repeating is not effective

82
Q

PT interventions for patients with loss of taste/smell

A

Use additional spices and colors to enhance food

83
Q

PT interventions for patients with environment problems

A

Avoid temperature extremes from air conditioning or heating

Developmental Concepts (12 decks)

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