NURS 5333 Family 1 Test 3 Geriatrics Part
1,2,3,4
Older adults or elderly over the age of ? are considered geriatric population
65 years
-they have a weaker immune system, so they do not mount a strong immune response
-this weaker immune system, health problems may be present, but present in an atypical
manner not with the usual symptoms
unique to geriatric patients
no evidence of fever in elderly?
EX) an elder may have an overwhelming infection, but not have normal reactions
-Often they can have sepsis and have a low or normal temperature.
What are the OTHER signs of illness in our >65 YOA population?
Decreased appetite, decreased activity, or changing mental status
Polypharmacy
The use of many different drugs concurrently in treating a patient, who often has several
health problems.
Elders
have an increased risk of skin breakdown and pressure sores due to the fact that they have
decreased subcutaneous fat
A geriatric assessment
-a thorough health assessment at least annually. These can be done by the primary care
providers, but often are not because of the time involved
-medical, social, and environmental factors that affect the wellbeing of the geriatric patient
-Medicare actually allows for an annual health wellness visit
-Studies have shown that patients who participate in this annual health wellness visit
actually have a lower mortality rate
The goals of the geriatric assessment are
identify problems early, to intervene, to improve the quality of life for patients, to optimize
their health outcomes and through identifying problems early.
When developing plans, they should be patient-centered collaborative plans of care.
-Nutrition needs to be a part of every geriatric assessment
, The components of a geriatric assessment are
functional status, fall risk, medication review, nutrition, vision and hearing, cognition, mood
or mental status, and ability to care for oneself as well as toileting and immunization needs.
Screening vision in the elderly
a simple Snellen test can be done in the office. A formal vision exam does not need to be
done unless the Snellen result is abnormal or the patient complains of visual changes
Elderly and BMI: normal BMI is 23 to 30.
A BMI less than 22 kilograms per meter squared is associated with increased mortality and
a sign of malnutrition.
-they have enough money to actually purchase food?
-Do they have someone who can help them with the shopping? Do they have transportation
to go and get food? Are they able to safely prepare meals by themselves? How many meals
a day do they eat? Do they get any assistance? Do they have any meals on wheels?
objective assessment is comparing the current weight to a previous weight
Weight loss of greater than or equal to 5% in one month or greater than or equal to
10% over a six-month period is an indication of a problem and needs to be further
assessed
Assessing fall risk
it's simple to just ask the patient if they have had a fall in the last year. Those who have
fallen in the last year have a 2.8 times higher risk of a subsequent fall. If this is the case,
then safety needs to be addressed, and there needs to be measures implemented to avoid
subsequent falls.
Mood or the presence of depression can be assessed simply through simple PHQ-2.
If the score is greater than three, then one would want to do the more extensive PHQ-9.
These questionnaires can be completed at every visit.
assessing a patient's social situation, you want to look for social isolation
asking the patient if they have someone available to help them in an emergency, or if they
are sick. If the answer is no, then it points you to a lack of social support and that needs to
be addressed.
- ask the patient if they're aware what kind of social services are available for them.
functional assessment means assessing the ability to perform activities of daily living and
safe ambulation
-the Get Up and Go Test. This test involves asking the patient to get up from the chair
without using their arms, walking 10 feet, turning around and walking back to the chair and
1,2,3,4
Older adults or elderly over the age of ? are considered geriatric population
65 years
-they have a weaker immune system, so they do not mount a strong immune response
-this weaker immune system, health problems may be present, but present in an atypical
manner not with the usual symptoms
unique to geriatric patients
no evidence of fever in elderly?
EX) an elder may have an overwhelming infection, but not have normal reactions
-Often they can have sepsis and have a low or normal temperature.
What are the OTHER signs of illness in our >65 YOA population?
Decreased appetite, decreased activity, or changing mental status
Polypharmacy
The use of many different drugs concurrently in treating a patient, who often has several
health problems.
Elders
have an increased risk of skin breakdown and pressure sores due to the fact that they have
decreased subcutaneous fat
A geriatric assessment
-a thorough health assessment at least annually. These can be done by the primary care
providers, but often are not because of the time involved
-medical, social, and environmental factors that affect the wellbeing of the geriatric patient
-Medicare actually allows for an annual health wellness visit
-Studies have shown that patients who participate in this annual health wellness visit
actually have a lower mortality rate
The goals of the geriatric assessment are
identify problems early, to intervene, to improve the quality of life for patients, to optimize
their health outcomes and through identifying problems early.
When developing plans, they should be patient-centered collaborative plans of care.
-Nutrition needs to be a part of every geriatric assessment
, The components of a geriatric assessment are
functional status, fall risk, medication review, nutrition, vision and hearing, cognition, mood
or mental status, and ability to care for oneself as well as toileting and immunization needs.
Screening vision in the elderly
a simple Snellen test can be done in the office. A formal vision exam does not need to be
done unless the Snellen result is abnormal or the patient complains of visual changes
Elderly and BMI: normal BMI is 23 to 30.
A BMI less than 22 kilograms per meter squared is associated with increased mortality and
a sign of malnutrition.
-they have enough money to actually purchase food?
-Do they have someone who can help them with the shopping? Do they have transportation
to go and get food? Are they able to safely prepare meals by themselves? How many meals
a day do they eat? Do they get any assistance? Do they have any meals on wheels?
objective assessment is comparing the current weight to a previous weight
Weight loss of greater than or equal to 5% in one month or greater than or equal to
10% over a six-month period is an indication of a problem and needs to be further
assessed
Assessing fall risk
it's simple to just ask the patient if they have had a fall in the last year. Those who have
fallen in the last year have a 2.8 times higher risk of a subsequent fall. If this is the case,
then safety needs to be addressed, and there needs to be measures implemented to avoid
subsequent falls.
Mood or the presence of depression can be assessed simply through simple PHQ-2.
If the score is greater than three, then one would want to do the more extensive PHQ-9.
These questionnaires can be completed at every visit.
assessing a patient's social situation, you want to look for social isolation
asking the patient if they have someone available to help them in an emergency, or if they
are sick. If the answer is no, then it points you to a lack of social support and that needs to
be addressed.
- ask the patient if they're aware what kind of social services are available for them.
functional assessment means assessing the ability to perform activities of daily living and
safe ambulation
-the Get Up and Go Test. This test involves asking the patient to get up from the chair
without using their arms, walking 10 feet, turning around and walking back to the chair and
