Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

82 Cards in this Set

  • Front
  • Back
title 19, both state and federally supported, low income (elderly excluded here); food stamps housing
medical insurance; federally suppotred, has 4 parts to it
Medicare Part A
paid for by gov; hospital stays (includes a deduction)
Medicare Part B
what pays the doct, not necessary to carry, but saves $ in the long run
Medicare Part D
Two teers: 1. all genetics
2. brand names w/min copayments
Prescirption drug coverage-pritoized to your private insurance company
What happens if you don't have part D?
Insurance premium will go up 1% every month -confusing to elderly
Fasting growing population?
Elderly--5 mil americans over age of 85
1499.99 in bank, car at home worth under 30,000, based on income and assests (check this one)
a process that converts a healthy adult into a frail one; break down of immune system
What is the single area that has produced long-gevity?
Cardiovascular Area-but to really know we need longitudinal studies @ least 50 years long
ability of body to fix itself--older people hemostates is not as good
Aspiration ammonia
coughing to get stuff outta lungs (losing cilia)
**what does decreased body water do to meds?
H20 soluble meds concentration should be decreased, and fat soluble meds concentration should be increased --note ppl should do weight baring activities here
What is senile purpura
bluish color on skin; blood spots on hands
Epidermis changes to skin?
epidermis is thinner
***What is the pupils blood supply?
No blood supply
Changes in aqueous kinetics
Glaucoma-causes increased pressure in the eye
Increased density of lens
Why do elderly eat spicy & sweet foods?
Taste buds are desensitized
What does atrophy of cochlear hair cells cause?
Presbycusis-lose both increase or decrease to high-pitched sounds
**Aorta becomes more rigid and lose of elasticity?
Left ventriulcar hypertrophy
Orthostatic hypotension defined as
decreased barorecptor reflex less than 20mmHg
*What's CAD
What's normal BP levels for an elderly
altered CO, decrease in number of adrengic receptors, and decreased HR all lead to
decreased response to stress
**creatinine clearne
140-age x body weight (kg)
72x serum creatinine

Mulitply by .85 for female
what can help with memory loss?
brain excersises imparative
What two problems do all falls have?
environmental and genetic
If anemia is seen in elderly thne
it must have an underlying cause
3 endocrine disorders seen in elderly?
hypothroidism; DM, CAM, decreased T cell function
what can you do* to help with decreased gastic HCL production?
give H2 blockers; affects abrsoption in stocah by increase in gastric pH in elderly
***What three things increase?
sytemic hypertension, hypotension, incontinence
*what's presbyoyia versus prescusbus?
Presbyopia si loss of lens elasticity in eyes; prescycusis is loss of auditory neuros and atropy of choclear hair cells leading to decrease ability to hear high and low pitched sounds
*what are the top 4 drugs elderly consume?
1. cV agents
2. diuretics
3. analgesics
4. GI agents
**Be able to twist C clearance around
don't give drugs in cyc p450 pathway; cc decreased in elderly so half life of a drug is increased (ex coudamin--2 days higher in older peeps)
**what are the principles for prescribing to eldery?
Start low and go slow and *avoid adverse drug events--most serious complication for elderly prescribing
What two drugs have adverse side effects to elderly
antipshytoic, and antibotoics
**Prinicipels for G. perscriing?
1. evaulaute need
2. take history
3. know pharm
4. make it easy
5. remember drugs can cause illness
*What B.E.E.R.S?
list of 33 drugs you should never prescribe to elderly;
DO's for presciring?
treat a diagnosis not a symptom; ask about herbals (selnenum); write out instructions;aconsult a pharm, drug holidays
What four catgegoirs of drugs can elderly receive full adult dose?
lAX, antibotics, diuretics, and pain meds
**What is the protein requirement?
.8gm/kg (body lb)/day; albumin levels below 3.0g/dl is poor prognostic sign/
**what is the caloric requirment?
30kcal/kg (ideal body weight)/day
**What is the fluid requirment of the elderly?
30ml/kg (IBW)/day
What are signs of protein calorie malnutrition?
anemia, fatigue, dementia, increased infections
one cause of anoxeria
increased activity of CCK (satiey)
how much percent a day do bed fast patients lose?
cardinal featurse of protein-eg malnution?
alopecia(balding), glossities, decreased cholesterol (think malignanacy)
Vitamin B12 defieciency
decreased intake and decreased absorption leads to def (macroscytic anemia)
What's needed for heart problems?
**List types of prevention:
Primary prevention-proactive
secondary preventin-chaning habits
*What three areas are involved in primary prevention?
immunization* (flue shot-pneumococall vaccine), injury prevention, diet and exercise
**name examples in secondary prevention?
alchol and drug abuse, smooking cessation, TB skin testing, screening (history and physical exam); note MCV on CBC
should old peeps exercise?
yes, 30 minutes 3x a week(2/3 of max heart rate)
*When should ammonia shot be given?
1x before 65, and 1x for 65 every 10 years
Death and dying: define polymyaligia
"shoulder aching syndrome"; hips hurt; elevated ESR!!; >100 (should be around 15); no weakness but tenderness; morining stifneess>1 hr for 4 weeks; STEROIDS IMMEDI
Temporal arterieis symptoms*
dipolpia; headache; loss of vision,
What has slower onset-symptoms?
poly R-slower onset; malaise, anorexia, weight loss, anemai
What is the loss of vision caused by in temporal artieries?
occulision of ciliary artery d/t giant cell arterieist; infaraction of opitc nerve (will lose sight in affected eye immediately)
How do you diagnose TA and what do you look for?
TA biopsy..ESR>30; negative Rh factor
Both you treat with steroids, but which one is more common?
What percentage of hip fractures result from a fall?
Why do medis cause ppl to fall?
Diuretics lower K+ levels, and hurry to pee
*What are the two reasons for a fall?
1. environmental causes
2. oragnic causes (drugs in body)
when a pateint has repeatedly fallen, what is the order you can look for things?
1. look at meds first
2. enviromental
3. underlying med condition (uti causes mental changes)
*Major signs of death
"modeling"-dark pathcy areas, cool limbs, sleeping, death rattle, jack stocks breathing, *hearing last sense to go, urine decreases
what's kubler ross stage of greving?
if stiffness goes away in morning or less than an hour?
*intoduction II*
Most older pppl have at least one...........condition and many have more than one
chronic condition; (*Note, here arthirist is #1 chrnoic condition, then hypertension, hearing, heart disease)
What percentage of health care cost can be attriubed to elderly?
more than 1/3 for only 15% of population
What does abuse of the elderly entail?
verbal/physical/psyhological, establish a rapport with patient and note any stress or dietary changes
What percentage of the toal health costs of the gross national product can be contriubted to elderly?
15% (wow!)
what's the average life expectacny (in 1991?)
75.5 years
What are some risk factors for falls?
sensory, vstibular, propoictive, (CNS anything)_; systemic diseases, depression, meds, environment
*What are the risk factors?
1. advancing age
2. family history of dementia
3. presence of Down syndrom
4. exposure to aluminum
5. females
6. mutation in chromsome 14
*If given a score, know if mild, late, terminant, or dead?
Mild-"confused state"/years 2-8/small tasks/lost in familial places -Stage II

Late score/0-9 MMSE/inconstince/remote memory gone; >yr 6
Terminant stage-fetal postion
Stage IV=death
*What is the workup for AZD?
1. verifty dementia is present
2. history
3. physical-CBC/meds review/CT-rules out mulit-infarct
4. mental status examination
*What is the treatment for AZD?
Ach inhibitors-memantipine * Aricept (Donepezil HCL)-to enhance cognitive function/once daily
General understanding of AZD?
Pathological loss of memory and dementia when it interferes with daily living/#1 deficient seen=judgement impairment/life expentency 8.5 years from the onset of symptoms/AZD is a disease of exclusion-rule everything else out
AZD is characterized by:
Amyloid plagues, neurofibrillary tangles, MAYBE atrophy
Neruologic signs
abrupt onset/progeesive decline
How many months are there b/n the onset and diagnosis of the diease?
32 months...nursing home after 56 months or 4 years
Genetic Research evidence:
14, 21-(21 is amloyoid plague protein (APP))
APoE4-chromsome 19/late onset AZD