627900
Description
Flashcards by Kate Caldwell, updated more than 1 year ago
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Created by Kate Caldwell
about 10 years ago
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| Question | Answer |
| Which food group should be increased during illness? | PROTEIN (unless renal disease) |
| What effect does Sorbitol have on the GI system? | malabsorption--> dehydration |
| What BMI is overweight? | >25 |
| What BMI is obesity? | >30 |
| What is the red flag of weight loss? | 10 pound+ weight loss over 6 months that is unintentional |
| How many inches in height do ederly lose with age? | 2-4 inches |
| On the nutritiona assessment took, what score indicates malnourishment? | <17 |
| What is the max score on the nutritional assessment tool? | 30 |
| Which protein is the best indicator of chronic malnourishment? | prealbumin, because it has the shortest half life |
| What prealbumin level indicates malnorishment? | <5-15 |
| How much protein is recommended daily? | 1 gram/kg/day |
| How much protein daily is recommended for adult with sarcopenia? | 1-1.5grams/kg/day (30 grams at each meal!) |
| Anytime elderly complains of GI pain, what should be ruled out first? | cardiac issue |
| How is dysphagia treated? | thickened liquids or pureed fods |
| From what side is the abdomen assessed? | from the right side (so liver can be palpated) |
| With diarrhea,what foods should beavoided? | veggies, spices, and dairy: follow the brat diet |
| How is anemia classified? | by mean corpuscular volume (MCV) or the size of the RBCs |
| Women are diagnosed with anemia if Hgb is less than... | <12 |
| When is Hgb falsely high? | If dehydrated, smoker, or in a high elevation |
| When is anemia treated? | When hgb falls below 8 |
| With iron deficiency anemia, what happens to RBCs? | they become smaller, so the MCV is lower |
| How do we treat iron deficiency anemia? | 325 mg Iron daily with OJ |
| What is B12 deficiency? | AKA pernicious anemia: lack intrinsic factor, so B12 isn't absorbed |
| How do we test for B12 anemia? | Shilling Test: urine test over 24 hour period |
| How do we treat B12 anemia? | B12 injection for life |
| How often are vitals taken during blood transfusion? | q5minutes for the first 15 minutes of transfusion |
| How to we manage a blood reaction? | stop transfusion; flush line with saline |
| What happens with HR in elderly? | Decreases |
| What happens with BP in elderly? | Increased systolic BP |
| What is the #1 risk factor for CAD? | HTN |
| Which diuretic is the first line treatment for HTN? | HCTZ |
| Which HTN med is best for diabetics? | ACE inhib |
| What is the first line diuretic for CHF? | Lasix |
| With HF, how often should patient weight? | daily! |
| Which lab level is checked during HF? | BNP |
| What happens to RR in elderly? | Increases |
| Which COPD is the blue bloater? | chronic bronchitis |
| Which COPD is the pink puffer? | Emphysema |
| What is often the first and only sign of pneumonia in elderly? | change in mental status! |
| What is treatment for TB? | INH or Rifampin for 9 months, keep in negative pressure room |
| With the Epworth Sleepiness Scale, what score indicates you aren't getting enough sleep? | 9+ |
| What questions are asked on the ESS? | likelihood of falling asleep in various siuations |
| What questions does the PittsburgSleep Quality index ask? | During the last month, how often have you had trouble falling asleep because.... |
| Which sleep scale is more specific? | pittsburg |
| How do we diagnose sleep apnea? | polysomnogram in sleep lab |
| Why is drug abuse hard to see in elderly? | symptoms mimic other age related illnesses |
| Which labs monitor warfarin therapy? | INR and PT |
| Which lab monitors heparin therapy? | PTT |
| What is normal PTT? | 60-70 |
| IF taking warfari, what should INR be? | 2-3 |
| What is the ESR? | Time it takes RBCs to settle in NSS over 1 hour |
| What do an elevated ESR and CRP mean? | inflammation |
| What is the Beer's Criteria? | If a medication MUST be used, go low and go slow: applied to benzos, antibitioics, iron, and anti-psych |
| What are side effects of anticholinergics? | dry mouth, flushing, confusion |
| How can we aid a med side effect of upset tummy? | Sit upright for 30 minutes after eating |
| Where do most med errors occur? | in LTC facilities |
| What causes OA? | loss of cartilage and synovial fluid in the joints |
| What are s/s of OA? | pain, stiffness, and joint crepitus, Herberdens node and Bouchards nodes. NO SYSYTEMIC effects |
| What are herberden's nodes? | occur distally on fingers |
| What are bouchard's nodes? | Occurs proximally on finger |
| How do we treat OA? | heat or cold (whatever works), NSAIDS, capsasin, Tylenol, or surgery |
| What is spinal stenosis? | A bony overgrowth of joints in the spine |
| With RA, when is pain worst? | in the AM |
| Compared to OA, when does RA start? | Earlier, in 30s and 40s |
| What is the pattern of joint inflammation in RA? | symmetrical, pannus formation |
| Which RA deformity is most common? | Ulnar shift: fingers turn outward |
| Which two DMARDS are commonly used to treat RA? | plaquenil and methotrexate |
| What substances accumulates with gout? | uric acid |
| Which med treats acute gout? | Colchicine |
| Which med treats chronic gout? | allopurinol |
| What foods should be avoided with gout? | alcohol, anchovies, liver |
| What are risk factors for osteoporosis? | early menopause, low vitamin D, white and small |
| How do we diagnose osteoporosis? | DEXAscan |
| When should bisphosphonates be stopped for osteoporosis? | When improvement ceases: can worsen osteoporosis |
| What are s/s of PAget's disease? | Bone enlargement, bone pain, H/A, hearing loss, fractures |
| What is osteomyelitis? | infection of the bone |
| How do we prep stump for prosthesis? | Stump conditioning: proper wrapping that is tighter at the bottom |
| How do we prevent amputee contractures? | tummy time! |
| How long should stump be elevated post op? | 24 hours on ONE pillow only |
| How do we treat phantom limb pain? | Pain meds! |
| What is the leading cause of hip fractures ? | FALLS! |
| What is the timed up and go assessment? | Get up from chair, walk 5 feet, turn around ad sit down using NO SUPPORT from ARMS: should take 20-30 seconds with a normal score of 1 |
| What are intrinsic risks for falls? | poor vision, poor cognition, poor proprioception |
| What are extrinsic risks for falls? | environment (throw rugs), meds, restraints, CATS meow |
| After hip replacement, how are legs positioned? | abduction (away from body)using a wedge pillow: NO ABDUCTION/crossing legs |
| How do we walk with a cane>? | Cane on strong side! |
| What are s/s of fat emboli? | SUDDEN SOB, agitation, chest pain, tachycardia, and petechial rash on chest and back (from RBC breakdown) |
| Why are fingertips not used on casts? | They can leave dents |
| What are s/s of compartment syndrome? | throbbing pain unrelieved by pain meds |
| How soon will limb lose function with compartment syndrome? | Within 6 hours there is cell death |
| What are the 6 Ps to assess for compartment syndrome? | Parasthesia, pain, pressure, pallor, paralysis, pulselessness (late sign) |
| What is a red flag sign of infection with a cast? | BAD odor |
| What is the goal of traction? | To keep the limb in alignment |
| What is Buck's traction? | Skin traction exerted by straight pull with a weight |
| How much does renal blood flow decrease as we age? | Decreases 10% per decade after the age of 40 |
| What are tests for provocation? | Completed with a full bladder to check for incontinence: coughing, bouncing, listening to water run! |
| What causes overflow incontinence? | Poor nerve endings and muscles that can't contract well |
| With overlow incontinence, what is the post void residual? | >100 mL |
| Which two incontinencies will Kegals help? | Stress and Urge |
| What is the biggest BPH risk factor? | aging! |
| How do we diagnose BPH? | digital rectal exam |
| What meds should be avoided with BPH? | anticholinergics, because they cause urinary retention |
| What do proscar and Avodart treat? | BPH |
| how long do proscar and Avodart take to work? | 6 months |
| What does Saw Palmeto cause? | treats BPH (maybe), but causes increased bleeding risk |
| What kind of catheter is used in BPH patients? | Coude |
| What is a side effect ofTURP? | erectile dysfunction |
| After a TURP, on CBI, what fluid is used to flush? | NSS |
| With CBI following a TURP, how long after clots common? | for first 24-36 hours |
| when is triple lumen catheter for CBI D/Cd? | Once urine returns to yellow (about 2-3 days) |
| How do we diagnose prostate cancer? | digital rectal exam and a PSA >4 ng |
| What is a rare side effect of Viagra? | blindness |
| What is andropause? | Age related decrease in testosterone |
| What are 5 components of metabolic syndrome? | abdominal obesity, HTN, high triglycerides, high HDL, and high BS |
| What are microvascular complications of DM? | renal dysfunction, neuropathy, and retinopathy |
| What is an early indicator of DM? | freuquent UTIs |
| What are s/s of hypoglycemia in older adult? | confusion, weakess, diaphoresis, tremors |
| How much carbs should be in diabetic diet? | 45-60% of diet |
| What are s/s of hyperthyroidism in elderly? | tachycardia, fatige, tremors, nervousness, Afib |
| What are s/s of hypothyroidism in elderly? | fatigue, cold intolerance, weigh gain, confusion |
| Why shouldn't we take generic forms of Synthroid? | Can cause angina or cardiac arrhythmias |
| Where does cancer love to go? | liver, lungs, and brain |
| What are s/s of lung cancer? | chest pain, cough, high # resp infections |
| What is a late sign of pancreatic cancer? | jaundice |
| What are causes of stomach cancer? | unknown! |
| What is the max score on the caregiver strain tool? | 26: super strained!! |
| What is the goal of palliative care? | to eliminate or lessen pain |
| What is needed for hospice care? | Proven that you have less than 6 months months to live |
| What is the number one sign of approaching death? | change in breathing! (death rattle, cheynne stokes, etc) |
| How do we treat increased secretions in dying? | NO SUCTION: give anticholinergics |
| What also are s/s of approaching death? | dark urine, blood pools in dependent areas, decrease intake of food and water, loss of ability to close eyes |
| What is the drug of choice for pain in dying? | morphine...still treat if unresponsive |
| If the patient is a viable organ donor, what do we do afte death? | keep ventilated to maintain perfusion |
| How long can body stay on floor after death? | <4 hours |
| Who pronounces death in a nursing home? | RN |
| If patient dies I semiprivate room, who moves? | move the living patient |
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