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21 Cards in this Set

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timed “Up & Go” (TUG) test. The patient is asked to rise from a chair, walk 10 feet, turn around, walk back, and sit down again in the same chair
The average healthy adult can complete the task in less than 10 seconds; those completing the task in more than 14 seconds are considered to be at high risk for subsequent falls
The Institute of Medicine recommends a vitamin D intake of
600 units/d for all men and women aged 51 to 70 years old and 800 units/d for men and women older than 70 years.
The Mini–Mental State Examination (MMSE) has been the standard screening instrument for cognitive function, with a sensitivity of 76% and specificity of 88% for detecting cognitive impairment.
Scores of 24 to 25 out of 30 suggest mild impairment, scores of 19 to 24 suggest mild dementia, and scores of 10 to 19 suggest moderate dementia
Medical conditions associated with depression
hypothyroidism, hyperthyroidism (“apathetic hyperthyroidism”), chronic pain, Parkinson disease, cancer, diabetes mellitus, vitamin B12 deficiency, alcohol abuse, and use of corticosteroids or interferon
The most common cause of hearing loss
presbycusis, or age-related hearing loss. Presbycusis results in high-frequency hearing loss, which typically impairs sound localization and hearing the spoken voice (particularly in noisy environments).
Among the available screening tests, the whispered voice test,
(examiner stands 2 feet behind a seated patient and assesses the ability of the patient to repeat a whispered combination of numbers and letters), or a single question about whether the patient has hearing difficulty seem to be nearly as accurate as hand-held audiometry or a detailed hearing loss questionnaire
The most common causes of visual impairment in older persons
refractive errors, cataracts, and age-related macular degeneration (AMD)
The American Academy of Ophthalmology recommends comprehensive eye examinations
every 1 to 2 years for persons 65 years or older who have no risk factors
four medications were responsible for two thirds of emergency hospitalizations for adverse drug events.
Hospitalizations involving three of them (warfarin, insulin, and oral hypoglycemic agents) were related to unintentional overdose. Warfarin was implicated most frequently, accounting for one third of emergency hospitalizations. The fourth class of drugs, oral antiplatelet agents, were implicated by acting alone or by interacting with warfarin
Urinary incontinence is categorized as
(1) urge incontinence (loss of urine accompanied by sense of urgency; caused by detrusor overreactivity); (2) stress incontinence (loss of urine with effort, coughing, or sneezing; caused by sphincter incompetence); (3) mixed urge and stress incontinence; and (4) overflow incontinence (caused by outlet obstruction).
Functional incontinence
not getting to the toilet quickly enough
the two most effective behavioral therapies for incontinence
Pelvic floor muscle training (PFMT, or Kegel exercises) and bladder training/urge suppression techniques are
considered first-line therapy for patients with stress incontinence and is of likely benefit in patients with mixed urge and stress incontinence.
pelvic floor muscle traiing
effective in elderly nursing home residents with functional incontinence.
Prompted voiding (periodically asking the patient about incontinence, reminding and assisting the patient to go to the toilet, and providing positive reinforcement for continence)
In patients with stress incontinence for whom PFMT has not been successful, what is another option
duloxetine a serotonin and norepinephrine reuptake inhibitor
first line therapy for urge incontinence
anticholinergic antimuscarinic medications are first-line therapy. Options include oxybutynin, tolterodine, fesoterodine, darifenacin, solifenacin, and trospium.
Medications that have been found to be ineffective for incontinence
pseudoephedrine (an α-agonist), oral estrogens (may worsen incontinence), and transdermal and vaginal estrogens
Stage I ulcers treatment
can generally be treated with transparent films and do not require debriding
Stage II ulcers treatment
occlusive dressing to keep the area moist. Wet-to-dry dressings should be avoided because debridement is usually unnecessary at this stage.
Stage III and IV ulcers treatment
generally require surgical or nonsurgical debridement, treatment of wound infection, and appropriate dressings based on the wound environment
For nonhealing wounds that are stage III or higher
imaging to rule out underlying osteomyelitis is indicated