533 Exam 3 Latest Questions And All
Correct Answers.
goal of geriatric primary care - Answer maintain independence, function, and comfort for the individual
ageism - Answer culturally rooted discomfort with growing older
screening tools for dementia - Answer Folstein Mini-Mental State Examination, the Mini-Cog screen for
dementia, the Short Portable Mental Status Questionnaire, the AD8 Dementia Screening Interview, and
the Montreal Cognitive Assessment (MoCa)
what helps in diagnosing dementia - Answer detailed hx of cognitive change and lifelong habits most
often provided by family or friends, record of the patient's baseline mental status, ruling out depression
as a factor in impaired mental status, and tracking the results of subsequent mental status testing are
helpful for accurate diagnosis and management
USPSTF rec for screening for dementia - Answer insufficient evidence to recommend for or against
screening so generally testing should be done only after concern for cognitive impairment is raised
Tools for the assessment of functional status - Answer Barthel Index, the Physical Self-Maintenance
Scale, and the Katz Index
Function is addressed on two levels - Answer (1) basic activities of daily living, including feeding,
bathing, dressing, ambulation, and toileting; and (2) the more complex, instrumental activities of daily
living, including cooking, shopping, using the telephone, reading, writing, and managing money
evidence-based recommendations for tests and screenings to help providers and patients make
decisions on appropriate care based on the individual's general health, predicted longevity, and personal
and family history - Answer tests should focus on the function, comfort, and safety of the individual
The goal in completion of advance directives - Answer provide the individual autonomy in decisions
regarding his or her manner and location of death as well as relieving family burden and conflict while
the older individual is mentally competent to do so.
,do advance directives need lawyers? - Answer no, witnesses and notarization are all that are typically
required. Typically emergency medical technicians are unable to implement advance directives
the incidence of AD doubles when - Answer every 5 years after 65y
AD - Answer chronic, irreversible illness with a gradual onset and a steady decline in cognition. Short-
term memory loss is the primary symptom in AD, along with one or more of the following:
disorientation; disturbance in executive functioning (planning, organizing, and abstract thinking);
problems with activities of daily living; and one of three common neurologic disorders—aphasia, apraxia,
or agnosia. Day-night sleep cycles are often reversed; consciousness and psychomotor changes are not
evident until late in the disease. Irritability, withdrawal, and apathy may be exhibited in the early stages
of the disease. Psychotic symptoms such as paranoia, hallucinations, delusions, and agitation can be
seen later in the disease
delirium - Answer common cause of cognitive change in the sick or hospitalized older adult, is a
transient waxing and waning level of consciousness. It is characterized by acute onset and fluctuations in
orientation and attention
most significant e/e imbalance in geriatrics - Answer sodium imbalance d/t dehydration
why dehydration is common in geriatrics - Answer 1. thirst response, which is stimulated by
dehydration, is diminished and results in an increased solute/water ratio. 2., decreased renal plasma
flow may be responsible for a decline in the body's ability to concentrate urine 3., vasopressin release
stimulated by low fluid volume is diminished
clinical presentation of dehydration - Answer vague/nonspecific, confusion, lethargy, rapid wt loss,
functional decline, often feature of FTT
PE for dehydration - Answer cv assessment, may see orthostatic drop in BP and rise in HR, temp can be
elevated, dry mucous membranes in severe, poor skin turgor is unreliable in older adults, tongue can be
swollen and furrowed
labs for dehydration - Answer electrolytes, bun/cr ratio, osmolality, hct/hg, glucose
, BUN/CR ratio > 25:1 =dehydration
Na >148= dehydration
with isotonic or hypotonic dehydration, serum sodium is normal or low
HCT will be elevated
UA and CXR appropriate
Oral fluid replacement - Answer include half of the calculated fluid deficit plus ongoing losses in the
first 24 hours, totaling at least 1500 mL/day
SQ fluid rehydration - Answer Maximum volume of (isotonic) fluid administered subcutaneously is 1500
mL per site per 24 hours
IVF - Answer fast, depends on serum na level, usually only in hospital setting, complications with fluid
overload, hr, cerebral edema
DDROPP - Answer diseases, drugs, recovery, onset, prodrome, precipitants
helps ensure a complete post fall assessment
The assessment should also focus on any history of coronary artery disease or arrhythmias, vision and
hearing problems, neurologic dysfunction, lower extremity joint pain or foot problems, fractures,
cognitive changes, and medications
TUG test for mobility - Answer Completion of the task in 20 seconds or less correlates with functional
independence; those taking 30 seconds or more are considered at high risk of falling.
dx for falls - Answer CBC, e/e, bun/cr, serum glucose, stool occult blood test, ecg,
Correct Answers.
goal of geriatric primary care - Answer maintain independence, function, and comfort for the individual
ageism - Answer culturally rooted discomfort with growing older
screening tools for dementia - Answer Folstein Mini-Mental State Examination, the Mini-Cog screen for
dementia, the Short Portable Mental Status Questionnaire, the AD8 Dementia Screening Interview, and
the Montreal Cognitive Assessment (MoCa)
what helps in diagnosing dementia - Answer detailed hx of cognitive change and lifelong habits most
often provided by family or friends, record of the patient's baseline mental status, ruling out depression
as a factor in impaired mental status, and tracking the results of subsequent mental status testing are
helpful for accurate diagnosis and management
USPSTF rec for screening for dementia - Answer insufficient evidence to recommend for or against
screening so generally testing should be done only after concern for cognitive impairment is raised
Tools for the assessment of functional status - Answer Barthel Index, the Physical Self-Maintenance
Scale, and the Katz Index
Function is addressed on two levels - Answer (1) basic activities of daily living, including feeding,
bathing, dressing, ambulation, and toileting; and (2) the more complex, instrumental activities of daily
living, including cooking, shopping, using the telephone, reading, writing, and managing money
evidence-based recommendations for tests and screenings to help providers and patients make
decisions on appropriate care based on the individual's general health, predicted longevity, and personal
and family history - Answer tests should focus on the function, comfort, and safety of the individual
The goal in completion of advance directives - Answer provide the individual autonomy in decisions
regarding his or her manner and location of death as well as relieving family burden and conflict while
the older individual is mentally competent to do so.
,do advance directives need lawyers? - Answer no, witnesses and notarization are all that are typically
required. Typically emergency medical technicians are unable to implement advance directives
the incidence of AD doubles when - Answer every 5 years after 65y
AD - Answer chronic, irreversible illness with a gradual onset and a steady decline in cognition. Short-
term memory loss is the primary symptom in AD, along with one or more of the following:
disorientation; disturbance in executive functioning (planning, organizing, and abstract thinking);
problems with activities of daily living; and one of three common neurologic disorders—aphasia, apraxia,
or agnosia. Day-night sleep cycles are often reversed; consciousness and psychomotor changes are not
evident until late in the disease. Irritability, withdrawal, and apathy may be exhibited in the early stages
of the disease. Psychotic symptoms such as paranoia, hallucinations, delusions, and agitation can be
seen later in the disease
delirium - Answer common cause of cognitive change in the sick or hospitalized older adult, is a
transient waxing and waning level of consciousness. It is characterized by acute onset and fluctuations in
orientation and attention
most significant e/e imbalance in geriatrics - Answer sodium imbalance d/t dehydration
why dehydration is common in geriatrics - Answer 1. thirst response, which is stimulated by
dehydration, is diminished and results in an increased solute/water ratio. 2., decreased renal plasma
flow may be responsible for a decline in the body's ability to concentrate urine 3., vasopressin release
stimulated by low fluid volume is diminished
clinical presentation of dehydration - Answer vague/nonspecific, confusion, lethargy, rapid wt loss,
functional decline, often feature of FTT
PE for dehydration - Answer cv assessment, may see orthostatic drop in BP and rise in HR, temp can be
elevated, dry mucous membranes in severe, poor skin turgor is unreliable in older adults, tongue can be
swollen and furrowed
labs for dehydration - Answer electrolytes, bun/cr ratio, osmolality, hct/hg, glucose
, BUN/CR ratio > 25:1 =dehydration
Na >148= dehydration
with isotonic or hypotonic dehydration, serum sodium is normal or low
HCT will be elevated
UA and CXR appropriate
Oral fluid replacement - Answer include half of the calculated fluid deficit plus ongoing losses in the
first 24 hours, totaling at least 1500 mL/day
SQ fluid rehydration - Answer Maximum volume of (isotonic) fluid administered subcutaneously is 1500
mL per site per 24 hours
IVF - Answer fast, depends on serum na level, usually only in hospital setting, complications with fluid
overload, hr, cerebral edema
DDROPP - Answer diseases, drugs, recovery, onset, prodrome, precipitants
helps ensure a complete post fall assessment
The assessment should also focus on any history of coronary artery disease or arrhythmias, vision and
hearing problems, neurologic dysfunction, lower extremity joint pain or foot problems, fractures,
cognitive changes, and medications
TUG test for mobility - Answer Completion of the task in 20 seconds or less correlates with functional
independence; those taking 30 seconds or more are considered at high risk of falling.
dx for falls - Answer CBC, e/e, bun/cr, serum glucose, stool occult blood test, ecg,
