Geriatrics/ LTC Exam Questions and
Answers (Graded A)
Life expectancy - ANSWER - -statistical measure of the average time an organism is expected
to live, based on the year of their birth, current age and demographic factors
-average wordlwide is 73.2 years old
-for males: 70.7
-for females: 73.6
life span - ANSWER - length of time a person lives
COPD - ANSWER - What is it? Low, progressive obstruction of the airways making it difficult to
breathe
PLAN:
o Smoking cessation
o Manage exacerbations
Symptoms:
o Reduced energy intake is common due to: hypercapnia( excess co2 production; results in
morning headache/confusion)/ 02 saturation( reduced 02 can cause intestinal problems)/ fatigue
( they would rather breath than eat) and chewing problems due to dyspnea
MNT:
o Energy balance is critical: 30-35 kcal/kg depending on initial wt
o Protein: 1-1.5g/kg- to restore and maintain lung and muscle strength
o Balance macronutrients (pro15-20%, fat 30-45%, cho 40-55%)
o Micros: vit c: increased need for smokers/ ca & mg: meet needs; important for muscle
relaxation and contraction / vit D and K- prevent/ slow osteoporosis /
o sodium and fluid: restricted with cor pulmonale( may need to increase K) to control fluids (also
control amt of food in stomach—too much will push up on the lungs)
,o Foods: no tough or stringy foods, avoid gas forming vegetables, increase use of omega 3 FA ,
antioxidants: increase citric fruits, whole grains, and nuts, fluid: 1Ml/kcal; consume liquids
between means, reduce sodium to limit edema and ease breating, increase fiber ( psyllium,
crushed bran, prune juice, f/v), small concentrated feedings to prevent fatigue, rest before
meals, and eat slowly and chew foods well
-small, frequent, mini-meals and snacks
-easy to prepare and eat
-nutrient dense supplements (smoothies, meatloaf, muffins w/ cream cheese, tuna salad, cereal
w/ fruit)
Common physical signs of COPD
1. barrel chest: rounded chest due to lungs being chronically overinflated with air
2. digital clubbing: thinkening of the flesh under the fingernails and toenails, nails curve
downward. theory due to vasodilation in the distal circulation leading to hypertrophy of the nail
bed
3. cyanosis: blu
Cor pulmonale - ANSWER - -abnormal enlargement of the right side of the heart as a result of
disease of the lungs or the pulmonary blood vessels
-swollen airways become extra sensitive to some things that you are exposed to in the
evironment every day (asthma triggers). when you breathe in a trigger, your airway create extra
mucus and swell even more, making it difficult to breath
repiratory distress syndrome - ANSWER - ARDS: acute respiratory distress syndrome,
respiratory failure
-lungs no longer able to exchange gases
-hypermetabolism leading to increased energy needs
MNT:
-meet basic nutrition requirements, maintain stable weight, facilitate weaning from vent
-provide adequate but not excessive calories, avoid excess non-protein cals
, -1.5-2 g protein/kg to maintain lean body mass
pulmonary aspiration - ANSWER - -entry of material (such as food/drink/stomach materials)
from the GI into the larynx (voice box) and lower respiratory tract
emphysema - ANSWER - -gradual damage of the air sacs (alveoli) in the lungs, making you
progressively more SOB
-smoking is the leading cause
-inner walls of the air sacs weaken and eventually rupture, creating one larger air sac instead of
many small ones= reduces surface area of the lungs = decreases amount of oxygen that
reaches the bloodstream
chronic bronchitis - ANSWER - bronchitis: inflammation of the bronchial tubes that results in
excessive secretions of mucus into the tubes with tissue swelling that may narrow or close off
bronchial tubes
-chronic: cough that occurs every day with sputum production that lasts for at least 3 mos , 2
years in a row
cause: smoking
bronchiectasis - ANSWER - -chronic condition where the walls of the bronchi are thickened from
inflammation and infection =results in mucus accumulation
-periodic flare-ups of breathing difficulty (exacerbations)
-lung function gradually declines over years, pts w/ frequent exacerbations may lose lung
function at a faster rate
symptoms:
-coughing up yellow/green mucus everyday
-SOB
-felling run down or tired
-fevers or chills (usually develop during exacerbations)
-coughing up blood or mucus mixed with blood (hemoptyisis)
Answers (Graded A)
Life expectancy - ANSWER - -statistical measure of the average time an organism is expected
to live, based on the year of their birth, current age and demographic factors
-average wordlwide is 73.2 years old
-for males: 70.7
-for females: 73.6
life span - ANSWER - length of time a person lives
COPD - ANSWER - What is it? Low, progressive obstruction of the airways making it difficult to
breathe
PLAN:
o Smoking cessation
o Manage exacerbations
Symptoms:
o Reduced energy intake is common due to: hypercapnia( excess co2 production; results in
morning headache/confusion)/ 02 saturation( reduced 02 can cause intestinal problems)/ fatigue
( they would rather breath than eat) and chewing problems due to dyspnea
MNT:
o Energy balance is critical: 30-35 kcal/kg depending on initial wt
o Protein: 1-1.5g/kg- to restore and maintain lung and muscle strength
o Balance macronutrients (pro15-20%, fat 30-45%, cho 40-55%)
o Micros: vit c: increased need for smokers/ ca & mg: meet needs; important for muscle
relaxation and contraction / vit D and K- prevent/ slow osteoporosis /
o sodium and fluid: restricted with cor pulmonale( may need to increase K) to control fluids (also
control amt of food in stomach—too much will push up on the lungs)
,o Foods: no tough or stringy foods, avoid gas forming vegetables, increase use of omega 3 FA ,
antioxidants: increase citric fruits, whole grains, and nuts, fluid: 1Ml/kcal; consume liquids
between means, reduce sodium to limit edema and ease breating, increase fiber ( psyllium,
crushed bran, prune juice, f/v), small concentrated feedings to prevent fatigue, rest before
meals, and eat slowly and chew foods well
-small, frequent, mini-meals and snacks
-easy to prepare and eat
-nutrient dense supplements (smoothies, meatloaf, muffins w/ cream cheese, tuna salad, cereal
w/ fruit)
Common physical signs of COPD
1. barrel chest: rounded chest due to lungs being chronically overinflated with air
2. digital clubbing: thinkening of the flesh under the fingernails and toenails, nails curve
downward. theory due to vasodilation in the distal circulation leading to hypertrophy of the nail
bed
3. cyanosis: blu
Cor pulmonale - ANSWER - -abnormal enlargement of the right side of the heart as a result of
disease of the lungs or the pulmonary blood vessels
-swollen airways become extra sensitive to some things that you are exposed to in the
evironment every day (asthma triggers). when you breathe in a trigger, your airway create extra
mucus and swell even more, making it difficult to breath
repiratory distress syndrome - ANSWER - ARDS: acute respiratory distress syndrome,
respiratory failure
-lungs no longer able to exchange gases
-hypermetabolism leading to increased energy needs
MNT:
-meet basic nutrition requirements, maintain stable weight, facilitate weaning from vent
-provide adequate but not excessive calories, avoid excess non-protein cals
, -1.5-2 g protein/kg to maintain lean body mass
pulmonary aspiration - ANSWER - -entry of material (such as food/drink/stomach materials)
from the GI into the larynx (voice box) and lower respiratory tract
emphysema - ANSWER - -gradual damage of the air sacs (alveoli) in the lungs, making you
progressively more SOB
-smoking is the leading cause
-inner walls of the air sacs weaken and eventually rupture, creating one larger air sac instead of
many small ones= reduces surface area of the lungs = decreases amount of oxygen that
reaches the bloodstream
chronic bronchitis - ANSWER - bronchitis: inflammation of the bronchial tubes that results in
excessive secretions of mucus into the tubes with tissue swelling that may narrow or close off
bronchial tubes
-chronic: cough that occurs every day with sputum production that lasts for at least 3 mos , 2
years in a row
cause: smoking
bronchiectasis - ANSWER - -chronic condition where the walls of the bronchi are thickened from
inflammation and infection =results in mucus accumulation
-periodic flare-ups of breathing difficulty (exacerbations)
-lung function gradually declines over years, pts w/ frequent exacerbations may lose lung
function at a faster rate
symptoms:
-coughing up yellow/green mucus everyday
-SOB
-felling run down or tired
-fevers or chills (usually develop during exacerbations)
-coughing up blood or mucus mixed with blood (hemoptyisis)
