Geriatric Veterinary Nursing

The criteria for senior vs geriatric is ___

age

If an animal is a senior depends on the ___, ___ and ___

species, breed, size

When becoming a senior increases ___ related ___

senescence, issues

Geriatric animals generally have about ___ of their life remaining

10%

A geriatric animal typically has decreased ___, or a condition that needs ___ ___

function, medical support

Health care goals regarding senior and geriatric animals

• client education

• preventative care

• early recognition

• current diseases treatment

• hospice care

With senior patients, the client must be informed about the level of ___ changes

care

Preventative care for senior animals changes due to the increased ___ to certain dieases

predisposition

how important early recognition of ___ ___ or decreased ___

behavioral changes, function

Also if neccessary hospice care if a ___ ___ occurs

terminal disease

An animals QOL depends if their ___ ___ are met

basic needs

QOL can be quantified with the ___ scale

HHHHHMM

HHHHHHMM stands for

hurt, hunger, hydration, hygiene, happiness, mobility, more good than bad

A score of ___ on the HHHHHMM scale is acceptable

35

Physiologic effects of aging: ___ changes, ___ changes, ___ ___ changes

behavioral, apperance, daily function

some behavioral changes with aging includes: ___ ___, response to ___, and ___ interactions

sleep changes, commands, social

Apperance changes with aging includes: ___ ___ specifically ___/___, ___, then ___ ___, and ___ ___

hair coat, dull/dry, graying, muscular atrophy, lenticular sclerosis

aging daily functional changes include: ___, (decreased ___/___,) and ___ ___ (decrease in ___, ___ and ___)

musculoskeletal, activity/mobility, special senses, hearing, olfaction, vision

senior/geriatric wellness includes: ___, ___, ___ and ___ ___

PE, vacinations, parasites, client education

A PE for a senior animal should be q _ ___ and increases in occurence with ___ ___

6 months, chronic disease

A geriatric PE should include___ ___( a ___, ___ and may or may not have ___), and ___

lab work, MDB, thyroid, imaging, grooming

Clients should be educated on senior care including: ___, ___, ___ and ___

dental, nutrition, exercise, behavior

Nutritional concerns related to aging changes include:

• decreased ability to adapt

• protein importance

• sarcopenia

• weight gain

As an animal ages their ability to ___ to nutritional changes like ___, or ___ decreases overall

adapt, diet, amount

With senior animals a change in ___ may be required depending. If there is an ___ ___ will, they need an increase, but it the pet has ___ ___ it will require a decrease

protein, turnover balance, renal disease

Senior dogs have turnover balance due to protein ___ increasing, and protein ___ decreasing

breakdown, synthesis

In senior cats may require more protein due to turnover balance because their digestion becomes ___

impaired

Sarcopenia is when there is a decrease in ___ ___ ___ occuring without disease

lean muscle mass

Monitor sarcopenia by utilizing a ___, which has ___ ___, and ___

MCS, subjective classification, assessment

Some subjective classification for a MCS includes: ___, ___ ___, ___ ___ and ___ ___

normal, mild lolss, moderate loss, severe loss

An assessment for MCS includes: ___, ___ and ___ on ___ prominences, and ___ muscles

visual, palpation, focus, bony, epaxial

The most common nutritional aginig related change is ___ ___

weight gain

Monitoring for weight gain using ___, and the primary concern is ___, which can increase ___ and ___

BCS, obesity, mobidity, mortality

obesity can cause: ___ ___, ___, ___/___ issues, ___, ___ ___, etc.

chronic inflammation, osteroarthritis, cardiovascular/pulmonary, hypertension, diabetes mellitus

Cognitive dysfunction syndrome is a ___ disorder that ___ accompanies with aging

neurogenerative, doesn’t

Clinical signs of cognitive dysfunction syndrome in cats/dogs: ___, ___ problems, ___ ___, ___ ___/___ ___, altered response to ___, altered ___/___ ___

confusion, memory, aberrant activity, relatioships/social interations, stimulus, sleep/wake cycles

memory problems in cats/dogs can appear as ___ ___, getting ___ in corners, forgetting ___, and where to ___

house soiling, stuck, grooming, eat

Aberrant activity can appear as ___, ___ behavior, and ___

anxiety, repetitive, apathy

Typically horses that are aged older than ___ are affected by cognitive dysfunction syndrome

25 years

Clinical signs of cognitive dysfunction syndrome in horses: ___ ___, ___, unusual ___ on companions, ___ ___, ___/___ change, frequent ___, ___ ___, altered ___/___, ___ ___/___, ___ ___/___

uncharacteristic forgetfulness, confusion, dependency, aimless wandering, depression/mood, yawning, head pressing, eating/drinking, compulsive walking/circling, unprovoked kicking/biting

The diagnosis of cognitive dysfunction syndrome is the ___ ___ and ___ ___

clinical signs, change overtime

A methods of overviewing cognitive dysfunction syndrome is ___-__

DISHA-AL

DISHA-AL stands for

disorientation, interations disrupted, sleep patterns disturbed, house training forgotten, activity levels altered, anxiety increased, learning/memory

When looking at DISHA-AL exclude all other reasons ___ like ___ or ___ induced

potentials, medical, drug

managment methods of cognitive dysfunction syndrome includes: ___ ___, ___ ___, and ___

environmental enrichment, dieatary modification, pharmaceutical

how to enrich the enviroment: ___/___, ___ ___, maintaining a ___ environment like locations, times, and companions

play/interaction, food puzzles, familiar

Modifications to the diet to help with cognitive dysfunction syndrome:

• Medium chain triglycerides

• antioxidants

• omega 3 FA

• vitamins E, D, B6, B12

• L-carnitine

• amino acids

Common issues with the musculoskeletal system: ___ and ___

sarcopenia, osteoarthritis

Clinical signs of sarcopenia includes: lower ___ and ___

endurance, weakness

Osteoarthritis is the gradual ___ ___

cartiladge degradation

Clinical signs of OA: decreased ___, due both to reluctance to move, and stiff joints, ___, ___ and ___ change

mobility, lameness, withdrawal, behavioral

Common cardiovascular issues in a decrease in ___, in dogs ___ ___, in cats ___ ___, and in horses either ___/___ ___, or ___ ___

CO, valvular disease, myocardial disease, mitral/aortic insufficiency, atrial fibrillation

decreased CO leads to decreased ___ and ___

efficiency, endurance

valvular disease occurs in ___ of dogs and ___ of them are ___ valve insuffiency

30%, 75%, mitral

Senior cats often get the cardiac issue ___ ___

myocardial disease

Horses are likely to get the cardiac problems ___/ ___ ___, or ___ ___

mitral/aortic insuffiency, atrial fibrillation

Common aging problems regarding the urinary system: decreased overall ___, and ___. In female dogs ___ ___, and in intact male dogs ___ ___

function, CKD, urinary incontinence, prostatic hyperplasia

As pets age their urinary functions change : like their ability to ___ urine decreases, and clear ___ also decreases, and they may or not have ___. As functions decrease ___ ___ increase

concentrate, waste, hypertension, clinical signs

When less than ___ of nephrons are impaired there won’t be clinical signs

75%

When nephron impairment is equal or greater than ___ clinical signs are apparent, and they will be in stages ___, ___ of kidney disease

75%, 3, 4

CKD or ___ ___ ___ has ___ stages in dogs and cats

chronic kidney disease, 4

Stage I CKD in dogs/ cats appear as ___, but no ___

damage, signs

Stage II CKD in dogs/cats includes decrease in ___, ___ occurs, however no ___. There may be a decrease in ___, and can have an increase in ___

GFR, azotemia, signs, concentration, volume

Stage III CKD has increased ___, and begins to have ___ ___

azotemia, clinical signs

Stage IV CKD has a severe increase in ___, and has ___ ___

azotemia, clinical signs

Clinical signs of CKD in horses: ___ ___, ___/___, ___ ___, specifically between the ___ ___, and ___

weight loss, polyuria/polydipsia, ventral edema, front legs, sheath

Another urinary condition occurs in female dogs, ___ ___, which is caused by ___ ___ ___

urinary incontinence, sphincter mechanism incompetence

intact male dogs are likely to have the urinary condition: ___ ___, which causes ___ and ± ___ ___

protstatic hyperplasia, straining, perineal hernia

Common GI problems: ___ disease and ___ ___ in cats and dogs, and ___ ___, ___ and ___ diseases in horses, decreased ___/___ function, decreased ___ requirement, ___ function

peridontal, tartar accumulation, wave mouth, EOTRH, sinus, gastric/intestinal, energy, hepatic

Wave mouth in horses is due to their ___ ___ wearing ___

hyposodont teeth, unevenly

EOTRH is ___ ___ ___ ___/___

equine odontoclastic tooth resorption/hypercementosis

EOTRH is ___ and causes ___ teeth

painful, loose

Sinus diseases in horses happen usually with proximity to ___ ___

teeth roots

gastric and intestinal functions begin to decrease due to ___ ___ changes, ___ ___ changes, and ___ begin to ___ affecting absorption

gastric secretions, intestinal elasticity, villus, shrink

Older animals require less energy so ___ should be decreased, but not ___ or ___ as it actually increases in necessity

calories, protein, nutrients,

Hepatic function changes as they age: a decrease in ___/___, decrease in the ability to ___, and ± decrease in ___/___

size/weight, regeneration, processing/biotransformation

Common neurologic problems include: ___ ___ including hearing loss, vision loss, olfaction decreases, and ___ issues

special senses, CNS

Vision loss can result from ___ ___, ___ ___, and ___

lenticular sclerosis, retinal degeneration, cataracts

Olfaction decreases with age resulting in ___ or ___, which can lead to loss of ___ ___

hyposmia, anosmia, food intake

The issues with the CNS result from decreased ___ ___ resulting in ___ reactions, loss ___ ___ ___, decreased ___ and decreased ___/___

brain size, slowed, fine motor control, proprioception, balance/coordination

Integumentary issues include the skin losing ___, and ___, and ___

elasticity, thinning, alopecia

Endocrine diseases that could affect dogs: ___, ___, and ___ ___

hypothyroid, cushing, diabetes mellitus

Endocrine diseases that affect cats: ___ and ___ ___

hyperthyroid, diabetes mellitus

Endocrine diseases affecting horses: ___, and ___

PPID, laminitis

PPID or ___ ___ ___ ___ is also referred to as horse ___

pituitary pars intermedia dysfunction, cushings

commonly ___ can develop on older patients

neoplasia

With hospice care there may be specific requirements especially if they are ___ or have an ___ ___

geriatric, terminal illness

The primary goal of hospice care is maintaining the ___

QOL

areas of focus with hospice care: ___/___, ___ ___, ___ ___ and ___

nutrition/hydration, pain management, general nursing, mobility

There are various modalities to manage pain: ___, ___ techniques, ___/___ medicine

pharmacologic, rehabilitation, complementary/alternative

General nursing for hospice involves: ___, and ___ care

hygiene, recumbent

recumbent care relates to preventing ___ ___ with bedding/padding, and the patient’s ___

pressure sores, bladder

The patient’s mobility can be assisted with devices like ___/___ that should be properly fitted, and can used on slippery surfaces, and also ___ can be used

slings/harnesses, carts

When making a decision regarding a patient’s end of life depends on their ___ and ___

QOL, owner

The Client when making a decision regarding end of life for a patient should be educated regarding both ___ and ___ ___, and be offered ___ ___ trying to minimizing their guilt

euthanasia, natural death, emotional support