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How do you assess the legs for edema? - ANSWER -Press finger against swollen
area for 5 seconds and remove
What is pitting edema? - ANSWER -excess amount of fluid in absence of
additional colloid (particles) AKA "edema that you can make an imprint with your
finger in"
**gravity dependent (seen in legs) to determine severity estimate the indentation in
cm, 1+ 2+ 3+ 4+
What is nonpitting edema? - ANSWER -skin feels unusually tight or firm,
pressure leaves no indentation b/c fluid has coagulated in the tissues
What is considered a low BMI? - ANSWER -anything below 19 is considered
low BMI
How do you assess mobility? (Muscles) - ANSWER -Functional assessment for
ADLs
How do you calculate pack year? - ANSWER -# of packs a day x # of years
smoking= Pack Year
Older Adult Health History - ANSWER -The interview will likely take longer, so
plan accordingly. Depending on the person's condition you may need to break the
interview into two sessions. You can gather certain health history and or review of
systems forms from home, as long as the person handwriting is adequate. Some
aging people may need a longer response time.
Assessing the pulse in older adults - ANSWER -Maybe more difficult to feel and
the rate maybe more moderate.
Heart Failure in geriatric patients - ANSWER -Dyspnea, Orthopnea, Crackles/
wheezing, Decreased BP, Nausea, vomiting, ascites, Pitting edema, anxiety, failing
O2, jugular vein distension, fatigue, S3 gallop, enlarged spleen or liver, decreased
urine output, weak pulse, confusion, anxiety, Infarct
, Palpating cold feet - ANSWER -accompanies shock, cardiac arrest, peripheral
arterial insufficiency, Raynaud Disease.
Geriatric Physical assessment hearing - ANSWER -Presbycusis. Sensorineural
loss that affects the middle ear structures or causes damage to nerve cells in the
inner ear or CN 8. (Assessed by whisper test)
Ears and the older adult - ANSWER -cilia lining the ear canal become coarse and
stiff causing cerumen to accumulate and impact, especially because cerumen
becomes drier due to atrophy of the apocrine glands; noise pollutions puts a person
at higher risk of hearing loss.
Assisted living- self ADL's - ANSWER -The Lawton IADL scale developed to
determine the most suitable living situation for older adults. It determines
competence and maintained of self living skills such as shopping, cooking, and
managing finances. Contains 8 items: using phone, shopping, meal prep,
housekeeping, laundry, transportation, self-medication and management of
finances. Assesses where the person needs help rather than focusing on the score.
Hips in aging adult- Osteoarthritis - ANSWER -deterioration of articular
cartilages, subchondral bone remodeling, synovial inflammation, and formation of
new bone (osteophytes). Increased risk in older Caucasian women. Asymmetric
joint involvement. Pain w/ motion and limited ROM.
CN in older adults - ANSWER -Nerve conduction slows down between 5-10%
with the aging adult making reaction time slower.
How do you assess muscle strength? - ANSWER -Ask the person to flex and hold
as you apply opposing force. Muscle strength should be equal bilaterally and fully
resist against your opposing force. Grading scale 5-0. 5- full rom with full
resistance. 3- full rom with gravity. 1- slight contraction.
Assessing limping gait - ANSWER -Could have something injured or could have
spastic hemiparesis due to UMN lesion of the corticospinal tract. (stroke/ Trauma)
Heberden's nodes - ANSWER -Swelling of distal interphalangeal finger joints,
characteristic of osteoarthritis. (DIP swelling 2 degrees to osteophytes) .