EMT-B Chapter 33 – Geriatric Emergencies

question

Which of the following is not one of the leading causes of death in the older population? a. heart disease b. diabetes c. AIDS d. cancer
answer

c
question

Geriatric patients present as a special problem for caregivers because: a. the classic presentation of disease is often altered b. geriatric patients tend not to understand their underlying conditions c. their medications are rather difficult to learn d. the typical diseases of the geriatric population are uncommon
answer

a
question

Stereotyping of elderly people that often leads to discrimination is called: a. geritism b. geriographics c. oldism d. ageism
answer

d
question

Which of the following is not a common stereotype regarding geriatrics? a. most elderly people have dementia b. elderly people are hard of hearing c. geriatric patients are likely to die on an EMS call d. elderly people are immobile
answer

c
question

Which of the following is generally not acceptable when interviewing an older patient? a. do not initiate eye contact, because many geriatric patients might find this disrespectful b. speak slowly and distinctly c. give the patient time to respond unless the condition appears urgent d. explain what you are doing before you do it
answer

a
question

Which of the following is not considered a common condition of the elderly? a. hypertension b. sinusitis c. gastroenteritis d. arthritis
answer

c
question

Geriatric patients are commonly found living in all of the following locations except: a. their homes b. nursing homes c. skilled nursing facilities d. churches
answer

d
question

You are responding to the dementia unit at a nursing home for respiratory distress. When you arrive, you notice that the patient is experiencing mild dyspnea and has an altered mental status. What can you do to help determine if the patient’s altered mental status is appropriate for her underlying dementia? a. as long as the patient is alert and able to answer most questions there is no need to determine if this is normal behavior b. ask the patient’s roommate if this is normal behavior c. find a staff member who can explain the patient’s underlying mental status to you d. because the patient already has dementia, there is no need to investigate this further
answer

c
question

Anatomic changes that occur as a person ages predisposes geriatric patients to: a. airway problems b. fungal infections c. communicable diseases d. mental status changes
answer

a
question

Which of the following statements regarding geriatrics is false? a. chronic mental status impairment is a normal process of aging b. multiple disease processes and complaints can make assessment complicated c. communication may be more complicated with an older adult d. you should find and account for all patient medications
answer

a
question

The last meal is particularly important in a patient with: a. hypertension b. myocardial infarction c. COPD d. diabetes
answer

d
question

The heart rate should be in the normal adult rage for a geriatric patient but can be altered by medications such as: a. insulin b. beta-blockers c. alpha-blockers d. aspirin
answer

b
question

Which of the following is not considered a typical intervention when treating an elderly patient? a. oxygenation b. administration of glucose c. immobilization d. psychological support
answer

c
question

The \”E\” of the GEMS diamond stands for: a. environmental assessment b. events leading to the incident c. extrication of the patient d. emergency assessment
answer

a
question

The alveoli in an older patient’s lung tissue can become enlarged and less elastic, making it: a. easier to inhale air b. harder to inhale air c. easier to exhale air d. harder to exhale air
answer

d
question

_______ is the leading cause of death from infection in Americans older than age 65 years. a. chronic bronchitis b. pneumonia c. endocarditis d. influenza
answer

b
question

A patient with leg pain who complains of sudden shortness of breath, tachycardia, fever, chest pain, and a feeling of impending doom is likely experiencing a(n): a. pulmonary embolism b. pneumonia c. myocardial infarction d. aortic aneurysm
answer

a
question

Geriatric patients are at risk for _________, an accumulation of fatty material in the arteries. a. vasculitis b. arteriosclerosis c. atherosclerosis d. varicose veins
answer

c
question

A drop in blood pressure with a change in position is referred to as: a. orthostatic hypotension b. metastatic hypotension c. malignant hypotension d. psychogenic hypotension
answer

a
question

Which of the following is not considered a risk factor for geriatric patients to develop heart failure? a. hypertension b. coronary artery disease c. atrial fibrillation d. palpitations
answer

d
question

All of the following are true of delirium except: a. it may have metabolic causes b. the patient may be hypoglycemic c. it develops slowly over a period of years d. the memory remains mostly intact
answer

c
question

An 82 year old woman has slurred speech, weakness on the left side of her body, visual disturbances, and a headache. This patient is likely to be suffering from a: a. myocardial infarction b. stroke c. diabetic emergency d. spinal cord injury
answer

b
question

The brain decreases in terms of ___________ and volume as a person ages. a. length b. width c. size d. weight
answer

d
question

Older people develop an inability to differentiate colors and have: a. increased sensitivity to light b. decreased eye movement c. decreased daytime vision d. decreased night vision
answer

d
question

_________ and long-term exposure to loud noises are the main factors that contribute to hearing loss> a. heredity b. injury c. infection d. medications
answer

a
question

Which of the following statements regarding dementia is false? a. patients may have anxiety about going to the hospital b. some patients are confused and angry c. there may be a decreased ability to communicate d. due to memory loss, they are able to adapt easily to changes in their daily routine
answer

d
question

Which of the following statements about changes to the gastrointestinal system is correct? a. gastric secretions are reduced as a person ages b. dental loss is not a normal result of the aging process c. blood flow to the liver is increased as a person ages d. gastric motility increases and results in an increase in gastric emptying
answer

b
question

All of the following are common specific gastrointestinal problems in the elderly except: a. ulcerative colitis b. diverticulitis c. peptic ulcer disease d. gallbladder disease
answer

a
question

A patient with an abdominal aortic aneurysm most commonly complains of abdominal pain that radiates to the: a. chest b. lower legs c. back d. shoulders
answer

c
question

Changes to the kidney and genitourinary tract in elderly patients can cause all of the following except: a. urinary incontinence b. urinary retention c. an increased response to sodium deficiency d. enlargement of the prostate
answer

c
question

A patient experiencing weight gain, fatigue, cold intolerance, drier skin and hair, and a slower heart rate could be suffering from: a. hyperglycemia b. ketosis c. hyperthyroidism d. hypothyroidism
answer

d
question

Which of the following is not a factor that affects the development of osteoporosis? a. hypertension b. smoking c. level of activity d. alcohol consumption
answer

a
question

________ is a progressive disease of the joints that destroys cartilage and leads to joint spurs and stiffness. a. osteoporosis b. osteosarcoma c. osteoarthritis d. osteoplegia
answer

c
question

All of the following are considered to be reasons for medication noncompliance except: a. financial challenges b. patient disagrees with the diagnosis c. impaired cognitive ability d. inability to open pill bottles
answer

b
question

Which of the following statements regarding depression is true? a. treatment typically involves medication, because counseling typically does not work b. older adults in skilled nursing facilities are less likely to develop depression c. it generally does not interfere with ability to function in the elderly d. it is diagnosed three times more commonly in women than in men
answer

d
question

Elderly pedestrians struck by a vehicle commonly suffer injuries to the: a. chest b. abdomen c. extremities d. back
answer

c
question

All of the following are common predisposing events that can lead to suicide in the elderly except: a. death of a loved one b. hallucinations c. alcohol abuse d. physical illness
answer

b
question

Elderly people are more likely to experience burns because of: a. altered mental status b. inattention c. compromised neurologic status d. all of the above
answer

d
question

Signs and symptoms of possible abuse include all of the following except: a. chronic pain with no medical explanation b. no history of repeated visits to the emergency department or clinic c. depression or lack of energy d. self-destructive behavior
answer

b
question

Because the brain tissue shrinks with age, older patients are more likely to sustain: a. basilar skull fractures b. depressed skull fractures c. open head injuries d. closed head injuries
answer

d
question

The most important piece of information to establish immediately when responding to a skilled nursing facility is determining: a. when someone last saw the patient b. which nurse is overseeing patient care c. what is wrong with the patient d. how often this patient is transported to the hospital
answer

c
question

MRSA is commonly found on which of the following? a. decubitus ulcers b. feeding tubes c. indwelling catheters d. all of the above
answer

d
question

In most states, for a DNR to be considered valid it must have been signed within the last: a. 12 months b. 18 months c. 24 months d. DNRs are valid regardless of the timeframe
answer

a
question

Burns in elderly abuse typically result from which of the following? a. cigarettes b. matches c. hot liquids d. all of the above
answer

d
question

Clues that might indicate elderly abuse would include all of the following except: a. bruises on the buttocks and lower back b. weight gain c. wounds in various stages of healing d. lack of hygiene
answer

b
question

T/F Some elderly people may not take all of their medications to save money.
answer

T
question

T/F Your first words to the patient and the attitude behind them can gain or lose a patient’s trust.
answer

T
question

T/F Hip fractures are less likely to occur when the patient has osteoporosis.
answer

F
question

T/F Chest pain, shortness of breath, and an altered mental status should always be considered serious.
answer

T
question

T/F More responsive nerve stimulation may lower the heart rate and the strength of heart contractions.
answer

F
question

T/F Multiple disease processes and multiple and/or vague complaints can make assessment complicated.
answer

T
question

T/F The \”S\” in the GEMS diamond stands for social assessment.
answer

T
question

T/F Loss of mechanisms to protect the upper airway include increased cough and gag reflexes.
answer

F
question

T/F Changes in the cardiovascular performance of a geriatric patient are the direct consequence of aging.
answer

F
question

T/F Respiratory rates in an elderly patient with chest pain tend to be lower.
answer

F
question

T/F The treatment goal of a stroke is to salvage as much brain tissue as possible.
answer

T
question

T/F Glaucoma, macular degeneration, and retinal detachment can all cause vision problems in the geriatric patient.
answer

T
question

T/F Taste can be diminished in an older patient due to a decrease in the number of taste buds.
answer

T
question

T/F Neuropathy is a dysfunction of the central nervous system.
answer

F
question

T/F Irritation of the lining stomach or ulcers can cause forceful vomiting that tears the esophagus.
answer

T
question

T/F Inflammation of the gallbladder will present with left upper quadrant pain and fever.
answer

F
question

T/F The blood glucose level will be greater than 500mg/dL in DKA.
answer

T
question

T/F Pneumonia and urinary tract infections are common in patients who are bedridden.
answer

T
question

T/F Decreased liver function makes it easier for the liver to detoxify the blood.
answer

F
question

T/F Most elderly suicides occur in people who have recently been diagnosed with depression.
answer

T
question

T/F There is a lower mortality from penetrating trauma in older adults.
answer

F
question

T/F Many elderly patients take blood-thinning medications that can help correct internal bleeding.
answer

F
question

T/F Broken bones are common in the geriatric population and should be splinted in a manner appropriate to the injury.
answer

T
question

T/F Most indoor hypothermia deaths involve geriatric patients.
answer

T
question

T/F A \”health care power of attorney\” is an advance directive that is exercised by a person who has been authorized by the patient to make medical decisions for the patient.
answer

T
question

Using the patient’s ________ shows respect and helps the patient to focus on your questions.
answer

name
question

Hip fractures are more likely to occur when bones are weakened by ________ or infection.
answer

osteoporosis
question

__________ is a useful therapy for many geriatric problems, including vague complaints of weakness or dizziness.
answer

oxygen
question

_________ is an inflammation/infection of the lung form bacterial, viral, or fungal causes.
answer

pneumonia
question

The core body temperature should be assessed to determine the presence of a(n) __________.
answer

fever
question

_________ refers to stiffening of the blood vessel wall.
answer

arteriosclerosis
question

Severe blood loss can occur when a(n) ________ bursts.
answer

aneurysm
question

With _________ heart failure, fluid backs up into the lungs.
answer

left-sided
question

__________ is the gradual hearing loss that occurs as we age.
answer

presbycusis
question

An older person may have a decreased sense of _________ and _________ perception from the loss of end nerve fibers.
answer

touch, pain
question

_________ is a condition in which small pouches protrude from the colon.
answer

diverticulosis
question

__________ __________ form when a patient is lying or sitting in the same position for a long time.
answer

pressure ulcers
question

As you get older, the brain shrinks, leading to higher risk of ___________ _________ following head trauma.
answer

cerebral bleeding
question

___________ ____________ may help determine if a loss of consciousness occurred before an accident.
answer

bystander information
question

Dentures may cause a(n) __________ _________ in a trauma patient.
answer

airway obstruction
question

When assessing the abdomen, remember that elderly patients have a ________ __________ __________ and may not show signs of rigidity in abdominal trauma.
answer

flaccid abdominal wall
question

Patients with __________ will require padding in order to keep the patient supine.
answer

kyphosis
question

In addition to hip fractures, elderly people with osteoporosis are at risk for _________ fractures.
answer

pelvic
question

__________ ___________ are facilities that serve patients who need 24-hour care; they are sometimes a step down from a hospital.
answer

nursing homes
question

__________ __________ are specific legal papers that direct relatives and caregivers about what kinds of medical treatment may be given to patients who cannot speak for themselves.
answer

advance directives
question

Why is it important to understand the psychological changes with age?
answer

decline brain, respiratory, cardiovascular, renal systems.
question

How does aging affect the respiratory system?
answer

minor lung infection could be life-threatening in elderly decreased lung mass/decreased breathing capacity use accessory muscles when having breathing difficulty cough + gag reflex decrease with age so it is hard time clearing secretions can’t cough = get respiratory infection alveoli gets bigger but elasticity decreases -harder to expel air pulmonary respiration – exchanging oxygen and carbon dioxide decreases can’t compensate for hypoxia or shock
question

What is the GEMS diamond? How can it facilitate your overall care of an older patient?
answer

patient that lives alone Geriatric -wait for crisis to call for help Environment – hazards Medications -OTC may interact with prescription Social Assessment – help with daily activities
question

What are some common factors that affect an older patient’s vital signs?
answer

chronic disease medications capillary refill time not accurate blood pressure increases with age poor circulation
question

What should concern you about patients who take numerous medications?
answer

overdosed or underdose or interaction medications stay in body longer + are not detoxified by liver as fast Identify what pill was taken, how long ago, why?
question

Why do older patients commonly refuse EMT transport?
answer

Fear of being put in a nursing home or hospital not aware condition has deteriorated Stranger Anxiety Money Ask patient what they are fearful about? Reassure her but don’t make false promises.
question

The patient’s past medical history + signs + symptoms what do you suspect as the cause of her problem?
answer

Symptoms:fever/chills/SOB Patient has pneumonia Pneumonia creates a barrier for gas exchange in lungs. Decreased cough mechanism, can’t expel secretions. signs:fever/green or yellow mucus, chills
question

How does dementia differ from delirium? Is dementia a normal part of aging process?
answer

DELIRIUM – inability to focus, think logically DEMENTIA – progressive disorientation, loss of cognitive function, psychomotor skills, social skills.
question

What strategies should you use when communicating with older patients?
answer

Speak respectfully + introduce yourself + partners Look directly at patient + speak slowly + clearly Explain what you are doing before you do it. Don’t talk about patient in front of her.
question

English 2nd Language
answer

May revert back to native language when stressed. Do not assume patient can’t understand you.
question

Difficulty Communicating
answer

Elderly people can’t express themselves when stressed.
question

Common Condition for Geriatrics
answer

Hypertension Arthritis Heart Disease Diabetes Cancer Sinusitis
question

Common Causes of Death for Geriatrics
answer

Heart Disease Cancer Stroke Chronic Obstructive Pulmonary Disease Pneumonia Diabetes Trauma
question

Medical + Trauma Conditions Superimposed on Each Other
answer

Fall from dizziness or weakness Recovery from hip fracture difficult because Osteoprosis. Wounds for Diabetes take longer to heal.
question

Do not remove Dentures
answer

Unless they obstruct airway or interfere with ventilation when rescue breathing needed.
question

Geriatrics Patient Assessment Guidelines
answer

environment unsafe? introduce yourself + use patience hearing/vision impairments ABC’s + vital signs multiple medications elderly do not have flexibility or reserve poor nutrition thermoregulate cold all the time memory + cognition impaired skin fragile + tears easily
question

GEMS Diamond
answer

Geriatric – impaired Environment – hazardous Medical Assessment – prescriptions, OTC Social Assessment – help daily living
question

Pneumonia
answer

inflammation infection of the lung from bacteria, viral or fungal causes.
question

Older People
answer

hobbies or activités are healthy + vital
question

(L) side heart failure
answer

fluid backs up in lungs short of breath
question

(R) side heart failure
answer

fluid backs up in body peripheral edema or swelling tissue
question

Heart Failure Signs
answer

hypertension – high BP coronary artery disease atrial fibrillation – atria no longer contract normally
question

Heart Attack Signs
answer

dyspnea or SOB, nausea/vomiting, weak/dizziness, syncope/fainting, fatigue diaphoresis – sweating pale, cyanosis, mottled skin, decreased breathing sounds, peripheral edema – swelling
question

Silent Heart Attack
answer

no symptoms usually in women + people with diabetes
question

Stroke
answer

Leading cause of death Acute AMS, numbness, weakness, paralysis on one side of body, slurred speech, difficulty speaking/aphasia, visual problems, headache, dizziness, incontinence, seizure
question

Hemorrhage Stroke
answer

broken blood vessel causing bleeding in brain. fatal
question

Ischemic Strokes
answer

blood clot blocks the flow of blood to a portion of the brain. brain tissue distal to this clot is deprived of oxygen + will die if clot not removed.
question

Elderly More likely to be Struck by a Vehicle
answer

hearing/vision loss, posture
question

Causes of Syncope in Geriatric Patients
answer

arrhythmias + heart attack vascular + volume changes neurologic causes
question

over the counter medications
answer

aspirin antacids cough syrup decongestants can interact with prescription medications.
question

Elderly impending shock
answer

heart rate lower from beta blockers
question

Elderly impending trauma
answer

takes coumadin or blood thinning medications
question

Falls Common in Elderly
answer

debilitating problems environment
question

vacuum mattress
answer

conform to body contours to immobilize geriatric patients with pelvic fractures
question

Elderly Patient Head Trauma
answer

subdural hematomas/signs + symptoms mimic stroke alcohol recurrent falls repeated head injury use of blood thinners
question

categories for elderly abuse
answer

PHYSICAL – assault, neglect, dietary, maintenance of home, personal hygienic PSYCHOLOGICAL – neglect, verbal, treating person like infant, deprivation of sensory stimulation FINANCIAL – theft of valuables, embezzlement
question

elderly abuse
answer

carefully documented be thorough, objective, factual, avoid opinions
question

check for signs of elderly neglect
answer

poor hygiene poor dental hygiene poor temperature regulation lack of amenities in home
question

Why is assessing an elderly patient challenging?
answer

communication hearing/vision AMS, complicated medical history multiple medications
question

Why is necessary to obtain an accurate geriatric assessment?
answer

patience + good communication skills slow deliberate approach to patient history
question

Why are geriatric patients prone to pneumonia?
answer

inability to cough
question

What do changes in cardiovascular system bring?
answer

atherosclerosis aneurysm stiffening heart values orthostatic hypotension venous stasis deep venous thrombosis heart attack heart failure stroke
question

Why type of patient doesn’t present symptoms of a heart attack?
answer

women + diabetes patients
question

Why are geriatric patients prone to fall?
answer

bones are fragile
question

Why causes serious problems in geriatric patients?
answer

polypharmacy or multiple medications
question

What is a risk factor for suicide?
answer

depression
question

What do you do to treat a geriatric patient with trauma?
answer

assess injuries falls
question

What should you do when you respond to a nursing home?
answer

determine chief complaint
question

AAA – abdominal aortic aneurysm
answer

fatal hypertension/atherosclerosis or artery walls thicken rapid blood loss
question

advanced directive
answer

specific legal papers that direct relatives about what kind of medical treatment may be given to person who can’t speak for themselves.
question

aneurysm
answer

abnormal blood filled dilation of the wall of a blood vessel.
question

ascites
answer

fluid in abdomen
question

cataracts
answer

clouding of the lenses or their surrounding membranes difficulty distinguishing colors re: accidents falling/medication
question

decubitis ulcers or bedsores
answer

non blanching redness/damage under skin blisters or ulcers affecting dermis or epidermis invasion of fat layer through fascia invasion of muscle or bone
question

deep venous thrombosis
answer

blood clots in superficial venus + blood closes in deep veins
question

delirium
answer

sudden change is mental status cognitive process inability to focus think logically maintain attention
question

dementia
answer

slow onset progressive disorientation, shortened attention span, loss of cognitive function (memory)
question

dyspnea
answer

short of breath
question

elderly abuse or granny beating
answer

any action on the part of an older person’s member that takes advantage of the older person’s property, emotional state
question

geriatrics
answer

assessment of person who is 65 years old
question

jugular vein distention
answer

fluid backs up in body
question

kyphosis or hunch back
answer

stooped posture atrophy of the supporting structure of the body lost of height from compression of spinal column use a scoop stretcher or flat board to transport patient
question

melena
answer

black tarry stool
question

MRSA
answer

living in closed quarters like nursing homes organism can be bed sores/decubitus ulcers feeding tubes/catheters spread from broken sign, touch object with bacteria
question

neuropathy
answer

disorder of nerves of the peripheral nervous system function + structure of peripheral motor, sensory, autonomic neurons impaired
question

osteoporosis
answer

bone disease in post menopausal women reduction in bone mass leading to fractures
question

peptic ulcer disease
answer

use NSAIDS gnawing, burning pain, goes away, comes back
question

polypharmacy
answer

multiple medications by patient
question

Presbycusis
answer

gradual hearing loss that occurs as we age
question

Pulmonary Embolism
answer

sudden blockage of an artery by a venous clot
question

respiratory syncytial virus
answer

infection of the upper + lower respiratory tracks. symptoms like common cold + more severe. highly contagious from discharge of nose + throat
question

syncope
answer

fainting or interruption of blood flow to the brain
question

unilateral pedal edema
answer

swelling in one ankle or foot source of a clot
question

urinary tract infection
answer

bacterial infection that affect the urinary track
question

What is a frequent reoccurring condition that affects the elderly?
answer

respiratory distress
question

Patient having difficulty speaking from stroke. What technique should you use?
answer

listen carefully to the answers
question

Which of the following conditions is considered to be a risk factor for congestive heart failure?
answer

coronary artery disease
question

Patient was awakened by suffocation or respiratory distress. What are her symptoms a characteristic of?
answer

exertional dyspnea
question

Clarify her symptoms of sudden feeling of suffocation + respiratory distress?
answer

What position do you normally sleep in?
question

Ausculating patient’s lungs you hear rales. These sounds are caused by air passing through
answer

fluid in alveoli
question

Pulse oximeter is unable to provide accurate reading. What is possible cause of this?
answer

poor circulation
question

Observing GEMS you find what condition in the home?
answer

environmental too many cats, strong odor
question

Social Assessment When Caring for Elderly
answer

Need help with daily living, dressing, eating
question

Patient takes numerous medications. 11 bottles were in a bag. What might the problem be?
answer

polypharmacy – multiple medications
question

Why is it important to understand the psychological changes with age?
answer

decline brain, respiratory, cardiovascular, renal systems.
question

How does aging affect the respiratory system?
answer

minor lung infection could be life-threatening in elderly decreased lung mass/decreased breathing capacity use accessory muscles when having breathing difficulty cough + gag reflex decrease with age so it is hard time clearing secretions can’t cough = get respiratory infection alveoli gets bigger but elasticity decreases -harder to expel air pulmonary respiration – exchanging oxygen and carbon dioxide decreases can’t compensate for hypoxia or shock
question

What is the GEMS diamond? How can it facilitate your overall care of an older patient?
answer

patient that lives alone Geriatric -wait for crisis to call for help Environment – hazards Medications -OTC may interact with prescription Social Assessment – help with daily activities
question

What are some common factors that affect an older patient’s vital signs?
answer

chronic disease medications capillary refill time not accurate blood pressure increases with age poor circulation
question

What should concern you about patients who take numerous medications?
answer

overdosed or underdose or interaction medications stay in body longer + are not detoxified by liver as fast Identify what pill was taken, how long ago, why?
question

Why do older patients commonly refuse EMT transport?
answer

Fear of being put in a nursing home or hospital not aware condition has deteriorated Stranger Anxiety Money Ask patient what they are fearful about? Reassure her but don’t make false promises.
question

The patient’s past medical history + signs + symptoms what do you suspect as the cause of her problem?
answer

Symptoms:fever/chills/SOB Patient has pneumonia Pneumonia creates a barrier for gas exchange in lungs. Decreased cough mechanism, can’t expel secretions. signs:fever/green or yellow mucus, chills
question

How does dementia differ from delirium? Is dementia a normal part of aging process?
answer

DELIRIUM – inability to focus, think logically DEMENTIA – progressive disorientation, loss of cognitive function, psychomotor skills, social skills.
question

What strategies should you use when communicating with older patients?
answer

Speak respectfully + introduce yourself + partners Look directly at patient + speak slowly + clearly Explain what you are doing before you do it. Don’t talk about patient in front of her.
question

English 2nd Language
answer

May revert back to native language when stressed. Do not assume patient can’t understand you.
question

Difficulty Communicating
answer

Elderly people can’t express themselves when stressed.
question

Common Condition for Geriatrics
answer

Hypertension Arthritis Heart Disease Diabetes Cancer Sinusitis
question

Common Causes of Death for Geriatrics
answer

Heart Disease Cancer Stroke Chronic Obstructive Pulmonary Disease Pneumonia Diabetes Trauma
question

Medical + Trauma Conditions Superimposed on Each Other
answer

Fall from dizziness or weakness Recovery from hip fracture difficult because Osteoprosis. Wounds for Diabetes take longer to heal.
question

Do not remove Dentures
answer

Unless they obstruct airway or interfere with ventilation when rescue breathing needed.
question

Geriatrics Patient Assessment Guidelines
answer

environment unsafe? introduce yourself + use patience hearing/vision impairments ABC’s + vital signs multiple medications elderly do not have flexibility or reserve poor nutrition thermoregulate cold all the time memory + cognition impaired skin fragile + tears easily
question

GEMS Diamond
answer

Geriatric – impaired Environment – hazardous Medical Assessment – prescriptions, OTC Social Assessment – help daily living
question

Pneumonia
answer

inflammation infection of the lung from bacteria, viral or fungal causes.
question

Older People
answer

hobbies or activités are healthy + vital
question

(L) side heart failure
answer

fluid backs up in lungs short of breath
question

(R) side heart failure
answer

fluid backs up in body peripheral edema or swelling tissue
question

Heart Failure Signs
answer

hypertension – high BP coronary artery disease atrial fibrillation – atria no longer contract normally
question

Heart Attack Signs
answer

dyspnea or SOB, nausea/vomiting, weak/dizziness, syncope/fainting, fatigue diaphoresis – sweating pale, cyanosis, mottled skin, decreased breathing sounds, peripheral edema – swelling
question

Silent Heart Attack
answer

no symptoms usually in women + people with diabetes
question

Stroke
answer

Leading cause of death Acute AMS, numbness, weakness, paralysis on one side of body, slurred speech, difficulty speaking/aphasia, visual problems, headache, dizziness, incontinence, seizure
question

Hemorrhage Stroke
answer

broken blood vessel causing bleeding in brain. fatal
question

Ischemic Strokes
answer

blood clot blocks the flow of blood to a portion of the brain. brain tissue distal to this clot is deprived of oxygen + will die if clot not removed.
question

Elderly More likely to be Struck by a Vehicle
answer

hearing/vision loss, posture
question

Causes of Syncope in Geriatric Patients
answer

arrhythmias + heart attack vascular + volume changes neurologic causes
question

over the counter medications
answer

aspirin antacids cough syrup decongestants can interact with prescription medications.
question

Elderly impending shock
answer

heart rate lower from beta blockers
question

Elderly impending trauma
answer

takes coumadin or blood thinning medications
question

Falls Common in Elderly
answer

debilitating problems environment
question

vacuum mattress
answer

conform to body contours to immobilize geriatric patients with pelvic fractures
question

Elderly Patient Head Trauma
answer

subdural hematomas/signs + symptoms mimic stroke alcohol recurrent falls repeated head injury use of blood thinners
question

categories for elderly abuse
answer

PHYSICAL – assault, neglect, dietary, maintenance of home, personal hygienic PSYCHOLOGICAL – neglect, verbal, treating person like infant, deprivation of sensory stimulation FINANCIAL – theft of valuables, embezzlement
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elderly abuse
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carefully documented be thorough, objective, factual, avoid opinions
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check for signs of elderly neglect
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poor hygiene poor dental hygiene poor temperature regulation lack of amenities in home
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Why is assessing an elderly patient challenging?
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communication hearing/vision AMS, complicated medical history multiple medications
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Why is necessary to obtain an accurate geriatric assessment?
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patience + good communication skills slow deliberate approach to patient history
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Why are geriatric patients prone to pneumonia?
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inability to cough
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What do changes in cardiovascular system bring?
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atherosclerosis aneurysm stiffening heart values orthostatic hypotension venous stasis deep venous thrombosis heart attack heart failure stroke
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Why type of patient doesn’t present symptoms of a heart attack?
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women + diabetes patients
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Why are geriatric patients prone to fall?
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bones are fragile
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Why causes serious problems in geriatric patients?
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polypharmacy or multiple medications
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What is a risk factor for suicide?
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depression
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What do you do to treat a geriatric patient with trauma?
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assess injuries falls
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What should you do when you respond to a nursing home?
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determine chief complaint
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AAA – abdominal aortic aneurysm
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fatal hypertension/atherosclerosis or artery walls thicken rapid blood loss
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advanced directive
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specific legal papers that direct relatives about what kind of medical treatment may be given to person who can’t speak for themselves.
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aneurysm
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abnormal blood filled dilation of the wall of a blood vessel.
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ascites
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fluid in abdomen
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cataracts
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clouding of the lenses or their surrounding membranes difficulty distinguishing colors re: accidents falling/medication
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decubitis ulcers or bedsores
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non blanching redness/damage under skin blisters or ulcers affecting dermis or epidermis invasion of fat layer through fascia invasion of muscle or bone
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deep venous thrombosis
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blood clots in superficial venus + blood closes in deep veins
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delirium
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sudden change is mental status cognitive process inability to focus think logically maintain attention
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dementia
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slow onset progressive disorientation, shortened attention span, loss of cognitive function (memory)
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dyspnea
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short of breath
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elderly abuse or granny beating
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any action on the part of an older person’s member that takes advantage of the older person’s property, emotional state
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geriatrics
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assessment of person who is 65 years old
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jugular vein distention
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fluid backs up in body
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kyphosis or hunch back
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stooped posture atrophy of the supporting structure of the body lost of height from compression of spinal column use a scoop stretcher or flat board to transport patient
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melena
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black tarry stool
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MRSA
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living in closed quarters like nursing homes organism can be bed sores/decubitus ulcers feeding tubes/catheters spread from broken sign, touch object with bacteria
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neuropathy
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disorder of nerves of the peripheral nervous system function + structure of peripheral motor, sensory, autonomic neurons impaired
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osteoporosis
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bone disease in post menopausal women reduction in bone mass leading to fractures
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peptic ulcer disease
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use NSAIDS gnawing, burning pain, goes away, comes back
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polypharmacy
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multiple medications by patient
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Presbycusis
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gradual hearing loss that occurs as we age
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Pulmonary Embolism
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sudden blockage of an artery by a venous clot
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respiratory syncytial virus
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infection of the upper + lower respiratory tracks. symptoms like common cold + more severe. highly contagious from discharge of nose + throat
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syncope
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fainting or interruption of blood flow to the brain
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unilateral pedal edema
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swelling in one ankle or foot source of a clot
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urinary tract infection
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bacterial infection that affect the urinary track
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What is a frequent reoccurring condition that affects the elderly?
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respiratory distress
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Patient having difficulty speaking from stroke. What technique should you use?
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listen carefully to the answers
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Which of the following conditions is considered to be a risk factor for congestive heart failure?
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coronary artery disease
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Patient was awakened by suffocation or respiratory distress. What are her symptoms a characteristic of?
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exertional dyspnea
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Clarify her symptoms of sudden feeling of suffocation + respiratory distress?
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What position do you normally sleep in?
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Ausculating patient’s lungs you hear rales. These sounds are caused by air passing through
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fluid in alveoli
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Pulse oximeter is unable to provide accurate reading. What is possible cause of this?
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poor circulation
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Observing GEMS you find what condition in the home?
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environmental too many cats, strong odor
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Social Assessment When Caring for Elderly
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Need help with daily living, dressing, eating
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Patient takes numerous medications. 11 bottles were in a bag. What might the problem be?
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polypharmacy – multiple medications

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