Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
93 Cards in this Set
- Front
- Back
|
what is geriatrics?
|
it is the study of old age that includes the physiology, pathology, diagnosis and management of the disorders and dieseases of older adults. it is a very narrow study and only studies the biologic.
|
|
|
what is gerontology?
|
the combined biologic, pyschologic, and sociologic study of older adults within their enviornment. it is the whole life, a much broader field of study.
|
|
|
what is ageism?
|
prejudice or discrimination of older people, based on stereotype and inaccurate beliefs of older adults.
|
|
|
chronological age- what is young old, mid old, and old old.
|
young old- 65-70
mid old- 75-84 old old- 85-94 elite old- 95% |
|
|
geographicaly what states have the most elders?
|
warm climates. FL, TX, AZ, NY
|
|
|
according to living arragements, how many live on their own, with a spouse, with realitive, or live alone?
|
one their own- 3/4
with a spouse- 1/2 with relatives- small number alone- 1/3 |
|
|
what percentage of elderly fall below poverty level?
|
20%
|
|
|
how much does the average income drop by when they retire?
|
50%
|
|
|
t/f 3/5 of elderly have at least one chronic illness?
|
f- 4/5 have at least one chronic illness.
|
|
|
elderly are the largest consumers of what?
|
healthcare services
|
|
|
what percentage used ambulatory services and home health?
|
75%
|
|
|
what percentage rate their health as excellent?
|
70%- only 10% rate their health as poor.
|
|
|
what are the biologcial therories of aging?
|
biological clock/genetic therory
wear and tear theory immune theory cross link theory free radical theory somatic theory stress theory |
|
|
what theroy holds that life span depends on genetic factors, that DNA controls the clock inside your body, genetic mutation occurs during cell division that leads to diseases process and number of abnormal cell divisions increase as you age, which results in malfunctioning of tissues, organs, systems, and death?
|
biological clock/genetic therory
|
|
|
this theory holds that the exposure to radiations and chemcials produce chromosomal abnormalities that prevent the normal reproduction of cells.
|
somatic mutation theory
|
|
|
bodys response to stress
|
stress theory
|
|
|
this theory holds that stress, internal and external factors cause injury and death to cells. cells are unable to repair or replace themselves which leads to organ and system failure.
|
wear and tear theory
|
|
|
this theory holds that cells become less self regulatory overtime and the autoimmune system turns on itself which incorrectly labels cells as foriegn matter and leads to an attack. this makes elderly susceptible to infection and cancer.
|
immune theory
|
|
|
this theory holds that a highly unstable O2 molecule is looking for anything to hook up to and causes mutation of cells, thought to be part of normal metabolism, pesticides and pollutants.
|
free radical theory
|
|
|
this theory holds that normal cellular divisions is threatened as a result of radiation or chemical reaction and a cross linking agent attaches itself to the DNA and prevents normal cellular division during mitosis. these agents accumulate and interfere with intracellular transport.
|
cross link theory
|
|
|
what are the psychological theories of aging?
|
activity theory
disengagement theory continuity theory subculture of the aged |
|
|
this theory holds that both the person and society gradually withdrawl and seperate and disengage from one another. it is highly criticized. it is thought to benefit the older person for reflection on self and to get affairs in order.
|
disengagement theory
|
|
|
this theory holds that an older person should continue to live the way they lived throughout their middle aged lifespan, for as long as they can and deny the fact they are getting older. any type of neg influcence such as losing a spouse, should be overcome and society should apply the same norms
|
activity theory
|
|
|
this theory holds that the elderly have their own culture, prefer to be with the elders.
|
subculture of the aged
|
|
|
this theory holds that your personal and your basic patterns of behavior remain the same throughout life. use the same coping mechanisms that you used when you were younger.
|
continuity theory
|
|
|
what are the develpmental theories of aging?
|
maslow's
erikson butler/lewis |
|
|
which developmental theory holds that the major development task of the elder is to adjust to your own limitation and develop a sense of satisfaction with life lived, and to prepare for death?
|
butler/lewis
|
|
|
what is a nurse doing when she fosters hope, encourages reminiscing, uses humor carefully and shows respect?
|
interventions
|
|
|
what is physcial characteristics such a skin pigmentation, body stature, facial features and hair texures?
|
race
|
|
|
what is a shared system of beliefs, values and behavioral expectations that provide social structure?
|
culture
|
|
|
what is a sense of identification with a collective cultural group?
|
ethnicity
|
|
|
is it okay to ask a persons ethnicity?
|
yes
|
|
|
why is it important that we know their religion?
|
because of foods they can not eat, blood transfusions and opposite sex caregivers
|
|
|
should we know if the patient has folk remedies?
|
yes- because it may be important to the careplans and medications
|
|
|
which culture is maternally dominated?
|
african american (AA)
|
|
|
which cultures do not donate organs?
|
AA, hispanics, asians, middle eastern
|
|
|
which culture places the cause of death as important?
|
caucasian
|
|
|
which culture values eye contact and are very verbal and affectionate?
|
AA
|
|
|
which culture avoids eye contact and become very stoic when in pain?
|
asians
|
|
|
which culture would request a copy of the koran and prefer tittle?
|
middle-eastern
|
|
|
which culture is patriarchal, very affectionate and consider healthcare workers authoratative?
|
hispanic
|
|
|
Name the stages of grief
|
Denial
Anger Bargaining Depression Acceptance |
|
|
Explain traditional heart-lung death
|
when the heart & lungs stop pumping blood. Irreversible cessation of spontaneous respiration & circulation.
|
|
|
Explain whole-brain death
|
Irreversible cessation of all functions of the entire brain.
|
|
|
Explain Higher-Brain death
|
Irreversible loss of all "higher" brain functions (cognitive function)
|
|
|
Explain Living Wills
|
Provides specific instructions about the kinds of healthcare that should be provided or foregone in particular situations.
|
|
|
What are IADL's?
|
Balancing the checkbook, buying groceries to make a meal, if something breaks...knowing who to call.
|
|
|
What is the most common joint disorder?
|
DJD aka Osteoarthritis
|
|
|
What is primary DJD?
|
No defining injury or event that caused it.
|
|
|
What is secondary DJD?
|
The result of a previous injury.
|
|
|
What is DJD or Osteoarthritis
|
The progressive loss of joint cartilage which leaves bone on bone.
|
|
|
Explain the pathophysiology of DJD (Osteoarthritis)
|
The inflammatory process causes edema & pannus that destroys the cartilage of the joint. This causes the bone to harden & enlarge.
|
|
|
Who is at risk for OA/DJD?
|
Age - risk increases w/ age
Females - genetic predisposition Obesity - joints have to work harder Mechanical Joint Stress - employment/athletics (tennis elbow) Joint trauma Previous bone or joint disorders |
|
|
What are the symptoms of Osteoarthritis?
|
Pain & Stiffness (worse in AM or after extended sitting)
Joint movement is restricted |
|
|
How is DJD treated?
|
Non-Pharmacologic
* Lose weight * Reduce risk of injury Pharmacologic * Acetaminophen/Tylenol (1st choice) * NSAIDS/Ibuprofen/Aleve (2nd - r/t GI bleed) * Cox-2 inhibitors (Viox & Dextra pulled from market) Surgery * Joint debris scoped * Joint replacement (if scope unsuccessful) - Arthroplasty Dietary Supplements * Glucosamine, chondroitin & visco supplements Alternative Modalities * Heat therapy |
|
|
How is RA different from DJD?
|
RA - occurs first in small joint
DJD - occurs first in weight bearing joints RA - acute onset DJD - gradual onset RA - bilateral DJD - unilateral |
|
|
What are Bouchard's nodes?
What are Heberdens nodes? |
Nodules on the proximal finger joints
Nodules on the distal finger joints |
|
|
What is the symptomatology r/t RA?
|
Pain
Swelling, redness & heat Loss of joint function Small joints first then large joints Acute onset Bilateral Joint deformity |
|
|
How is a diagnosis of RA made?
|
RA factor in the blood (present in 80% of pts)
Elevated ESR Elevated C-Reactive Protein (synthesized in liver) Decreased RBC Arthrocentesis * Synovial fluid is cloudy & watery r/t elevated WBC's r/t inflammatory disease (normal synovial fluid is viscous & clear to straw colored) X-ray (shows joint erosion) |
|
|
How do you manage the symptoms/treat RA?
|
Early stages
* Alternate Rest & Activity * Aspirin or NSAIDS (take NSAIDS consistently) - decreases inflammation - decreases further joint destruction * No Narcotics * some PT/OT Moderate, Erosive Stage * PT/OT - muscle strengthening & ROM Persistent, Erosive * Surgery * Corticosteroids * Antirheumatic drugs (i.e. antimalarial/gold injections) Advanced * Chemotherapy drugs (Methotrexate) * Antidepressants (for depression) * Diet high in vitamins/protein/iron (r/t anorexia) * Narcotics b/c debilitating pain * Pt. may have trouble sleeping |
|
|
What is Osteoporosis?
|
A reduction in bone mass - bone reabsorption is greater than the formation of new bone cells. Bones porous & brittle (fracture easily) causing vertebral collapse & loss of height.
|
|
|
Who is at risk (modifiable risks) for Osteoporosis?
|
Low calcium intake (esp. when young bones developing)
Extended non-weight bearing Those w/ excessive caffeine, nicotine, alcohol intake Not taking estrogen after menopause Vitamin D deficient (reduces calcium absorption) Long term corticosteroid therapy Lack of weight bearing exercise |
|
|
What is the RDA for calcium?
|
800 mg/day for adults
1000-1500 mg/day for postmenopausal women 1300 mg/day adolescent from puberty to young adulthood |
|
|
Who is at risk (non modifiable risks) for Osteoporosis?
|
Small body frames
Asian or Caucasian females Family Hx Old Age Female |
|
|
How is a diagnosis of Osteoporosis made?
|
X-Ray
Bone Density Test Serum Calcium Levels |
|
|
How is Osteoporosis managed?
|
Diet
* Increase calcium & Vitamin D intake OTC * Supplements (Oyster shells, Tums) Prescription Therapy * Fosamax/Actonel - taken weekly (hard on GI tract-sit stand 30 min after) * Boniva - taken once a month (regrows bone) * Nasal spray - replaces calcium * HRT(increased cancer risk/cardiac problems) - Premerin or Prempro Eliminate Risk Factors |
|
|
List some complications of Osteoporosis.
|
Compression fractures
Hip fractures Mobility & respiratory issues |
|
|
Define contusion & give S&S. How do you treat a contusion?
|
Contusion - soft tissue injury r/t blunt force.
Pain, swelling & discoloration Ice it off & on. Should resolve in 1-2 wks. |
|
|
Define strain & give S&S.
|
Muscle pull from overuse or overstretching. Can be complete muscle tears w/ bleeding into tissue.
Sudden pain & localized tenderness (particularly w/ use) |
|
|
Define Sprain & give S&S.
|
Injury to ligament surrounding a joint from wrenching or twisting.
Swelling, tender & stiff, painful. X-ray to rule out bone injury. |
|
|
What is an Avulsion Fracture?
|
When bone fragment is pulled away with the separation of a ligament or tendon (associated w/ sprains)
|
|
|
What is the typical treatment of soft tissue injuries?
|
RICE
R - Rest (promotes healing - prevents reinjury) I - Ice (off & on for 20-30 mins for first 24-48 h) C - Compression (controls bleeding, reduces swelling, support) E - Elevation (reduces swelling by gravity) |
|
|
What is subluxation?
|
A PARTIAL dislocation of the articulating surfaces
|
|
|
What is a joint dislocation?
|
A condition in which the articular surfaces of the bones forming a joint are no longer in anatomical contact
|
|
|
List some complications of joint dislocation.
|
If traumatic, could be orthopedic emergency.
Damaged structure, blood supply & nerve damage causes: Avascular Necrosis - tissue death (anoxia) & diminished blood supply Nerve palsy (avascular necrosis & nerve palsy occur if not promptly treated) |
|
|
S&S of Traumatic Joint Dislocation
|
Pain
Change in contour joint Change in length of extremity Loss of mobility/movement of joint Change in axis of joint |
|
|
How is a joint dislocation diagnosed?
|
X-Ray
|
|
|
A neurovascular check of a dislocation would look at?
|
Circulation
Motion Sensation Color Temperature |
|
|
Define Osteomyelitis
|
Bone infection
|
|
|
How does Osteomyelitis occur?
|
* Extension of soft tissue infection
- infected pressure ulcer - vascular ulcers - incisional infection * Direct bone contamination - bone surgery - open fractures - GSW * Hematogenous (blood born) - infection spread from one area of the body by blood (as simple as abscessed tooth or URI) |
|
|
Is chronic osteomyelitis difficult or easy to treat?
|
Difficult. The bone can actually encapsulate the infection making it difficult to treat. The patients own immune system can't fight the infection & less penetration of antibiotics (sequestrum)
|
|
|
Who is most at risk for Osteomyelitis?
|
Elderly
Chronic Disease Poor Nutrition Impaired Immune Systems Obese |
|
|
What is the most likely pathogen related to Osteomyelitis?
|
Staph (70-80%)
|
|
|
What is the body's response to Osteomyelitis?
|
Inflammation
Increased vascularity & edema Thrombosis (after a few days) Ischemia r/t Thrombosis Bone necrosis develops |
|
|
What happens if Osteomyelitis is not treated?
|
Once the bone necrosis an abscess forms. The abscess develops a cavity containing dead bone tissue (called a sequestrum). This area of infection can't drain & may look like wound has healed but there will be a chronically infected sequestrum. This can last for years. Known as Chronic Osteomyelitis.
|
|
|
What is Chronic Osteomyelitis
|
Results from sequestrum that makes the Osteomyelitis difficult to treat.
|
|
|
What are the S&S r/t Blood Borne Osteomyelitis?
|
Acute
S&S of Septicemia * Chills * Fever * General Malaise * Rapid Pulse Systemic S&S may overshadow local S&S Localized area (eventually) * Painful * Swollen * Extremely Tender Patient reports throbbing pain that is worse w/ movement |
|
|
What are the S&S r/t Direct Contamination or soft tissue Osteomyelitis?
|
May not have signs of septicemia
Local area will be: * Swollen * Painful * Warm * Tender to touch |
|
|
What are the S&S r/t Chronic Osteomyelitis?
|
Continuous draining sinus (opening that has formed)
Recurrent pain, inflammation, swelling & drainage Low grade infection thrives in scar tissue (due to decreased oxygenation) |
|
|
What is the assessment/diagnostic findings of Acute Osteomyelitis?
|
In acute stage:
* X-Ray - shows swelling 2 weeks later * irregular decalcification areas of the bone * bone necrosis * periosteum is elevated * evidence of new bone growth Blood Studies * elevated WBC * elevated ESR Wound & blood cultures * to identify bacteria present & for correct antibiotic |
|
|
What is the assessment/diagnostic findings of Chronic Osteomyelitis?
|
X-Ray
* Large Irregular Cavities Anemia (RBC production down) Wound & blood cultures * to identify bacteria present & for correct antibiotic |
|
|
Management of Osteomyelitis
|
Prevention
* when having any type of bone surgery Optimal Health b4 surgery No infections b4 surgery (involving bone) * sore throat * UTI * tooth decay Prophylaxis antibiotic (during & 24 h after surgery) Quick removal of catheters/drains Aseptic wound care (surgeon changes 1st dressing) |
|
|
What is the medical mgmt. for Osteomyelitis?
|
Control/Stop infection
Diet high in vitamins & protein Immobilization of area (for pain & to prevent pathological fracture) IV antibiotics quickly & round the clock @ high doses (3-6 weeks & then oral for up to 3 months) If nonresponse to meds then surgery: * Bone opened & purulent/necrotic bone removed, sterile saline irrigation, antibiotic bead in joint (2-4 wks), continue IV antibiotic therapy * wound cavity filled w/ bone grafts |
