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elder health problem
med/surg ch 3 common health problems of older adults
| Question | Answer |
|---|---|
| ages of young old | 65-74 years old |
| ages of middle old | 75-84 years old |
| ages of old old | 85-99 years old |
| ages of elite old | 100+ years old |
| fastest growing subgroup of late adulthood is the ___, also known as the ___ | old old advanced older adult population |
| Common health issues and problems that can affect older adults in the community include | nutrition. mobility, stress and loss. accidents. drug use and misuse. mental health/behavioral health. elder neglect/abuse |
| in regards to nutrition older adults are most at risk for _ | protein-calorie malnutrition (protein energy malnutrition) |
| in regards to hydration, what should be taught to older adults? why? | fluid restrictions make them susceptible to dehydration and electrolyte imbalances that can cause serious illness/death. bc older adults have lower thirst, mobility, prescribed diuretics, limited bladder capacity - usually end up self limiting fluids |
| Benefits of regular exercise in older adults | dec. risk for falls, depression symptoms, risk for diabetes and coronary artery disease, weight/maintenance, inc. strength, balance, mobility, sleep, sense of well being, self-esteem, longevity |
| Frequent sources of stress for older adult | rapid environmental changes that req. immediate reaction, changes in lifestyle resulting from retirement or physical incapacity, acute/chronic illness, loss of s/o, financial hardships, relocation |
| Relocation stress syndrome | Relocation trauma. physical and emotional distress occurring after person moves from one setting to another. ex. sleep disturbance/inc physical symptoms (gi distress) |
| The majority of accidents occur where? | in the home |
| leading cause of decreased mobility in old age | incapacitating accidents |
| fallophobia | fear of falling - they avoid leaving home |
| presbyopia definition and effect on older adult | farsightedness that worsens with aging, makes walking more difficult, can't see location of next step. |
| eye issues that may affect the older adult | presbyopia, macular degeneration, cataracts, glaucoma or diabetic retinopahty. |
| most common cause of injury-related death in the young-old population | motor vehicle accidents |
| polypharmacy | use of multiple drugs |
| drug use/misuse issues with the older adult population | polypharmacy, otc and herbal remedies |
| effects of drugs on older adults | dec. tolerance for standard dosages, changes in absorption, distribution, metabolism and excretion of drugs from body, |
| age-related changes that affect absorption of drugs from oral route. | inc. gastric pH, dec gastric blood flow, dec. GI motility. Most older adults do not have major absorption difficulties despite the above. |
| age related changes that affect distribution of drugs | smaller amts of total body water, inc ratio of adipose tissue to lean body mass (inc. storage of fat soluble drugs), dec albumin level, dec. CO, |
| age related changes affecting metabolism of drugs | dec liver size, dec liver blood flow, dec liver enzyme activity. |
| age related changes affecting excretion of drugs | dec renal blood flow and red glomerular filtration rate - causing dec. creatinine clearance and thus slower excretion time - thus serum drug levels toxic. **monitor creatinine levels |
| to prevent ADEs in older adults follow this motto | start low, go slow (ADEs being adverse drug events) |
| common ADEs in older adults | edema, nausea/vomiting, anorexia, dehydration, dysrhythmias, fatigue, weakness, dizziness, syncope, urinary retention, diarrhea, constipation/impaction, hypotension, acute confusion |
| age related changes in cognition in the older adult | dec. reaction time to stimuli and impairment to memory for recent events. |
| abnormal changes in cognition in the older adult | severe gonitive impairment, depression, hallucinations and delusions |
| a person is legally competent if... | 18+ yrs, pregnant or married minor, legally emancipated minor who is self-supporting, not declared incompetent by court of law |
| clinically competent | legally competent and can make clinical decisions. Determined by ability to id problems, recognize options, make decisions and provide rationale supporting the decisions. |
| most common mental health/behavioral health problem in older adults | depression |
| depression | mood disorder that can have cognitive, affective and physical manifestations. can be primary, secondary, mild to severe or major |
| primary depression | results from lack of neurotransmitters norepinephrine and serotonin in the brain |
| secondary depression | "situational" from sudden change in person's life, such as illness or loss. |
| Geriatric depression scale - short form | assesses depression in older adults using 15 yes/no q's. score over 10 is indicative of depression. |
| dementia | chronic syndrome that involves a slow, progressive cognitive declined. Can not be reversed. Alzheimers is most common. Multi-infarct dementia is seond and is a vascular disorder accounting for 20-25% |
| delirium | acute state of confusion. some causes: drug therapy, electrolyte imbalance, infection, surgery, metabolic issue, neurologic disorders, circulatory, renal and pulmonary disorders, nut'l deficiencies, hypoxia, relocation, major loss. |
| Acutely confused pts who are released from the hospital are at an inc risk for... | functional decline, falls and incontinence at home |
| neglect | caregiver fails to provide for basic needs. |
| where is physical abuse more likely to occur? | "bathing suit zone" abs, butt, genitals upper thighs |
| financial abuse | property or resources are mismanaged/misused. more common than physical abuse. |
| emotional abuse | intentional use of threats, humiliation, intimidation and isolation |
| Fulmer SPICES framework | id's 6 serious "marker conditions" that can lead to longer hospital stays, higher med costs and even death. 1. sleep disorders. 2. problems w/ eating/feeding. 3. incontinence. 4. confusion. 5. evidence of falls. 6. skin breakdown |
| nocturia | urination at night. in hospital setting is an inc. risk for falls bc often don't ask for assistance, in dark and unfamiliar environment. |
| restraint | any device/drug that prevnets patient from moving freely and must be prescribed by health care provider. |
Created by:
FSclafani
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