Gerontology Exam 2

Front 1

Aging can bring a reduction in stages ____ and ____ during sleep, as well as _____ sleep

Back 1

3, 4, REM

Front 2

Aging can bring a reduction in what kind of sleep

Back 2

slow wave deep sleep, as well as REM

Front 3

Aging can bring an increase in what stage of sleep

Back 3

stage 1

Front 4

Aging can ___________ melatonin levels

Back 4

decrease

Front 5

Sleep deprivation can increase the risk of what diseases

Back 5

diabetes and heart problems

Front 6

____% of all adults suffer from insomnia. ____% of elderly

Back 6

• 10-20% all adults.
  
• 40-50% of elderly.
  

Front 7

Causes of insomnia

Back 7

• Depression
• Anxiety, PTSD
• Dementia
• Parkinsonism

Front 8

The most common sleep disorder

Back 8

Obstructive sleep apnea (OSA)

Front 9

Obstructive sleep apnea (OSA) is characterized by cessation/reduction in airflow for ______ sec

Back 9

> 10 sec

Front 10

Sleep apnea is characterized by a (increase)or(decrease) in dreaming

Back 10

decrease

Front 11

Causes of sleep apnea

Back 11

• Obesity
• Family history
• Gender (Men > Women)
• Small airways (allergies/trauma/anatomy)
• Smoking

Front 12

Sleep apnea puts you at greater risk for what conditions

Back 12

• Dementia
• Cardiovascular disease (stroke, MI, CHF)
• Poor blood sugar contro

Front 13

Women with OSA have a ____% higher rate of dementia

Back 13

85

Front 14

OSA

Back 14

Obstructive sleep apnea

Front 15

Treatment for sleep apnea

Back 15

• Identification first
• Weight loss
• Stop causative factors (smoking, meds, ETOH)
• CPAP machines
• Surgery

Front 16

Repetitive movement of legs during sleep is a condition called

Back 16

• Restless Leg Syndrome
  
• Periodic Limb Movement Disorder (PLMD)

Front 17

What medications can exacerbate restless leg syndrome

Back 17

• Antidepressants
• Antipsychotics
• Alcohol
• Muscle relaxants/sedatives

Front 18

Supplements that may help restless leg syndrome

Back 18

• Iron
• Magnesium
• Folic acid/B-complex

Front 19

Is poor sleep a normal part of aging?

Back 19

No

Front 20

T/F: it is the job of the nurse/doctors to judge the validity of reported pain

Back 20

False

Front 21

T/F: Pain is the cause of addiction in the elderly

Back 21

False

Front 22

____% of nursing home residents have pain. ____% of patients with advanced cancer.

Back 22

• 45-80%
• 75%

Front 23

What is the most common symptom associated with describing oneself as "ill"

Back 23

pain

Front 24

Acute pain lasts no longer than __ months

Back 24

6

Front 25

Chronic pain lasts longer than __ months

Back 25

6

Front 26

Treatment of pain in the elderly

Back 26

• Try non-pharmacologic first (heat, cold, relaxation, TENS)
• Administer pain meds on a regular basis to maintain therapeutic levels (avoid prn drugs)(avoid demerol)
• Monitor medications closely
• For severe pain, consider patient-controlled analgesic pump

Front 27

Exercise often should be attempted to treat ______

Back 27

pain

Front 28

Neuropathic pain

Back 28

pain that arises due to injury or disease of the nervous system

Front 29

Why are elders at risk for neuropathic pain

Back 29

They have fewer inhibitory nerves, lower endorphin levels, and a slowed capacity to reverse processes that sensitize nerves

Front 30

Common types of neuropathic pain

Back 30

• Diabetic neuropathy
• Post-stroke pain
• Post-herpetic neuralgia (shingles)

Front 31

Post herpetic neuralgia is present in ____% of those over 70 years of age

Back 31

>50%

Front 32

Treatment for neuropathic pain

Back 32

• First work on underlying cause
• Responds well to neuroleptic meds (antidepressants, anti-epileptics, gabapentin)
• Treat with alternative stimulation (ice, heat, mild compression)

Front 33

Onset of delirium

Back 33

hours to days

Front 34

Onset of depression

Back 34

weeks to months

Front 35

Onset of dementia

Back 35

months to years

Front 36

Most common cause of dementia

Back 36

Alzheimer's

Front 37

Causes of dementia

Back 37

• Alzheimer's
• Vascular dementia (multi-infarct; MID)
• Combination of AD and MID
• Pick's, Parkinson's, AIDS, Lewy body dementia, alcohol/drug induced

Front 38

Lewy-body dementia is commonly associated with what other condition

Back 38

Parkinson's

Front 39

Korsakoff syndrome

Back 39

Chronic memory disorder caused by severe thiamine (B1) deficiency. Most commonly from alcohol abuse.

Front 40

Alzheimer's is found in ___% of people over 65, and ___% of those over 85.

Back 40

10, 50

Front 41

There are how many people diagnosed with Alzheimer's in the US currently?

Back 41

4 million

Front 42

Which typically has diurnal fluctuations in its symptoms: delirium or dementia?

Back 42

Delirium

Front 43

Delirium is typically worse at _________

Back 43

night

Front 44

The rate of suicide among the elderly is ________ than the rate for the general public

Back 44

greater

Front 45

Among the elderly, who is at the greatest risk for suicide

Back 45

elderly white men, especially over the age of 85. Men are over 7 times likelier to commit suicide than women in later life.

Front 46

T/F: as people age, their rate of absorption changes

Back 46

True

Front 47

T/F: as people age, the extent that they absorb drugs changes

Back 47

False

Front 48

Some changes in digestion with aging

Back 48

• reduced salivary flow
• increase gastric pH (less acidic)
• decrease in small bowel surface area
• decreased absorption
• reduced gastric motility

Front 49

As a person age, their serum albumin change _________

Back 49

decrease

Front 50

As a person ages, they need ________ drug dosages to achieve the same effect

Back 50

lower

Front 51

The most important part to decreasing polypharmacy is

Back 51

discontinuing unnecessary drugs