Geriatrics - Exam 1

What is chronologic age?

Your actual age based on the number of years since birth

What is percieved age?

How old other people think you look or act

What is subjective age?

How old you personally feel

What is functional age?

How well you can physically, mentally, and socially function compared with others

What is ageism?

Stereotyping, prejudice, or discrimination based on a person’s age

What is aging anxiety?

Fear or worry about getting older and its consequences

What is age attribution?

Assuming a symptom or behavior is caused by aging without investigating other causes

Is significant confusion a normal part of aging? Causes?

No - look for causes such as infection, medications, dehydration, hypoxia, or metabolic problems

What is considered healthy aging?

Maintaining function and well-being while adapting to the aging process

What is active aging?

Maintaining participation in physical, social, and community activities

What is productive aging?

Continuing to make meaningful contributions through work, caregiving, volunteering, or service

What is effective aging?

Successfully adapting to age-related changes while maintaining function and quality of life

What is successful aging?

Low disease/disability, good physical and cognitive function, and continued engagement with life

What is compression of morbidity?

Delaying illness and disability until later in life, reducing the time spent seriously ill

What is the wear-and-tear theory?

Aging occurs partly because the body accumulates damage from use and stress over time

What is the free-radical theory?

Oxidative damage from free radicals contributes to cellular aging

What does the immunologic theory state?

Changes and decline in immune function contribute to aging and increased disease risk

What is the genetic/programmed theory?

Aging is partly controlled by genetic programming

What is the cellular theory?

Cells have limitations on division and repair, contributing to aging

What is the activity theory?

Maintaining meaningful activities and relationships promotes adaptation to aging

What is the continuity theory?

People tend to maintain familiar roles, activities, values, and relationships as they age

What is the disengagement theory?

Aging involves gradually withdrawing from certain social roles and activities

What is the nursing concern with disengagement theory?

Nurses should not assume older adults need or want to withdraw from activities and society

What does functional consequences theory focus on?

How age-related changes and risk factors affect function and wellness

What is the goal of functional consequences theory?

Maximize function, independence, and wellness

How do normal aging and pathological conditions differ?

Normal aging involves expected changes, pathology involves abnormal disease-related changes

What are IADLs?

More complex activities needed for independent living

What are examples of IADLs?

Managing money, medications, shopping, cooking, transportation, housekeeping, and communication

What is implicit bias?

Unconscious attitudes or stereotypes that can influence decisions and behavior

What is decision-making capacity?

the ability to understand, appreciate, reason about, and communicate a healthcare decision

What is a scam?

Fraudulent activity intended to obtain an older adult’s money, information, or property

How does aging affect renal medication clearance?

Renal function generally decreases, so medications may remain in the body longer

What can decreased renal function cause?

Drug accumulation and increased risk of toxicity

How does aging affect body composition?

Less total body water and lean muscle, with increased body fat

Why can fat-soluble medications last longer?

Increased body fat can store fat-soluble drugs and prolong their effects

Why can water-soluble medications have increased concentrations?

Older adults have less total body water

How can hepatic aging affect medications?

Reduced hepatic blood flow.metabolism can prolong effects of some drugs

What is polypharmacy?

taking multiple medications, increasing the risk of interactions and adverse effects

What factors increase adverse medication effects?

Polypharmacy, renal-hepatic changes, drug interactions, cognitive impairments, and complex regimens

What is the Beers criteria?

A list identifying medications that may be potentially inappropriate or high-risk for older adults

What medication class is strongly associated with falls in older adults?

Benzodiazepines

Why are benzodiazepines risky in older adults?

Can cause sedation, confusion, dizziness, impaired coordination, and falls

Why can benzodiazepines and gabapentin together increase fall risk?

Their CNS-depressant effects can increase sedation, dizziness, and impaired coordinated

What medications commonly cause anticholinergic effects?

Some antihistamines, bladder medications, antidepressants, and other anticholinergic drugs

What are common anticholinergic effects?

Confusion, dry mouth, constipation, urinary retention, and blurred vision

What medication class can increase osteoporosis risk?

Long-term systemic corticosteroids such as prednisone

What should nurses assess before administering medications to older adults?

Allergies, medication list, renal/hepatic function, interactions, vital signs, cognition, and fall risk

What is physiologic reserve?

Extra capacity the body has to respond to stress or illness

How might an older adult with an infection present atypically?

Confusion, weakness, falls, or decreased appetite instead of a high fever

What are cardiovascular changes occurring with aging?

Reduced lung elasticity, respiratory muscle strength, and cough effectiveness

What renal changes occur with aging?

Reduced renal blood flow and GFR and decreased ability to concentrate urine

What is orthostatic hypotension?

A significant drop in BP when moving to an upright position

What is postprandial hypotension?

A drop in BP after eating

Why does postprandial hypotension occur?

Blood is directed toward digestion and older adults may have less ability to compensate

What is presbycusis?

Age-related hearing loss, usually gradual and bilateral

What type of hearing is commonly affected first with presbycusis?

High-frequency hearing

What are risk factors for hearing loss?

aging, loud noises, ototoxic medications, smoking, and ear disease

What are ototoxic medications?

Medications that can damage hearing or balance

What medication class is notably ototoxic?

Aminoglycosides such as gentamicin, tobramyic, and amikacin

What is a cataract?

Clouding of the eye’s lens

What are symptoms of cataracts?

Blurred vision, glare, poor night vision, and faded colors

What is age-related macular degeneration?

Damage to the macular causing primarily central vision loss

What is glaucoma?

Optic nerve damage often associated with increased intraocular pressure

What type of vision is commonly lost with glaucoma?

Peripheral vision

What happens to muscle mass with aging?

Muscle mass and strength generally decrease

What happens to bone density with aging?

Bone density can decrease, increasing fracture risk

What happens to joints with aging?

Cartilage and joint structure can degenerate, causing stiffness and reduced mobility

What is osteoporosis?

Reduced bone mass and deterioration of bone tissue, increasing fracture risk

What are common osteoporosis risk factors?

Older age, female, family history, low calcium/vitamin D, inactivities, smoking/alcohol use

Which medication is especially associated with osteoporosis?

Long-term corticosteroids such as prednisone

Why can COPD treatment increase osteoporosis risk?

Repeated or long-term systemic corticosteroid use can weaken bones

How can osteoporosis be prevented?

Weight-bearing exercise, resistance training, adequate calcium/vitamin D, smoking cessation, and fall prevention

What are common symptoms of osteoarthritis?

Pain, stiffness, reduced ROM, and crepitus

What are non-drug treatments for osteoarthritis?

Exercise, weight management, physical therapy, strengthening, and assistive devices

What intrinsic factors increase fall risk?

Weakness, poor balance, impaired vision, cognitive impairment, gait problems, and orthostatic hypotension

What medication groups increase fall risks?

Benzodiazepines, opioids, sedating antihistamines, antihypertensives diuretics, and anticholinergics

How can hypoglycemic medications increase fall risk?

Hypoglycemia can cause weakness, confusion, dizziness, and LOC

What is cultural awareness?

More to do with an appreciation of the external signs of diversity, such as arts, music, dress, and physical characteristics

What is cultural sensitvity?

More to do with personal attitudes and not saying things that might be offensive to someone from a cultural or ethnic background different from the healthcare providers

What is cultural competence?

The ability to deliver health care with knowledge of and sensitivity to cultural factors that influence the bealth behavior and the curing, healing, dying, and grieving process of the person

What is cultural humilty?

humble and respectful attitude toward individuals or other cultures that pushes one to challenge their own cultural biases, realize they cannot possibly know everything about other cultures, and approach learning about other culture as a lifelong process

What does BEERs list do?

Suggests drugs to avoid and highlights high alert medications/patients

According to Beers list what are high alert medications?

• anticholinergic activity

• benzodiazepines

• tricyclic antidepressants

• warfarin

• NSAIDs

• fluoxetine

• digoxin

• oxybutynin

According to beers list what are high alert patients?

• impaired renal function

• impaired cognition or senses

• falls

• hypotension

• diabetes

• parkinsons

• poor nutrition

What are the 5 criteria list for Beer’s law?

• Meds to avoid if >65 and not hospice

• Meds to avoid with specific diagnoses

• meds to avoid due to drug interactions

• meds to avoid when harmful side effects outweigh the benefits

• meds that need to have the dose adjusted due to renal impairment