Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Primary care > Well elder > Flashcards

Well elder Flashcards

1
Q

Risk factors adverse effects

A

Age >85
Low BMI
6+ chronic conditions
Creatinine clearance

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

Prealbumin

A

19-38 mg/dl if 13 malnourished do not give protein bound drug
shows nutritional status over a week or two

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

Creatinine clearance calculation

A

(140-age in years)x body weight kg
___________________________
72 x serum creatinine

for women x all by .85

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

Depression

A

somatic- nonspecific complaints
find out baseline
lack of energy, somatic, difficulty getting along with others, isolation, withdrawal, lack of hygiene/appearance, self-destructive behaviors

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

Depression screening tools

A

Sleep Interest Guilt Energy Concentration Appetite Pscyhomotor Suicide (SIGECAPS)
PHQ2 PHQ9 Geriatric depression scale

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

Cognitive function AKA

normal aging=

A

“mentation”
slower thought process
decline in recent memory
multitasking more difficult

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

Cognitive function assessment tools and what they test
1)
2)

A

Mini mental status exam:
Orientation, registration, recall, attention, calculation, language, visual spacial

Mini cog:
3 item recall, clock drawing

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

Functional assessment
ADL
IADL

A

ADL: dressing, bathing, grooming, feeding, walking, toileting
IADL (skills needed to remain in community): laundry, shopping, medication management

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

Physical activity benefits

A 
Bone/muscle strength
function
QOL 
bowel function 
sleep 
wellbeing 
decrease falls and depression
decrease body fat 
lower BP and cholesterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
Pain assessment 
Pain is \_\_\_ by HCP 
Elders\_\_\_\_ or \_\_\_\_\_ pain 
Cognitive impairment assessment:
Untreated pain:

% who report pain:

A

pain is undertreated by HCP
elders minimize or underreport pain as they think its a normal part of aging
cognitive impaired- grimace agitated
untreated pain: adl impairment, cognitive dysfunction, depression, anxiety, social isolation, appetite and sleep impairment

25-50% community dwelling, 45-80% nursing home

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

Driving

Assessment

A

history of falls in last 1-2 years
visual deficit (visual fields, acuity, contrast sensitivity, delayed light accommodation)
cognitive deficit (trail making, clock drawing)
prior hx of accidents
current use of benzos or TCAs
motor function (ROM, strength, rapid pace walk)

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

Nutritional considerations

A
  • disease process
  • chewing/swallowing diff. (dentures, thrush)
  • tooth loss/pain
  • reduced social contact
  • finances
  • multiple medications
  • low BMI 10 lbs in 6 mos)- sentinel event in LTC
  • appetite stimulants (megace- cancer drug)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Biggest reason elderly are institutionalized

A

Urinary or fecal incontinence

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

Sexuality

A

medications: beta blocker SSRI impotence

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

Caregivers formal vs. informal

A

formal- health care professionals informal- family friends church community (unpaid)

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

HEALTH MAINTENANCE
immunizations
influenza: recommended for ________
nasal approved for_______ who not approved for?

A

everyone >6 months old including pregnant women and chronic health conditions
nasal approved for ages 2-49

17
Q

HEALTH MAINTENANCE
TB
Recommended for:

Two step- why?

A

not needed for people at low risk
risk:
exposure to TB
HIV infections or immunosuppressed
Symptoms of TB (fever, night sweats, cough, weight loss)
TB common country (Latin america, caribbean, africa, asia, eastern europe, russia)
Occupation in us (homeless shelters, prisons, nursing homes)
Illicit drug users

Two step: useful for health care workers who will be tested periodically, decreases likelihood that a boosted reaction to other TB tests will be mistaken as infection

18
Q 
HEALTH MAINTENANCE 
Shingles vaccine 
FDA approved for \_\_\_\_\_ 
50-59? 
How long does it last for? 
Previous shingles?
A

adults over age 50; however, routine use not recommended for adults 50-59, risk is greatest after age 60
Last: for 60+ vaccine protection decreases after 5 years
You CAN get the vaccine even if had shingles, do not have to wait after getting it

19
Q 
HEALTH MAINTENANCE 
More on shingles vaccine: other name\_\_\_\_\_\_ 
# doses 
Maximum age 
Live or attenuated
Contraindicated in
A 
Zostivax 
One time vaccine 
No max age 
Live 
Pregnancy and immunocompromised
20
Q

HEALTH MAINTENANCE
Pneumococcal
1)
2)

Can these be given on the same day?

A

Pneumococcal conjugate (PCV13 or prevnar 13)
Age 65+
OR adults 19+ immunocompromised (HIV, organ transplant, leukemia lymphoma, severe kidney disease)

Pneumococcal polysaccharide (PPSV23 or pneumovax)
65+
2+ at high risk for disease
19-64 who smoke or have asthma

NO: do not give at same time, PCV13 first then pneumovax

21
Q

Welcome to medicare visit

A

New medicare beneficiaries within first year
ID and decrease health risks, educate preventive services
Written shared plan, recommendations referrals, follow up annual visit q12 months

22
Q

Medicare?

Seven components for reimbursement

A

1) Med/surg history
2) Risk factors depression/mood
3) Functional ability and safety
4) PE: ht/wt/BMI/BP/visual
5) end of life planning
6) Education, counseling, referral
7) Orientation to preventive services

23
Q

-
-

A

-Documents: life sustaining treatments (MOLST)
(DNR.DNI, artificial hydration, nutrition, medications, do not hospitalize)
-Goals of care
-Health care proxy

24
Q

Patient self determination act 1990

A

informs patients of rights regarding health care decision making
most health care facilities required to provide this: right to refuse or accept tx, right to participate in own medical care decision making

25
Q

Values history

A

Not a legal document

Focuses on values, beliefs and preferences that matter most to the individual

26
Q

Advanced care planning
What is it ?

Includes:

A
  • planning for future medical care (wants and do not wants)
  • personal values and goals
  • ID proxy

Includes:

  • Advanced directive
  • Living will
  • Durable power of attorney for health care (DPAHC)/health care proxy (don’t need lawyer)
  • Durable power of attorney (needs lawyer, this is money/property)
27
Q

Aging with dignity

What is it?

A

Non-profit organization: maintain dignity with age promote better end of life care
5 wishes document: everyone 18 and older needs an advanced directive

28
Q

5 wishes document

A

from Aging with dignity

1) HCP: who should make decisions
2) Medical care want dont want
3) Comfortability (i.e. pain meds)
4) How i want people to treat me
5) What i want my loved ones to remember

29
Q

Advanced care planning

When is it too late?

A

It’s never too late: can’t control the progression of disease but we do have control

30
Q

MOLST
front:
back:

A

medical orders for life sustaining treatment
Front: emergency
Back: non emergency (artificial hydration, nutrition: to prolong inevitable)

31
Q

Resources advanced care planning

A 
Hard choices for loving people: help with medical treatments decisions (resuscitation, hospitalization) 
5 wishes 
Alzheimers associations 
A better ending 
Hospice and palliative care
32
Q

Advanced care
who should have document?
Alternate?

A

patient and spouse

should have alternate HCP listed

33
Q

Do not hospitalize

A

hospice for assisted living/nursing home

34
Q

MOLST
Components
Signatures

A 
Front:
-CPR
-Ventilation 
-Transfer to hospital 
Back: 
-Intubation and vent 
-Non-invasive ventilation 
-Dialysis 
-Artificial nutrition 
-Artificial hydration

Requires two signatures: patient, health care agent, guardian, parent of minor + physician, np, pa

Primary care (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions