OEC 6th Edition Chapter 31

You have been asked to deliver a talk about the geriatric population to the new OEC class. Which of the following points would you emphasize in your presentation?

A) Assessment can be difficult because most individuals older than 70 suffer from dementia.

B) Many elderly individuals have a combination of different diseases in various stages.

C) Geriatric patients actually account for a small number of emergency medical calls and transports.

D) Dementia is an inevitable part of aging.

B) Many elderly individuals have a combination of different diseases in various stages.

A new OEC technician asks you why the elderly are at higher risk for developing pneumonia than younger individuals. You inform him that the elderly are more susceptible to respiratory infections because of:

A) impaired swallowing of saliva.

B) decreased alveolar gas exchange.

C) a reduced cough reflex.

D) hardening of the major arteries.

C) a reduced cough reflex.

The son of an 88-year-old patient states that he told his mother to increase the amount of an antibiotic she was taking so she would "feel better faster." This represents a problem because the elderly have:

A) decreased respiratory function.

B) an increased risk for stroke.

C) decreased liver and kidney function.

D) an increased risk for cancer.

C) decreased liver and kidney function.

By age 85, the brain of a typical geriatric patient can shrink by as much as 10 percent due to:

A) reduced use in learning.

B) a decrease in brain cell numbers.

C) reduced fluid volume.

D) stroke activity.

B) a decrease in brain cell numbers.

In a typical geriatric patient, a reduction in cerebral blood flow can:

A) reduce the amount of glucose and oxygen that reaches the brain.

B) increase the patient's pulse rate.

C) decrease the patient's blood pressure.

D) increase the patient's respiratory rate.

A) reduce the amount of glucose and oxygen that reaches the brain.

Which of the following statements shows that an OEC technician has an accurate understanding of vital signs in relation to geriatric patients?

A) "The typical resting heart rate in geriatric patients is less than 60 beats per minute."

B) "Fever tends to be more common and more severe in elderly patients."

C) "There is no difference between the vital signs of a geriatric patient and those of a young adult."

D) "Respiratory capacity is greatly reduced in geriatric patients."

D) "Respiratory capacity is greatly reduced in geriatric patients."

For many geriatric patients, food is less appealing because:

A) they engage in less physical activity.

B) they sleep more and eat less.

C) their sense of smell is reduced, and they have fewer taste buds.

D) they have less money for purchasing appealing food.

C) their sense of smell is reduced, and they have fewer taste buds.

The lung capacity in a healthy 90-year-old patient is ________ that of a 30-year-old patient.

A) equal to

B) three-quarters of

C) one-quarter of

D) half of

D) half of

Some elderly patients have osteoporosis, a condition that results in:

A) decreased bone density.

B) decreased renal output.

C) decreased insulin production.

D) gall stone production.

A) decreased bone density.

For the same individual, on average, blood pressure at age 30 compared to blood pressure to age 70 will be:

A) higher.

B) lower.

C) the same.

D) unrelated.

B) lower.

In geriatric patients, strokes can be caused by a blockage or by:

A) a buildup of dopamine.

B) a buildup of epinephrine.

C) a rupture of a cerebral blood vessel.

D) trauma to the cortex.

C) a rupture of a cerebral blood vessel.

Family members tell you that three hours ago, their 76-year-old mother suddenly became confused and had great difficulty speaking. However, within 15 minutes, she returned to normal. Based on this description, an OEC technician should be suspicious of:

A) a stroke.

B) dementia.

C) Alzheimer's disease.

D) a transient ischemic attack.

D) a transient ischemic attack.

Which of these is a common cause of COPD?

A) Atherosclerosis

B) Chronic bronchitis

C) Eczema

D) Allergies

B) Chronic bronchitis

Over 60% of abdominal pain problems in geriatric patients require:

A) a trip to the emergency department.

B) a prescription for a narcotic drug.

C) surgical intervention.

D) evaluation for hernia.

C) surgical intervention.

Many elderly patients participate in a practice called "polypharmacy," which is the:

A) use of mail-order pharmacies.

B) simultaneous taking of multiple medications.

C) use of generic drugs.

D) use of designer drugs.

B) simultaneous taking of multiple medications.

To identify all the drugs, prescriptions, herbal supplements, and over-the-counter drugs that a patient may be taking in combination, OEC technicians should use:

A) SAMPLE.

B) OPQRST.

C) DCAP-BTLS.

D) AEIOU.

A) SAMPLE.

The class of medications that is most commonly prescribed to elderly patients is:

A) gastrointestinal medications.

B) respiratory medications.

C) neurological medications.

D) cardiovascular medications.

D) cardiovascular medications.

One group of drugs prescribed for geriatric patients is beta-blockers. This type of drug:

A) manages cardiac arrhythmias.

B) increases a patient's pulse rate.

C) increases a patient's cardiac preload.

D) thins a patient's blood.

A) manages cardiac arrhythmias.

Geriatric patients may also have a prescription for a diuretic such as HCTZ or Lasix. The role of this type of drug is to:

A) increase a patient's heart rate.

B) increase a patient's respiratory rate.

C) decrease the volume of fluid circulating in the cardiovascular system.

D) increase the preload of the atria.

C) decrease the volume of fluid circulating in the cardiovascular system.

The vital signs of elderly patients with excessive internal or external bleeding may not provide an indication of shock:

A) if these patients are taking beta-blockers or calcium channel blockers.

B) because the hearts of elderly patients pump less due to inactivity.

C) because elderly patients have the ability to compensate for bleeding.

D) if these patients are taking blood thinners.

A) if these patients are taking beta-blockers or calcium channel blockers.

Compared to younger patients, trauma in geriatric patients results in:

A) less-serious injuries due to the slower pace in older patients.

B) a higher mortality rate.

C) more bleeding.

D) more fractures of the extremities.

B) a higher mortality rate.

Correcting a life-threatening condition such as external bleeding in elderly patients can be more problematic because:

A) the skin of elderly patients does not rebound as quickly as it does in younger patients.

B) the veins of elderly patients have weaker walls than those in younger patients.

C) elderly patients may be on Lasix.

D) many elder patients are taking warfarin or other blood thinners.

D) many elder patients are taking warfarin or other blood thinners.

Which of the following statements about traumatic injuries in the elderly is true?

A) Motor-vehicle collisions are responsible for over 75 percent of deaths.

B) Head injuries are easier to detect in the elderly than in younger adults.

C) Hyperthermia is an early sign of trauma.

D) Injuries are most commonly caused by falls.

D) Injuries are most commonly caused by falls.

Falls result in ____% of all deaths in the geriatric population.

A) 5

B) 12

C) 40

D) 72

B) 12

Which of the following conditions must OEC technicians consider when evaluating hypotensive geriatric patients with altered mental status who show no signs of external bleeding, chest injury, or abdominal trauma?

A) A hip or pelvic fracture

B) A tib/fib fracture

C) A genetic hypotensive condition

D) Dehydration

A) A hip or pelvic fracture

An elderly woman has fallen down three steps and is complaining of back pain. After you perform a primary assessment, which of the following questions should you ask to elicit the next important piece of information?

A) "Did you become dizzy before you fell?"

B) "Why didn't you use the ramp on the other side?"

C) "Do you have a history of high blood pressure?"

D) "Who is your family doctor?"

A) "Did you become dizzy before you fell?"

Compared to younger individuals, geriatric patients who fall have a higher incidence of fractures to the _____ region of the spine.

A) C4-C5

B) T1-T2

C) L1-L2

D) C1-C2

D) C1-C2

Which of the following statements concerning insulin pumps is false?

A) They have an external on/off button.

B) They are implanted in the patient's chest.

C) They supply insulin via a catheter.

D) They are commonly found on a patient's belt.

B) They are implanted in the patient's chest.

An advance directive is a:

A) court order directing prehospital providers to administer care.

B) directive provided by medical control.

C) protocol directed by a paramedic on scene.

D) legal document that provides medical direction for life-saving efforts.

D) legal document that provides medical direction for life-saving efforts.

A hearing-impaired patient wearing a hearing aid is having a great deal of difficulty hearing your questions. Which of the following actions should you take first?

A) Ensure that their hearing aid is turned on.

B) Increase the pitch of your voice.

C) Write your questions on paper.

D) Position yourself in front of the patient and shout.

A) Ensure that their hearing aid is turned on.

When communicating with a geriatric patient, OEC technicians should:

A) use layman's terms.

B) use medical terms to describe their findings and treatment plan.

C) use anatomical pictures and point to the affected areas as they explain.

D) touch the patient as they explain the patient's medical issues and affected body areas.

A) use layman's terms.

Which of the following strategies is best for OEC technicians for communicating with a geriatric patient who has diminished eyesight?

A) Write your questions in large print on paper.

B) Increase both the pitch and the volume of your voice.

C) Stand in front of the patient and talk calmly.

D) Obtain needed information from family members.

C) Stand in front of the patient and talk calmly.

An effective way to interview a geriatric patient is to:

A) keep repeating your question if the patient is slow to respond.

B) use good listening skills.

C) write your questions down on paper and show them to the patient.

D) offer possible responses to assist the patient before she answers.

B) use good listening skills.

An elderly trauma patient may struggle with mental clarity, so OEC technicians should try not to:

A) ask about private matters.

B) ask open-ended questions.

C) enlist the help of family in assessment.

D) look for evidence of abuse.

B) ask open-ended questions.

You and your partner respond to the lodge to aid an elderly woman who is not feeling well. When you perform a secondary assessment:

A) you and your partner should take turns asking the patient questions.

B) you and your partner should ignore the patient and ask the family for information.

C) you should stand to the patient's side and raise your voice so the patient can hear you.

D) only one of you should ask the patient questions to avoid confusion.

D) only one of you should ask the patient questions to avoid confusion.

You have been called to an unknown medical emergency. On scene, you are presented with an 84-year-old patient who is confused and does not obey commands. Which of the following action would be most useful in determining the patient's normal mental status?

A) Examine the patient's pupils.

B) Question the patient's family members.

C) Identify the patient's medications.

D) Check the patient's vital signs.

B) Question the patient's family members.

When taking the pulse of an elderly patient, it is recommended that OEC technicians:

A) divert the patient's attention with conversation.

B) repeat and document the pulse rate every 2 minutes.

C) take the pulse on both sides and compare the two rates.

D) use electronic devices only to obtain the pulse.

C) take the pulse on both sides and compare the two rates.

You have been called by the caregiver of a 91-year-old woman with dementia. The patient is complaining of a possible fracture to her upper left arm. As you talk to the caregiver and note various bruises on the patient's body, you become suspicious of elder abuse. Which of the following actions is most appropriate at this time?

A) Contact the police to report your suspicion.

B) Confront the caregiver regarding the bruises on the patient's body.

C) Ask the patient if she is being abused.

D) Treat the patient for a possible broken arm.

D) Treat the patient for a possible broken arm.

Gastrointestinal changes in geriatric patients 

sense of smell declines, food becomes less appealing, gums and teeth deteriorate increasing malnutrition risk, gag reflex decreases, increasing aspiration risk

Kidney changes in geriatric patients 

Become less effective at filtering waste products, toxins, and medicines, and kidney function decreases 30-40%, alters water balance and electrolyte balance within the body 

Musculoskeletal changes in geriatric patients 

Bones lose density and muscle mass declines as the body ages. Disorders like osteoporosis, scoliosis, kyphosis, and lordosis can result. Causes changes in ligaments, becoming less flexible and stiffer. The rib cage becomes stiff and respiratory muscle loses strength

Integumentary changes in geriatric patients 

Skin thins by as much as 20% when aging occurs, skin loses elasticity, causing it to be more susceptible to tearing and other dermatologic injuries. Aging causes decreased fat content under the skin, which predisposes the body to hypothermia and bruising. Fewer sweat glands which can lead to hyperthermia

Endocrine changes in geriatric patients 

Endocrine function diminishes due to the pancreas becoming less effective in regulating blood glucose

Cardiovascular changes in geriatric patients 

As the heart ages, the walls of the ventricles become less effective at pumping blood. Blood vessels become stiffer from atherosclerosis. Results in decreased elasticity, and increased risk of hypertension, cardiac disorders, and cerebrovascular disease

Neurologic changes in geriatric patients 

Changes in the nervous system make the brain and peripheral nerves less effective in processing data and transmitting impulses between various body parts. Changes can seriously affect the body’s ability to respond to disease or trauma

Common illnesses to bear in mind

Hypertension (high blood pressure), altered mental status, stroke (narrowing of blood flow), abdominal emergencies

Considerations if a patient falls

Consider more heavily why they fall because could be due to underlying conditions, trauma for geriatric patients has higher mortality rate