Comprehensive Functional Assessment for Geriatric Nursing lecture notes (completed)

This flashcard set covers the key concepts, standardized assessment tools (cognitive, physical, nutritional, and psychological), and clinical outcomes associated with Comprehensive Functional Assessment (CFA) for older adults as presented in the lecture notes.

What is the definition of a Comprehensive Functional Assessment (CFA)?

A thorough evaluation of a person's ability to carry out basic tasks for self-care and tasks needed to support independent living.

According to the lecture, what percentage of older persons aged $65+$ require assistance with Activities of Daily Living (ADLs)?

$$20\%$$

What percentage of older persons aged $85+$ require assistance with ADLs?

$$45\%$$

What is the goal of a Comprehensive Functional Assessment?

To improve functional status and independence and enhance quality of life.

What are the five major components of a Comprehensive Functional/Geriatric Assessment?

Physical Functioning, Cognitive Status, Psychological Status/Spiritual, Social Functioning/Support, and Environmental Characteristics.

What are the three examples of Comprehensive Geriatric Functional Assessments mentioned?

Older Americans Resources and Services (OARS/OMFAQ), Resident Assessment Instrument (RAI)/Minimum Data Set (MDS 3.0), and Outcomes and Assessment Information Set Assessment (OASIS D).

Where was the Older Americans Resources and Services (OARS) assessment developed?

Duke University, Center for Study of Aging and Human Development.

What is the cumulative score range for the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ)?

$$6-30$$

The Minimum Data Set (MDS) is required by CMS for residents in which facilities?

Medicare/Medicaid approved Nursing Homes and Skilled Nursing Facilities (SNF).

Within how many days of admission must the Minimum Data Set (MDS) assessment be completed?

Within $14$ days.

What does the mnemonic FANCAPES stand for?

Fluids, Aeration and circulation, Nutrition, Communication, Activity, Pain, Elimination, and Social skills.

What does the mnemonic SPICES stand for regarding common geriatric syndromes?

Sleep disorders, Problems with eating or feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown.

What specific tasks are included in the Katz ADL Scale?

Eating, Bathing, Dressing, Toileting, Transferring, and Urine & Bowel Continence.

What distinct activities are measured by the Lawton IADL Scale?

Telephone Use, Shopping, Food Preparation, Housework, Transportation, Medication Use, and Money Management.

What is the combined potential score for the Tinetti Balance & Gait Assessment?

$28$ points.

According to the Tinetti Balance & Gait assessment, what score indicates a High Risk of falls?

$18$ points or less.

In the Timed Get Up & Go (TUG) test, what is considered a normal time for a patient to complete the task?

Less than $10$ seconds.

What score on the Hendrich II Fall Risk Model identifies a patient as High Risk?

A score of $5$ or greater.

In the Nutrition Screening Initiative (DETERMINE), what total score indicates a High Nutritional Risk?

A score of $6$ or more.

What score range on the Mini Nutritional Assessment (MNA) indicates that a patient is 'Malnourished'?

$0-7$ points.

What is the definition of Executive Functioning based on the lecture?

The ability to plan, problem solve, organize, strategize, pay attention, and manage details.

What are the five categories assessed in the Folstein Mini-Mental Status Exam (MMSE)?

Orientation, Registration, Attention and Calculation, Recall, and Language.

What are the components of the Mini Cog screening tool?

Listening to and remembering $3$ unrelated words and drawing the face of a clock set to a specific time.

What specific cognitive skills does the Clock Drawing screening tool test?

Constructional apraxia, visual-spatial skills, abstract thinking, language comprehension, numerical knowledge, and motor execution.

What is the 'Time & Change Test'?

A test where the patient must tell time on a clock set to $11:10$ and count out $\$1.00$ in change.

What total possible score exists for the Montreal Cognitive Assessment (MoCA), and what score is considered normal?

Total possible is $30$ points; a score of $26$ or more is considered normal.

What MoCA score range is typically associated with Mild Cognitive Impairment (MCI)?

$$19-25.2$$

Which assessment is described as being more sensitive than the MMSE for detecting Mild Cognitive Impairment (MCI)?

St. Louis University Mental Status (SLUMS).

What is the purpose of the Functional Assessment Staging Tool (FAST)?

It is a functional assessment scale used to stage the progression of Alzheimer's disease/dementia from stage $1$ to $7$.

What tool is used specifically to assess for delirium?

Confusion Assessment Method (CAM).

According to the CAM worksheet, what is required to suggest a diagnosis of delirium?

Evidence of Acute Onset and Fluctuating Course AND Inattention, along with either Disorganized Thinking OR Altered Level of Consciousness.

How many items are included in the short form of the Geriatric Depression Scale (GDS) referenced in the notes?

$15$ items.

What does the FICA Spiritual History Tool mnemonic stand for?

Faith and Belief, Importance, Community, and Address in Care.

In the OARS/OMFAQ, what is the difference between the Social Resource Scale and the Economic Resource Scale?

The Social Resource Scale assesses availability and relationships with family and friends; the Economic Resource Scale evaluates employment, income, assets, and insurance.

How many items are included in the Caregiver Strain Index?

$13$ Yes/No items.

What items are assessed in the Family APGAR?

Help from family, talking over things/sharing problems, support for new activities, expression of affection/emotions, and sharing time together.

What total score on the Pittsburgh Sleep Quality Index (PSQI) indicates poor sleep quality?

A total score of $5$ or greater.

What are the UDI-6 and IIQ-7 tools used to assess?

Urinary Incontinence (UI) and its impact on quality of life.

What scale is used to predict pressure sore/ulcer risk?

The Braden Scale.

What are clinical outcomes associated with performing a Comprehensive Functional Assessment (CFA)?

Reduced hospital use, reduced mortality rates, and improved functional ability (among others including improved mental status and lower readmission rates).