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CARE OF OLDER ADULTS EXAM REVIEW QUESTIONS WITH CORRECT ANSWERS
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CARE OF OLDER ADULTS EXAM REVIEW QUESTIONS WITH CORRECT ANSWERS
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CARE OF OLDER ADULTS EXAMREVIEW QUESTIONS WITH CORRECT
ANSWERS
Four Chronic Diseases - Answer-Heart disease, cancer(#1 cause of death), stroke, and
diabetes
-92% have one chronic disease
-77% have two
-3/4 of money the nation spends are on chronic diseases (1% is spent on preventing it)
-OA most common disability
-DM most complications
Falls - Answer-Unplanned descent w/ or w/out personal injury, results in individual
coming to rest on floor
-strongest assoc: previous fall, weakness, gait/balance impairment, meds (BP,
narcotics)
~hard convos to have w/ them
Co-morbidities - Answer-More than one chronic disease
-sequence of disease presentation may be considered (obese->HTN->DM-> heart
disease)
-inc complexity of managing disease in pt.
Complications of Chronic Disease - Answer-Cancers: chronic pain
DM: eye, renal, nerve damage
Obesity: BMI>30
Polypharmacy
acute care needs in presence of chronic disease: HTN, COPD
Inter-professional Care - Answer-NICHE Program- Nurses Improving Care for the
Hospitalized Elderly
ACE units- Acute Care of Elderly
PACE prog- Programs of All-inclusive care of elderly (living in comm but nursing home
eligable
Waiver Prog- need same care but dont want to be in nursing home $$
Adult Care
Right level of care at right time- independent living comm, ALF, home care, rahab
Geriatric Syndromes - Answer-Common health condition in an older adult that doesn't fit
into category or a specific disease or clearly identified disease
-very prevalent
-multifactorial
, -assoc w/ morbidity(state of chronic disease) and mortality(chronic disease relating in
death)
~polypharmacy, falls delirium, anxiety&depression, UI, sleep disorders, dysphagia,
pressure ulcers
Characteristics of Geriatric Syndromes - Answer--older age (80-90)
-baseline cog impairment
-baseline functional impairment(gait, assistive device)
-frailty(one who is independent)
-more than one geriatric syndrome
-poor health outcomes (CHF, COPD, heart disease)
Urinary Incontinence - Answer-Involuntary leakage of urine to degree that it troubles a
person
-requires assessment and tx(not just containment), often neglected
Causes: delirium/dementia, infection, psych(anxiety/depression), pharm, funct
impair(cant get there), stool impaction (press on bladder; stress)
Urge Incontinence - Answer-Bladder muscles contract at the wrong time "overactive
bladder"
Stress Incontinence - Answer-more common in women due to multiple pregnancies;
muscles arent as strong & urine leaks out when you strain (sneeze, cough, laugh)
Functional Incontinence - Answer-Aware they "need to go" but cant get to the bathroom
Overflow Incontinence - Answer-More common in neurological disorders; cant tell
bladder is full (bad controlled DM, pelagic)
Interventions for Incontinence - Answer-Assessment (bladder diary), behavior (bladder
prog), lifestyle mod, cath, continence products, pharm (flomax, detrol, ditropan), surgery
(stress incont->tuck muscles back up[not always effective]), non-surg (kegels)
Sleep Problems - Answer-Changes: sleep quality, insomnia, sleep apnea, restless leg
syndrome, circadian rhythm changes, fragmented sleep cycle (long naps during day)
~melatonin dec as we age
-assess sleep (diary), sleep study, med review, insomnia (other med conditions, trouble
falling or staying asleep), natural habits (alc), hormonal changes (cortisol-wakefulness;
melatonin (initiates sleep)
Anxiety - Answer-Most common psychiatric condition in elderly
-differentiate from underlying med condition that mimic anxiety
-med work up, review drugs, geriatric syndromes, substance use/abuse, suicide risk
~most appear over time
~can benefit from a variety of approaches (pharm or nonpharm)
~healthy teaching and fam involvement needed
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