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Description
Flashcards by Kate Caldwell, updated more than 1 year ago
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Created by Kate Caldwell
over 10 years ago
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| Question | Answer |
| What is the goal of gero patient care? | help maintain independence and functionality |
| What is the framework for the gero course? | AACN/Hartford Competencies |
| What is the web of healthcare? | seniors often shuffled from place to place |
| what is young old? | 65-74 |
| what is middle old? | 75-84 |
| what is old old? | 85+ |
| what is elite old? | 100+ |
| What is the fastest growing age group in the U.S? | 85+!!! |
| which states have the highest and lowest population of elderly? | Florida has most, Alaska has least |
| What are leading causes of death in age 65+? | heart disease, cancer, stroke, respiratory disease, pneumonia |
| what protects from aging? | <25 BMI, exercise, no smoking or drinking, low BP, stable marriage, education |
| What are stochastic theories of aging? | random! |
| what are the 4 stochastic theories of agin? | error, free radical, cross-linkage, wear and tear |
| what's error theory? | DNA and RNA change as we age |
| whats free radical theory? | free radical damage our cells, while antioxidants help eliminate them |
| what's cross-linkage theory? | aging proteins build up |
| what are 5 non-stoachastic theories of aging? | Programmed, immunity, neuroendocrine, metabolic, DNA |
| what's programmed theory? | cells no longer divide or produce |
| what's immunity theory? | faulty T and B cells |
| What's neuroendocrine theory? | feedback system is screwed up---> increased insulin --> aging |
| whats the metabolic theory? | metabolism wears out and slows |
| What are 5 sociological theories to aging? | disengagement, activity, continuity, astratifcation, person-environemnt |
| what's disengagement theory? | as people age, they tend to want to be alone |
| what's continuity theory? | how people are will remain constant |
| what's astratification theory? | elderly need to see children! |
| what's person environment theory? | how you've dealt with stress in the past shows how you'll deal with it in the future |
| What's Erikson's elderly stage? | Integrity vs. Despair: do we have regreats? |
| what are some common geriatric syndromes? | sleep dx, eating dx, incontinence, falls, confusion, skin breakdown, delirium, dizziness |
| what are 2 emerging geriatric syndromes? | Sarcopenia (lose muscle mass--> fat), and Frailty |
| how can we prevent sarcopenia? | do muscle strengthening exercises |
| what is the normal temp of the elderly? | low---rarely develop a fever |
| which two markers are there to aging? | C-reactive protein and interleukin-6: both are elevated in the frail |
| which marker of aging is elevated with inflammation in the elderly? | c-reactive protein |
| Failure to Thrive is manifested by what weight loss? | >5% of baseline |
| What are the 11 "D"s? | precipitating factors for failure to thrive: disease, dementia, dysphagia, deafness, depression, etc |
| what are ADLs? | brushing teeth, bathing, toileting, dressing |
| What are IADLs? | shopping, paying bills, cooking, laundry |
| What are EADLs? | working! |
| What does Naylor's transitional care model suggest? | you can't just move people around! |
| which medicare plan is for perscriptions? | D |
| which skin layer is avascular? | epidermis; outer layer |
| which skin layer decreases the most as we age? | epidermis |
| what area of the body develops for SQ as we age? | trunk/belly |
| what are lentigines? | age spots |
| how much fluid should elderly get to prevent dehydration? | 1-2 L /day |
| what are 3 common benign skin growths? | cherry angiomas, seborrheic keratosis, and acrochordons |
| where are seborrheic keratosis common? | in sun exposed areas |
| what are acrochordons? | skin tags |
| what is seborrheic dermatitis? | cradle cap! |
| where does intertrigo commonly develop? | in areas of skin folds |
| where does psoriasis commonly form? | elbows and knees |
| what is xerosis? | dry skin and pruritis |
| where do shingles develop? | on dermatomal lines (trunk and face, esp.) |
| what is the prodromal phase of singles? | pain! |
| which shingles are contagious? | weepy lesions |
| which skin condition is pre-malignant? | actinic Kerotosis |
| which skin cancer is most common? | basal cell carcinoma |
| what are s/s of basal cell? | pearly papule with depressed center |
| how do we treat basal cell? | excision; watch for infection, bleeding, and body image issues |
| what population is susceptible to squamous cell? | those who live near the equator |
| what are s/s of squamous cell? | thick, scaley lesions with moveable borders |
| which skin cancer has the most deaths? | melanoma |
| how do we treat melanoma? | excision and chemo |
| what are s/s of arterial ulcers? | cool, pallor, hairless, thick nails, decreased pulse |
| where are arterial ulcers usually located? | distal: toes and feet |
| what are s/s of venous ulcers? | warmth, redness, swelling, brown skin |
| where do venous ulcers occur? | legs and shins |
| how do we treat venous ulcers? | elevation and compression |
| what causes a pressure ulcer? | pressure of bone on soft tissue (inside source)--> tissue ischemia--> edema --> tissue necrosis |
| what 6 areas does the BRaden Scale look at? | sensory perception, moisture, activity, mobility, nutrition, shearing/friction |
| If black or elderly, what score puts you at risk for pressure ulcers according to the braden scale? | score of <18 |
| what does an albumin of <3.5 put you at risk for? | pressure ucler |
| What does low cholesterol put you at risk for? | pressure ulcer (poor diet) |
| when does the inflammatory stage of wound healing occur? | Day 4-5 |
| which wound healing stage has NO blood? | inflammatory |
| when does the proliferative stage of wound healing occur? | first 24 hours to 22 days |
| what does skin look like during proliferative stage? | beefy red due to blood |
| what nutrients are important for wound healing? | iron, oxygen, vitamin C, Zinc, magnesium, and protein |
| what's the final stage of wound healing? | maturation phase (day 21 to several years) |
| what are s/s of stage I pressure ulcer? | non-blanchable (won't turn white), reddened, skin intact |
| what are s/s of stage I pressure ulcer? | non-blanchable (won't turn white), reddened, skin intact |
| what are s/s of stage II pressure ulcer? | partial thickness, looks like a shallow blister |
| what are s/s of stage III PU? | full thickness, deep crater extending to SQ tissue, may have undermining |
| what are s/s of stage IV PU? | full thickness, damage to muscle or bone, may have undermining |
| what are s/s of unstageable PU? | eschar! |
| when should eschar NOT be removed? | if it is on the heel |
| how is slough removed? | irrigation |
| how is eschar removed? | debridement |
| how does autolytic debridement occur? | enzymes destroy necrotic tissue |
| what should PU dressing do? | provide moisture, but keep area around wound dry |
| what does tegaderm/transparent film dressing promote? | autolysis! |
| what PUs are hydro-dressings good for? | stage II and III |
| what 3 categories does the PUSH scale look at? | size, draining, and type of tissue effeted |
| As wound heals, what happens to PUSH score? | It should decrease |
| how do wounds heal? | from inside to outside, so we will see a decrease in depth before we see a decrease in width |
| what is paronchia? | infection around toes |
| what are s/s onchogryphosis? | thick, curved nails |
| what is a unique treatment for fungal nail infections? | Vicks vapor rub! |
| What's the physical performance measure? | shouldn't take more than 10 seconds to get up, walk ten feet, and sit back down: if it does, there is a mobility issue |
| what does the Barthel Index look at? | assistance needed: score of 100 is true independence |
| what does the SPICES tool look at? | sleep, eating, incontinence, confusion, falls, skin breakdown (geriatric syndromes)!! Help with any area improves quality of life |
| what are s/s of MI in eldery? | SOB, fatigue, epigastric pain |
| what 4 vaccines should elderly get for primary prevention? | Flu, Pneumonia, shingles, tetanus |
| How often should vision be checked? | at least every 2 year |
| What is presbyopia? | Loss of near vision |
| What are ectropia/entropia? | when eyelids turn outward or inward |
| How do we treat blepharitis? | baby shampoo! |
| What's the second leading cause of blindness? | Glaucoma |
| What causes glaucoma? | Increased IOP |
| What is normal IOP? | 12-22 mmHg |
| What are s/s of Acute: closed angle glaucoma? | PAIN, blurred vision, red eyes, halo around lights |
| What 3 meds treat both glaucomas? | beta blockers (timoptic), Myotics (pilocarpine), Prostoglandin analogs (xalantan) |
| What needs to be monitored on Betoptic or Timoptic? | HR and BP |
| What common side effect occurs on xalantan? | iris turns dark |
| What are s/s of Chronic: Open angle glaucoma? | NO PAIN, tired eyes, H/A, cloudy vision, halos around lights, LOSS OF PERIPHERAL VISION |
| What occurs with cataracts? | clouding of the lens due to a change in the composition of the lens |
| How do we treat cataracts? | When "ripened", we remove lens and put new one in |
| WHat needs to be watched after cataract surgery? | Don't increase IOP (no coughing, bending, pushing, looking down) |
| After cataract surgery, how long should eyes be protected from light? | 48 hours |
| What's the number one cause of blindness? | macular degeneration |
| What is lost with MD? | central vision |
| how do we diagnose MD? | Amsler chart: grid where they see fuzziness in middle |
| How we we treat MD? | Sterroid injection in to eye (its not curable) |
| Which type of MD is best? | DRY: beause it has a slower progression |
| What occurs during proliferative phase of diabetic retinopathy? | new, abnormal vessel form that easily burst |
| What are s/s of retinal detachment? | closing curtains, lights flashing, and floaters |
| What 3 meds cause tinnitus? | Lasix, gentamycin, and aspirin |
| which pitch is lost first? | high pitch, so speak in low tone and look at patient |
| What causes conductive hearing loss? | cerumen buildup, tumors, etc |
| What causes sensorineural hearing loss? | presbycusis, genetics, toxins |
| What's the best pharm treatment or vertigo? | Antivert |
| What is BPPV? | Vertigo caused by calcium deposists |
| What maneuver treats BPPV? | Eplpy maneuver |
| what are s/s of Meniere's disease? | severe vertigo, tinnitus, hearing loss |
| what is xerostomia? | dry mouth |
| How can we help xerostomia? | oral care, with no alcohol mouthwash, and chew xylitol gum to bring out sliva |
| Which type of neglect is common during the holidays? | abandonement |
| What did the omnibus act of 1987 do? | gave residents of nursing homes RIGHTS |
| If a patient has a DNR, where does it need to be? | IN THE CHART as an order |
| What can untreated sinusitis lead to? | meningitis |
| driving is what kind of ADL? | An EADL |
| If a person gets pneumonia vaccine before age 65, what needs to happen AFTER age 65? | a booster! |
| How is the mini cog performed? | 1) ask patient to remember 3 words 2) have them draw numbers and hands on clock 3) have them repeat the 3 words |
| With a mini cog, what signifies dementia? | 1-2 words right and a weird clock, or no words right |
| with a mini cog, what signifies NON dementia? | 1-2 words right (or more) and a normal clock |
| which memory goes first? | short term |
| what are s/s of delirium? | QUICK ONSET that is reversible if underlying cause is treated |
| what are some risk factors of delirium? | CHANGE IN SURROUNDINGS, meds, pain, infection, F/E imbalance, dehydration, alcohol |
| The DSM IV for dementia states they must have memory impaired, decreased executive function, and apraxia, agnosia, or agraphia. WHat are the later 3? | Apraxia: difficulty saying words, Agnosia: difficulty naming familiar objects. Agraphia: trouble writing |
| What is the progression of alzheimers? | SLOW, gradual onset that is irreversible |
| what do autopsies show of alzhiemers? | plaques and tangles that interfere with nerve cells |
| what 2 meds slow the progression of alzhiemers? | aricept and namenda |
| what are s/s of mild alz? | memory loss, getting lost, bad decisions |
| what are s/s of moderate alz? | increased memory loss, difficulty with learning and language, sundowner's, paranoia |
| what are s/s of SEVERE alz? | weight loss, dysphagia, incontinence, can't recognize family |
| What's unique about Sundowners? | Although they aren't competent at night, they are fully competent during the day! |
| What do most psych meds do to the eldery? | cause sedation |
| What causes vascular dementia? | Usually result of trauma, with cognitive decline resulting from ischemia or brain lesions |
| what are s/s of vascular dementia? | unilateral weakness, motor impairment, focal neuro signs |
| With which disease is Lewy Body Dementia common? | Parkinson's |
| what side effect does lewy body dementia result in? | EPS symptoms |
| What two things cause Parkinsons? | nerve cell degeneration and low dopamine |
| What is the #1 drug treatment for Parkinson's? | Levodopa/Carbadopa (Sinemet) |
| WHat is a levodopa drug holiday? | When symtpoms reutrn, take off for 10 days in hospital |
| What kind of surgery treats severe parkinsons? | Deep brain stimulation |
| What are common s/s of parkinsons? | bradykinesia, rigidity, resting tremor, and pin rolling (roll fingers together) |
| What is the number 1 risk factor for strokes? | HTN |
| What are s/s of stroke? | BAD HEADACHE, weakness, difficulty speaking, loss of balance |
| How do we determine which type of stroke someone had? | CT scan |
| How do we treat ischemic stroke (caused by clots) | TPA within 3 hrs of onset |
| How do we treat hemorrhagic strokes? | NO TPA!!!! Surgery to control bleed |
| What meds can reduce stroke risk? | ASA, Ticlid, Heparin, Coumadin, Plavix |
| How do we score the Geriatric Depression Scale? | Answer YES/NO to several questions. Score of > 5 means maybe depression and follow up. Score of >10 means probably depression |
| Which class of drugs works very well for anxiety? | SSRIs: treat anxiety and depression |
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