NURS 5333 Family 1 Geriatrics Study
Guide+Questions with Accurate Solutions
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 then sitting down again not using their arms. They should be able to complete this
activity in less than 12 seconds.
Functional Assessment: ADLs
-functional ability is to ask them if they're able to dress themselves, do they need
help with bathing and do they need help with toileting?
-Included in the functional assessment is the use of any assistive devices, such as canes,
walkers, or wheelchairs
-Medication review
assessment on any geriatric patient .
-Should be done at least once a year.
-Medication should be reviewed always when a patient establishes care with a new
provider, and it's important to also repeat the medication review after a
hospitalization -the patient should be instructed to bring a bag with all of their
medications to their initial visit or to their annual health wellness visit
-Those seniors at highest risk for polypharmacy are the ones that see multiple
providers, see multiple specialists in addition to their primary care provider and have
had a recent hospitalization or self-treat with multiple over-the-counter medications
that may interfere or interact with their prescribed medications
inappropriate medications for older adults. Some medicines that are safe for
children and adults are not safe for geriatric patients
-geriatric patients may have decreased renal function and that affects clearance of
medication and would necessitate an adjustment in dosing. The Beers Criteria &
STOPP and START & . Choosing Wisely website
-you should never start a new medication without knowing all of the
current medications the patient is on
, geriatric assessment, one should address the fact that a patient needs advanced
directives.
-it should always be instituted prior to a patient actually having a deterioration
of mental status or a sudden illness that requires major decisions
Ask them if they have completed those advanced directives and if they have, does
their primary care provider or your office have a copy
suspicion of a cognitive change or deterioration, then a cognitive evaluation should
be done.
-Mini-Cog and the Mini-Mental Status Exam are both licensed, and so you
need approval or payment before using these
-a Mini-Mental Status Exam or through a Mini-Cog. The Mini-Cog is quicker. It only takes
about five minutes or less and improves detection of cognitive changes to about 83%.
-encourage to exercise
two simple questions you can use to assess
-One, in the past year, have you lost urine or gotten wet? If the answer is affirmative,
-then if so, has it happened at least on six separate days? If both answers are
positive, then one would want to proceed with treatment of urinary incontinence.
urinary incontinence is that it can lead to skin breakdown and also is associated
with social isolation.
-an annual influenza vaccine in the fall of the year.
-Prevnar 13 to prevent pneumonia is indicated at age 65 with a follow-up
Pneumovax 23 one year later.
Guide+Questions with Accurate Solutions
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 then sitting down again not using their arms. They should be able to complete this
activity in less than 12 seconds.
Functional Assessment: ADLs
-functional ability is to ask them if they're able to dress themselves, do they need
help with bathing and do they need help with toileting?
-Included in the functional assessment is the use of any assistive devices, such as canes,
walkers, or wheelchairs
-Medication review
assessment on any geriatric patient .
-Should be done at least once a year.
-Medication should be reviewed always when a patient establishes care with a new
provider, and it's important to also repeat the medication review after a
hospitalization -the patient should be instructed to bring a bag with all of their
medications to their initial visit or to their annual health wellness visit
-Those seniors at highest risk for polypharmacy are the ones that see multiple
providers, see multiple specialists in addition to their primary care provider and have
had a recent hospitalization or self-treat with multiple over-the-counter medications
that may interfere or interact with their prescribed medications
inappropriate medications for older adults. Some medicines that are safe for
children and adults are not safe for geriatric patients
-geriatric patients may have decreased renal function and that affects clearance of
medication and would necessitate an adjustment in dosing. The Beers Criteria &
STOPP and START & . Choosing Wisely website
-you should never start a new medication without knowing all of the
current medications the patient is on
, geriatric assessment, one should address the fact that a patient needs advanced
directives.
-it should always be instituted prior to a patient actually having a deterioration
of mental status or a sudden illness that requires major decisions
Ask them if they have completed those advanced directives and if they have, does
their primary care provider or your office have a copy
suspicion of a cognitive change or deterioration, then a cognitive evaluation should
be done.
-Mini-Cog and the Mini-Mental Status Exam are both licensed, and so you
need approval or payment before using these
-a Mini-Mental Status Exam or through a Mini-Cog. The Mini-Cog is quicker. It only takes
about five minutes or less and improves detection of cognitive changes to about 83%.
-encourage to exercise
two simple questions you can use to assess
-One, in the past year, have you lost urine or gotten wet? If the answer is affirmative,
-then if so, has it happened at least on six separate days? If both answers are
positive, then one would want to proceed with treatment of urinary incontinence.
urinary incontinence is that it can lead to skin breakdown and also is associated
with social isolation.
-an annual influenza vaccine in the fall of the year.
-Prevnar 13 to prevent pneumonia is indicated at age 65 with a follow-up
Pneumovax 23 one year later.
