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Geriatric Falls
Falls and Immobility in the Elderly
| Question | Answer |
|---|---|
| Number one predictor of future falls | previous falls (slide says within the last year) |
| Ways to assess lower extremity function | Ask them to squat down. |
| Gait of elderly men | elderly men develop flexed posture and wide-based, short-stepped gait |
| Gait of Elderly women | elderly women develop narrow-based, waddling gait |
| AE of TCA's | orthostatic hypotension |
| AE of hypoglycemia | blurred vision, confused thinking; constant overuse can lead to LOC |
| effects of valsalva | bradycardic and hypotension; confusion, dizziness |
| Fall associated sx to ask about | lightheadedness, dizziness, vertigo, palp, chest pain, SOB, sudden focal neuro sx, aura, incontinence of urine/stool |
| LOC questions to ask | what is remembered immediatly afterward, could pt get up, how long, can witness verify LOC |
| Normal single limb stance time in 60-69 year old population | 27 seconds |
| Effects of Bed Rest | Decreases in stroke volume, CO, and O2 uptake. Reduced muscle blood flow, Deconditioning: increased postural sway, loss of lean muscle mass, decreased protein synthesis rate in muscle |
| Complications of Immobilization | thrombosis, OA, Chest Infection, hypothermia, pressure sores, continence, UTI, Constipation, Stiffness, Dehydration, Electrolyte upset, malnutrition, dependence, hypothermia |
| Consequences of dehydration | apathy, lack of energy, mental confusion, dry sore mouoth, dry fragile skin, urinary stasis and infection, constipation and impaction, orthostatic hypotension |
| Prevention of venous thrombosis | ROM, ambulation, avoidance of local pressure, avoidance of dependent position of legs, support stockings, ankle pumps, compression bandages, IPC, low dose heparin, adequate hydration |
| Predisposing Factors for Pressure Sores | Pressure, Shearing forces, friction (even just being slid off of their sheets), moisture |
| Pressure sore with full thickness skin loss involving damage or necrosis of subcutaneous tissue, may extend to but not through underlying fascia | Stage III |
| Reposition patients how often to avoid bed sores? | Every 2 hours. |
| Mortality rate post hip fx | 20% |
| Common location for vertebral compression fx | T8-L3 |
| Tx of Osteoporosis | Exercise, Calcium and Vit D supplements, Sodium Fluoride, Calcitonin therapy, Bisphosphonate |
Created by:
ltm12