©THEBRIGHTSTARS 2024
Kim's Geriatric Common Disorders-Leik
Review Exam Study Guide.
Elder Abuse-- - answer✔--Presence of bruising, skin tears, & fractures that are poorly
explained.
--Presence of STD, vaginal, and/or rectal bleeding, bruises on breasts are indicators of possible
sexual abuse.
--Malnutrition, poor hygeine, & pressure ulcers. Screen for abuse and financial exploitation.
Interview elder alone with these 3 questions: - answer✔--Do you feel safe where you live?
--Who handles your checkbook and finances?
--Who prepares your meals?
Geriatric assessment: - answer✔Assessment team: physician/NP, nurse, social worker,
dietician, physical therapist, others.
ADL's: dressing, feeding self, grooming, bathing.
Instrumental ADL's: driving, grocery shopping, laundry, cooking.
Cognition and mood disorders: Depression, geriatric bipolar disorder.
Risk of falls: history of falls, gait and balance, vision, hypotension, postural hypotension,
arrythmias, osteoporosis, type of shoes, assistive devices
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Polypharmacy (including herbs, alternative therapy): Advise pt to bring all meds, vitamins, and
other alternative medicines in a "brown bag." (???)
Tricyclic antidepressants (TCA's): - answer✔--Amitryptyline (Elavil) is the most sedating.
--Also causes confusion, delirium, and hallucinations.
--All TCA's cause sedation.
--Given at bedtime.
Benzodiazepines: - answer✔--Confusion, dizziness, ataxia resulting in falls, and other
accidents.
Hypnotics: - answer✔--Avoid long-acting (ie, Haldol).
--Prefer shorter duration (ie, Ambien).
Narcotics: - answer✔--Start with low doses.
--Longer duration in the elderly.
Muscle relaxants: - answer✔--Soma, Skelaxin, Norflex.
--Drowsiness, confusion, delirium.
Atypical antipsychotics: - answer✔--Block Box Warning of the high risk of mortality in
elederly (from long term care facilities) with dementia who are treated with atypical
antipsychotics.
--Ex: Seroquel
Antihistamines: - answer✔--Diphenhydramine (Benadryl) is the most sedating antihistamine.