geriatric assessment [EDocFind.com].ppt

7/25/2019 geriatric assessment [EDocFind.com].ppt

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Assessment Of Geriatric Patients:


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Effects of Aging :

Normal Part of Life.

Begins around age 30.

Chronic vs.. Acute. Normal aging vs. disease progression.


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Neurological System:

Brain changes with age.

!eterioration of nerve cells "age 20#.

$lowing refle%es. Clinical depression common.

&rustration common.

!ecreased hearing and e'esight.Altered mental status common.


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(

Cardiovascular System:

)'pertension common.

Changes in heart rate and rh'thm.

Calcium deposits around heart valves. Cardiac )'pertroph'

*hic+ening of walls of the heart.

!ecreased cardiac output.

Affects of CA!.,ea+ heart tr'ing to pump against constricted

vessels.


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Gastrointestinal System:

Constipation common.

$mooth muscle contraction diminished.

!eterioration of structures in mouth common.

!ecline in efficienc' of liver. educed a/ilit' to aid in digestion and meta/olism of

certain drugs

mpaired swallowing.

$tomach sphincter valve loss.

ncrease in heart/urn

alnutrition due to deterioration of small intestine.

!ecrease in nutrient a/sorption.


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Musculoskeletal System:

steoporosis common.

ineral loss.

Bones /ecome /rittle.

Narrowing dis+s causes +'phosis.Curving of the spine.

steoarthritis common.

Affects 4oints.Cause of falls.

mmo/ilit' can lead to death.


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Respiratory System:

Cough power diminished.

ncreased tendenc' for infection.

Less air and gas e%change due togeneral decline.

Lung tissue loses elasticit'.

uscles used to /reath lose strength andcoordination.


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Renal System:

!rug to%icit' pro/lem common.

7eneral decline in efficienc'.

educed si8e causes decrease in filtrationsurface area.

&luid and electrol'te im/alance.

Can not filter out drugs properl'.


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Skin:

Perspires less.

*ears more easil'.

)eals slowl'. icroorganisms can enter the /od'.


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mmune System:

&ever often a/sent.

Lessened a/ilit' to fight disease.


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Scene Si!e"up:

Assure scene safet'.

PP:.

Nursing home "):PA mas+#. edical or *rauma.


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nitial Assessment:

Assess mental status.

Assess airwa'.

Assess pulse. Assess s+in color ; temp.

!eh'dration chec+ for furrowed tongue or sun+en

e'es.

Lower total /od' water


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#ocused $istory and P%ysical E&am:

!etermine "trauma#.

Chief complaint "medical#.


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1(

'rauma Patient:

!etermine .

Conduct rapid trauma assessment.

!epressed perception of pain= severit' ma' /e

unrelia/le. Complete head to toe e%am "!CAPB*L$#.

Assess vital signs.

/tain $APL: histor' if possi/le.

!etailed ph'sical e%am.

ngoing assessment.


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Medical Patient:

Chief complaint.

*al+ to the patient if possi/le= not others.

>se proper name such as r.= rs.= iss. Patient ma' not report ever'thing.

!ela' in am/ulance.

&ear "independence= hospital to die=nursing home#.


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Medical Patient:

/tain $APL: histor'.

Conduct ph'sical e%am. "pg..22#.

:licit as much information as possi/le. $can the scene for clues.

Assess /aseline vitals.

Perform detailed ph'sical e%am on all

geriatric patients?


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Special Considerations:

Blindness

Position where patient might /e a/le to see 'ou.

:%plain procedures /efore doing them.

f patient has glasses ma+e sure the' are wearing

them.

Never pull /lind patient.

,al+ at their side and hold their arm.

Let them +now a/out o/stacles.

Never 'ell at a /lind patient.


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!eafness

Never assume the patient is deaf.

f patient is wearing a hearing aid= ma+esure it is on.

!etermine if the patient can lip@read.

Note writing.

Special Considerations:


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(%at AM )

am caused /' massive electrical discharge in

a group of nerve cells in the /rain.

can /e active or postictal.

*reatment for me is usuall' 1- lpm. /'

nonre/reather or positive pressure ventilations

depending on m' condition.

should /e transported in the recover' positionto protect m' airwa' if no trauma is present.


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(%at AM )

am responsi/le for over 100=00 deaths each 'ear

in the >.$.

Although do not directl' cause death= can cause

patients to stop eating= /ecome immo/ile= and

eventuall' /e su/4ect to numerous infections.

am the most common cause of dementia in the

elderl'.

involve the central nervous s'stem causing /raincells to degenerate and die.


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(%at AM )

am a common emergenc' for elderl' patients.

am caused /' reduced /lood flow to the /rain.

can /e reversed /' l'ing down.

' treatment includes

An Adeuate airwa'= )igh flow 2 /' N. or

B. Placement in the recover' position if

patient did not fall. f fall was suspected patientshould /e full' immo/ili8ed.


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(%at AM )

occur when a /lood vessel in the /rain /ecomes

/loc+ed /' a clot= o/structing /lood flow= or ruptures

allowing /lood to accumulate in the /rain tissue itself.

can cause increased CP. $ome of m' signs ; s'mptoms include

>neual pupils= slurred speech= headache= memor' disorder=

uscle wea+ness or paral'sis= usuall' unilateral= and so on.

' treatment would include Aggressive o%'genation= airwa' protection and suctioning=transported in an up@right position or lateral recum/ent if

unresponsive.


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(%at AM )

can /e chronic or acute.

can /e caused from a fatigued heart=

arteriosclerosis= and heart valve damage.

*he heart can no longer pump effectivel' causing/lood to /ac+ up in the peripher' and lungs.

Assessment findings include

D!= edema in the e%tremities= fatigue= altered

mental status= d'spnea= and rales. *reatment would include high flow 2= &owlers

position= and e%pediting transport.


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2(

(%at AM )

can /e silent or cause great pain.

am usuall' caused /' a lac+ of 2 to the

heart muscle.

am associated with chest pain= d'spnea= and

nitrogl'cerine.

*reatment includes high flow 2= assisting

with patients nitrogl'cerine with medicalcontrol order= and cautious /ut rapid transport.


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2-

(%at AM )

am a /loc+age in the /lood vessels of the

lungs.

can present with a ver' sudden onset of

d'spnea.

Predisposing factors include aging= smo+ing=

cancer= fractures of large /ones=

cardiovascular disease= ma4or surger'=prolonged /ed rest= and trauma.

*reatment is Big Es= and rapid transport.


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2

(%at AM )

can /e chronic or acute and usuall' caused /' fluid in

the lungs.

*he left ventricle starts to e4ect less /lood than the right

causing e%cessive /ac+up in the lungs. *he fluid /egins to lea+ into the space /etween the

alveoli and capillaries causing the edema.

$igns and s'mptoms include orthopnea "difficult'

/reathing when l'ing down#. Coughing up /lood tinged

sputum.

*reatment includes /ig Es= &owlers position= and

e%pedite transport.


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(%at AM )

can /e caused /' infection or through

aspiration.

$igns and s'mptoms include d'spnea=congestion without fever or chills= and a

productive cough of purulent sputum.

Care includes /ig Es= and transport inthe &owlers position.


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(%at AM )

am called a Fmini stro+eG.

have the same signs and s'mptoms of

a CA e%cept m' signs and s'mptomsare usuall' gone in 2( hours or less.

*reatment would /e the same as for a

CA.


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(%at AM )

can /e caused /' /' pulmonar' disease

processes such as chronic /ronchitis or

emph'sema.

' result is a distur/ance in gas e%change

and the a/ilit' of the /od' to move air in and

out of the lungs.

*reatment if patient is having difficult'/reathing provide high flow 2. Assist with

inhaler. *ransport in &owlers position.


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(%at AM )

can /e acute or chronic and results in

profound distur/ances in mental

functioning. can /e caused /' medications=

Al8heimerEs disease= /rain lesions=

heart disease and so on.


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(%at AM )

ma' /e caused /' poor e'esight=

forgetfulness= or confusion.

*reatment includes airwa'= o%'gen= andprevention of aspiration.

*a+e all medications with 'ouH.


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A*use of t%e Elderly:

&amil' mem/ers.

nstitutions.

Can /e mental= ph'sical or se%ual. !o not confront famil' mem/ers.

eport all suspected a/use.

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