Podcast
Questions and Answers
What does the acronym GEMS diamond stand for?
What does the acronym GEMS diamond stand for?
Geriatric Environment Medical Assessment Social Network
Why was GEMS diamond created?
Why was GEMS diamond created?
It serves as an acronym for the issues to be considered when assessing every older patient.
What is polypharmacy?
What is polypharmacy?
The use of multiple medications by a patient, typically seen in elderly people.
Define unilateral pedal edema.
Define unilateral pedal edema.
What questions are important to ask when assessing why an elderly patient fell?
What questions are important to ask when assessing why an elderly patient fell?
Why are older patients more likely to sustain closed head injuries such as subdural hematomas?
Why are older patients more likely to sustain closed head injuries such as subdural hematomas?
In an elderly patient with a hip fracture, why is it important to use blanket rolls?
In an elderly patient with a hip fracture, why is it important to use blanket rolls?
Why is it sometimes difficult to determine if an elderly patient is in shock based on their blood pressure?
Why is it sometimes difficult to determine if an elderly patient is in shock based on their blood pressure?
Patient care for a pulmonary embolism should focus on what?
Patient care for a pulmonary embolism should focus on what?
Geriatric patients are at risk for atherosclerosis resulting in what?
Geriatric patients are at risk for atherosclerosis resulting in what?
Specific legal documents that direct relatives and care providers about the extent of treatment that may be given for patients who cannot speak for themselves are known as what?
Specific legal documents that direct relatives and care providers about the extent of treatment that may be given for patients who cannot speak for themselves are known as what?
An examination of the geriatric patient's residence for steep stairs, missing handrails, adequate food, and overall appearance of the home falls under which aspect of the GEMS diamond?
An examination of the geriatric patient's residence for steep stairs, missing handrails, adequate food, and overall appearance of the home falls under which aspect of the GEMS diamond?
Determining the chief complaint in the older medical patient is often how?
Determining the chief complaint in the older medical patient is often how?
Sudden unconsciousness in the older patient from standing too quickly, bearing down for a bowel movement, diabetic shock, or heart attack is called what?
Sudden unconsciousness in the older patient from standing too quickly, bearing down for a bowel movement, diabetic shock, or heart attack is called what?
Symptoms such as difficulty breathing, toothache or arm cramps, and syncope in the older patient often indicate what?
Symptoms such as difficulty breathing, toothache or arm cramps, and syncope in the older patient often indicate what?
Children may have experienced a serious injury, even though there may be little or no outward signs, for what reason?
Children may have experienced a serious injury, even though there may be little or no outward signs, for what reason?
Which of the following is a consideration when immobilizing a small child with a suspected head and neck injury?
Which of the following is a consideration when immobilizing a small child with a suspected head and neck injury?
In the pediatric patient when immobilization is necessary, what part of the body should be secured to the immobilization device first?
In the pediatric patient when immobilization is necessary, what part of the body should be secured to the immobilization device first?
Immobilization is necessary for all children who have what possible injuries?
Immobilization is necessary for all children who have what possible injuries?
What are the 6 steps in order when immobilizing a pediatric to an immobilization device?
What are the 6 steps in order when immobilizing a pediatric to an immobilization device?
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Study Notes
GEMS Diamond
- GEMS stands for Geriatric, Environment, Medical assessment, Social network.
- Created to address key issues in assessing elderly patients without replacing the ABCs of care.
Polypharmacy
- Refers to the use of multiple medications by elderly individuals.
- Highlights potential negative effects associated with taking numerous medications.
Unilateral Pedal Edema
- Pedal edema involves swelling in the foot and ankle due to fluid overload.
- Unilateral pedal edema means the swelling is present in only one leg.
Fall Assessment in Elderly Patients
- Important questions include events leading to the fall, balance issues, dizziness before the fall, and memory of the event.
- Inquire about fainting episodes or changes in medication routines.
Closed Head Injuries in the Elderly
- Elderly individuals are prone to closed head injuries like subdural hematomas due to brain tissue shrinkage.
- Stretched veins from brain atrophy increase risk of injury during trauma.
Management of Hip Fractures
- Using blanket rolls helps maintain the leg in a static position to prevent further injury.
Shock Evaluation in Older Patients
- Determining shock can be challenging due to medications like beta-blockers, which prevent tachycardia.
- Normal heart rates may not accurately reflect the condition of a patient on heart medication.
Pulmonary Embolism Care
- Focus on airway, ventilatory, and circulatory support.
- Perform suctioning and provide high-flow oxygen; position the patient for comfort.
- Follow emergency cardiovascular care guidelines if the patient is in arrest.
Risks for Geriatric Patients
- Increased risk for atherosclerosis can lead to heart attack and stroke in elderly individuals.
Advance Directives
- Legal documents that outline treatment preferences for patients unable to communicate their wishes.
Environmental Assessment in Geriatrics
- Evaluating living conditions such as stair safety, food availability, and home upkeep are part of GEMS environmental assessment.
Challenges in Determining Chief Complaint
- Older patients often present with vague or atypical symptoms, complicating diagnosis.
Syncope in Older Patients
- Sudden loss of consciousness can occur due to standing quickly, straining, diabetic shock, or heart attack.
Cardiovascular Symptoms in the Elderly
- Symptoms such as difficulty breathing, toothaches, and syncopal episodes often indicate underlying cardiovascular disease.
Pediatric Injury and Compensation
- Children can sustain serious injuries with minimal outward signs due to their physiological ability to compensate for blood loss.
Immobilization of Small Children
- When immobilizing a child with suspected injuries, secure the torso first to the backboard with appropriate padding.
Pediatric Immobilization Process
- All children with potential head or spinal injuries should be immobilized after traumatic events.
- Steps for immobilizing include maintaining a neutral head position, applying a cervical collar, and ensuring secure strapping to the device.
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