Frail Elder Midterm Questions & Answers 100% Correct!

The ability of an organism to maintain optimal internal environment in face of physiologic stress, the process in which the body maintains internal equilibrium - ANSWERShomeostasis narrowing of reserve capacity, the chance of developing some diseases increases with age, the normal decline the the body's functional reserves - ANSWERShomeostenosis the limit beyond which homeostasis cannot be restored - ANSWERSphysiologic limit describe the structural changes of the heart normally seen with aging - ANSWERS^ LV wall thickness, decreased LV chamber size, aortic valve/mitral annulus calcification describe normal cellular changes of the heart with aging - ANSWERSdecrease in number of cardiomyocytes, increased myocyte size, increased apoptosis, lipid deposits, fibrosis, thickening of arterial intima what are normal molecular changes seen in the heart with aging - ANSWERSaltered ca2 handling, decreased beta-adrenergic responsiveness what are normal functional changes seen in the heart with aging - ANSWERSincreased after load, diastolic dysfunction, decreased contractility and maximum heart rate the HRmax decreases progressively by about ___ BPM/year - ANSWERS1 SVxHR= - ANSWERSCO what is the clinically measured index of contractility - ANSWERSejection fraction what are changes with aging that effects blood pressure - ANSWERShypertension (systolic), predisposed to hypotension, baroreflex decreases with age, arterial stiffening, decline of cerebral autoregulation what are SX of dehydration - ANSWERSAMS, lethargy, syncope, weakness what are causes of dehydration - ANSWERSpoor intake, DM, diarrhea, CKD, febrile illness, vomiting, diuretics what does the physical exam of dehydration show - ANSWERSdecreased skin turgor, dry MM, orthostatic hypotension what does lab work show with dehydration - ANSWERS^ HCT, BUN/cr ratio (normally 10:1) what is the treatment for dehydration - ANSWERSUnless patient in shock, safely correct 2-3 days, Oral rehydration if possible, Isotonic saline, Monitor labs and PE what is orthostatic hypotension associated with - ANSWERSdizziness, presyncope, syncope, falls, stroke, MI Fall in systolic BP of 20mm Hg OR Diastolic drop of 10mm Hg - ANSWERSorthostatic hypotension what are differential diagnoses of orthostatic hypotension - ANSWERSCommon: Medications such as diuretics, anticholinergics, nitrates, antihypertensives, anti-Parkinsonian, Dehydration, Blood loss/anemia, Hypokalemia, Bed rest/deconditioning, Malnutrition, Less common: aortic stenosisSevere venous insufficiencyParkinson's DiseaseDiabetic autonomic neuropathyIdiopathicPerhaps more w/ tall thin elderly men how do you assess for orthostatic hypotension - ANSWERSMeasure BP and HR after 1