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32 Cards in this Set
- Front
- Back
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Name the types of urinary incontinence.
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transient, urge, stress, overflow, mixed, and functional
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What conditions are commonly assoc. with transient incontinence?
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Drugs, Restricted Mobility, Infection/Inflammation, Polyuria
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What is the MC form of incontinence among the elderly?
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urge
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What type of incontinence is MC in females?
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Stress
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What type of incontinence is MC in men?
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overflow
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What causes overflow incontinence?
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obstruction of urinary outflow (BPH) or impaired detrusor contractility
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What is the primary Sx of uncontrolled bladder contraction?
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urgency - can usually Dx type of incontinence by Hx alone
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If a pt presents with incontinence and hematuria, what is in your DDx?
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neoplasm, calculi - get cytoscopy, US, or radiography
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What lab test can be done to exclude overflow incontinence?
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post - void residual. if <50-100, can r/o overflow incontinence
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What are some Tx for overflow incontinence?
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suprapubic cath, chronich indwelling cath, intermittent cath, Tx of BPH in men
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What is the pathognomic feature of delirium?
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an ACUTE change in baseline mental status developing over hours to days
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T or F, delirium always has an organic or physiological cause.
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True
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What are the 3 types of delirium?
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hyperactive - hallucinations and paranoia
hypoactive - lethargic, fluctuating levels of consciousness mixed - daytime sedation, nighttime mania |
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what must you always distinguish delirium from?
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depression and dementia - know baseline from caregivers
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What are the foremost precipitating factors in delirium?
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meds (>40%), immobilization, indwelling cath, use of physical restraints, dehydration malnutrition, iatrogenic complications, organ insufficiency, infection, metabolic derangements, and illicit drug use or withdrawal
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What are ways to prevent delirium?
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keep active, avoid restraints, avoid sedatives, keep well nourished and hydrated
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What are the cardinal features of delirium?
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inattention, disorganized thinking, altered level of consciousness, psychomotor retardation, agitation, hallucinations, or illusion and paranoid delusions. It has an acute and flucuating course which distinguishes it from dementia. It must occur in the context of a medical illness, metabolic derangement, drug toxicity, or withdrawal
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Describe the CAM.
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Pt must have 2 cardinal features + disorganized thinking or altered level of consciousness
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KEY facts on delirium
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medical emergency, DDx is broad, need immediate w/u, w/u is expensive
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T or F, pts who experience delirium are more likely to be diagnosed with dementia later
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true
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What are the essentials of Dx for dementia?
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memory impairment AND at least 1 or more of the following: language impairment, apraxia, visuospatial deficits, decreased executive functioning, significant impairment in social or occupational functioning, significant decline from previous level of functioning, deficits not occuring solely in the presence of delirium
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What are risk factors for vascular dementia?
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HTN, HLD, DM, smoking, age, male gender
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What are risk factors for Alzheimer's Dementia?
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age, FHx, female gender, and head trauma
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What labs should be ordered with a CC of memory loss?
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TSH, B12, Ca
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What are the core features of Dementia with Lewy Bodies?
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parkinsonism, fluctuation in cognitive impairment, and visual hallucinations
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What is the goal of Tx of dementia?
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preservation of function
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What is the Tx for AD?
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cholinesterase inhibitors
1.tacrine 2.donepezil 3.rivastigmine 4.galantamine |
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What is Tx for vascular dementia?
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No approved drug therapies - focus on prevention with drugs like Plavix and ASA therapy.
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What are some nonpharmacologic approaches to problem behavoirs?
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maintain familiarity, tell - don't ask, keep behavoir logs
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What are some management issues related to dementia?
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advance directives, safety (driving and wandering, etc.), caregiver assistance
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What is the MC cause of syncope in the elderly?
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cardiovascular
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Is syncope a Dx?
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No - it is a sx of an underlying d/o.
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