Geriatric Health Assessment Quiz

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Questions and Answers

Syncope in the older patient is:

  • Most commonly caused by a silent myocardial infarction.
  • Caused by an interruption of blood flow to the brain. (correct)
  • Generally of no concern unless the patient was injured.
  • Rarely life threatening but should be evaluated by a physician.

Many older victims of physical abuse may make false statements or lie about the origin of their injuries because:

  • Most elderly patients have dementia.
  • They are protective of the abuser.
  • They fear retribution from the abuser. (correct)
  • They do not want to be bothersome.

Findings during the social assessment of an older patient include all of the following, EXCEPT:

  • Daily activity assistance.
  • Interaction with others.
  • Delays in obtaining meals.
  • Outdated medications. (correct)

In contrast to delirium, dementia:

<p>Is usually considered irreversible. (C)</p> Signup and view all the answers

When caring for a geriatric patient with a traumatic injury, it is important to consider that:

<p>The injury may have been preceded by a medical condition. (C)</p> Signup and view all the answers

You should be MOST suspicious that a patient is experiencing:

<p>A subdural hematoma. (D)</p> Signup and view all the answers

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:

<p>Tachypnea and paroxysmal nocturnal dyspnea. (C)</p> Signup and view all the answers

Which of the following statements regarding the aging process is correct?

<p>Aging is a linear process; the rate at which a person loses functions does not increase with age. (C)</p> Signup and view all the answers

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:

<p>Pneumonia. (D)</p> Signup and view all the answers

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:

<p>Determine the onset of the patient's symptoms. (A)</p> Signup and view all the answers

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:

<p>Pneumonia. (D)</p> Signup and view all the answers

Common causes of syncope in older patients include all of the following, EXCEPT:

<p>Vasoconstriction. (C)</p> Signup and view all the answers

When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT:

<p>Accuse a caregiver of physical abuse. (C)</p> Signup and view all the answers

The purpose of the GEMS diamond is to:

<p>Help EMS personnel remember what is different about elderly patients. (C)</p> Signup and view all the answers

With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of:

<p>Compression fractures. (C)</p> Signup and view all the answers

An older patient with significant dehydration would MOST likely present with:

<p>Dizziness or fainting upon standing. (A)</p> Signup and view all the answers

A 'silent' heart attack occurs when:

<p>The usual chest pain is not present. (B)</p> Signup and view all the answers

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should:

<p>Attempt to resuscitate the patient. (B)</p> Signup and view all the answers

An abdominal aortic aneurysm:

<p>Is often the result of hypertension and atherosclerosis. (C)</p> Signup and view all the answers

Which of the following patients is at highest risk for a pulmonary embolism?

<p>71-year-old male with recent surgery to a lower extremity. (C)</p> Signup and view all the answers

Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?

<p>A decreased level of consciousness is not a normal part of the aging process. (D)</p> Signup and view all the answers

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should:

<p>Observe for conditions that may make the residence unsafe. (A)</p> Signup and view all the answers

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

<p>Attempt to differentiate between chronic and acute problems. (C)</p> Signup and view all the answers

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. As your partner administers oxygen to the patient, you should:

<p>Determine the patient's baseline mental status. (B)</p> Signup and view all the answers

A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for:

<p>Head trauma. (A)</p> Signup and view all the answers

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. You should:

<p>Direct your partner to manually stabilize her head while you open her airway and ensure that her oropharynx is clear of secretions or blood. (D)</p> Signup and view all the answers

Which of the following observations or statements represents the 'E' in the GEMS diamond?

<p>The patient's residence is cold due to a malfunctioning heater. (C)</p> Signup and view all the answers

Talking about an elderly patient in front of him or her to other members of the family:

<p>May cause the patient to think that he or she has no say in making decisions. (B)</p> Signup and view all the answers

Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown?

<p>Human resource agencies fail to investigate. (D)</p> Signup and view all the answers

Osteoporosis is MOST accurately defined as:

<p>A decrease in bone mass and density. (C)</p> Signup and view all the answers

Flashcards

Syncope in Older Patients

Syncope, or fainting, in older adults is mainly caused by a temporary interruption of blood flow to the brain. Although generally not life-threatening, it's crucial to consult a doctor for evaluation.

Physical Abuse in Elderly

Physical abuse in the elderly often involves victims hiding their injuries due to fear of retaliation from the abuser. It's crucial to assess for signs of abuse while being sensitive to the patient's situation.

Social Assessment Findings

Social assessments often reveal delays in receiving meals and assistance with daily activities for older individuals. It's important to note that outdated medications are not a typical finding in social assessments.

Delirium vs. Dementia

Dementia is a progressive and generally irreversible decline in cognitive functions, while delirium is an acute and potentially reversible disturbance in mental abilities. Delirium usually has a sudden onset, unlike dementia's gradual progression.

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Traumatic Injuries in Older Adults

Traumatic injuries in geriatric patients can be more complex than in younger individuals, often stemming from underlying medical conditions rather than just the injury itself. They may also present with atypical signs of shock or pain.

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Stroke in Older Patients

Knowing the exact time of symptom onset is crucial in treating an acute ischemic stroke in elderly patients. Older adults often present with atypical stroke symptoms, making early detection challenging.

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Pulmonary Complications in Older Adults

Sedentary behavior, especially after hip fracture, can lead to pneumonia in older adults due to reduced lung capacity. Symptoms like productive cough, fever, and chills may indicate pneumonia, particularly in those with weakened immune systems.

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Aging and Functionality

The decline in vital organ function with age is not a linear process, but rather a gradual worsening over time. Notably, a 10% to 20% reduction in brain weight and volume increases the risk of head trauma in older adults.

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Emergency Care for Older Adults

When finding an older adult unresponsive, the priority is to stabilize their head and ensure airway patency. Before starting the medical assessment, examine the patient's living environment for potential safety hazards.

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GEMS Diamond and Elderly Care

GEMS (Geriatric Emergency Management System) provides valuable reminders to understand the unique needs of elderly patients. Observations about their living conditions can reveal hidden issues, like malfunctioning heaters.

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Elder Abuse

The true extent of elder abuse is difficult to quantify due to factors such as victims' reluctance to report abuse, societal ignorance, and varied definitions of abuse.

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Investigating Elder Abuse

Investigating elder abuse is crucial, and numerous agencies play a role in identifying and addressing it.

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Osteoporosis

Osteoporosis is a condition characterized by a decrease in bone mass and density, leading to increased fracture risk, especially in the spine.

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Osteoporosis and Spinal Stiffness

The inherent stiffness and brittleness of the spine due to aging can contribute to compression fractures in individuals with osteoporosis.

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Atypical Presentations in the Elderly

Older patients may have impaired cognitive skills, potentially leading to misunderstandings during communication about their care.

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Assessing Acute Changes in Behavior

When assessing acute changes in an elderly patient's behavior, always consider their baseline mental status.

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Dehydration in Older Adults

Symptoms like dizziness or fainting upon standing can indicate significant dehydration in older patients.

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Left-Sided Heart Failure

Left-sided heart failure may present with paroxysmal nocturnal dyspnea (sudden breathlessness at night) and tachypnea (rapid breathing) in older patients.

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Cognitive Impairment in Older Patients

Cognitive impairment can lead to misunderstanding during communication - be patient and respectful.

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Importance of Baseline Mental Status

When assessing a patient's behavior, it is essential to consider their usual mental status. A change in behavior may indicate something serious.

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Dehydration and Falls

Older adults are more prone to falls, and dehydration is a common contributing factor. This is because dehydration can lead to dizziness.

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Left-Sided Heart Failure and Dyspnea

Left-sided heart failure can cause shortness of breath (dyspnea), especially at night. Elderly patients may experience this as difficulty lying flat.

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Syncope in Older Adults: A Potential Warning Sign

Syncope, or fainting, should be taken seriously in older people. While it may not always be a serious issue, it could signal a more significant health problem.

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Assessing for Abuse in Older Adults

It's important to assess for signs of abuse in older adults, but also be mindful of their fears. They may be unwilling to reveal abuse.

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Osteoporosis: More Than Just Weak Bones

Osteoporosis affects more than just bone strength - it can also contribute to spinal stiffness and compression fractures.

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Understanding Atypical Presentations

Older patients might present with atypical symptoms, making diagnosis more challenging. It's key to be observant and consider the patient's medical history.

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Study Notes

Syncope in Older Patients

  • Syncope is mainly caused by an interruption of blood flow to the brain.
  • It should be evaluated by a physician even if it is rarely life-threatening.

Physical Abuse in Elderly

  • Victims may lie about their injuries due to fear of retribution from the abuser.
  • It is crucial to assess for signs while being sensitive to the patient's situation.

Social Assessment Findings

  • Common findings include delays in obtaining meals and assistance with daily activities.
  • Presence of outdated medications is not a typical finding in social assessments.

Delirium vs. Dementia

  • Dementia is generally considered irreversible, while delirium can be reversible with treatment.
  • Dementia often develops gradually, contrasting with the acute onset of delirium.

Traumatic Injuries in Geriatric Patients

  • Traumatic injuries may stem from underlying medical conditions rather than just the injury itself.
  • Geriatric patients may not exhibit classic signs of shock or pain.

Stroke and Older Patients

  • In case of acute ischemic stroke, knowing the onset of symptoms is critical.
  • Patients often present with atypical symptoms, increasing the challenge of early identification.

Pulmonary Complications

  • Sedentary behavior, particularly post-hip fracture, can lead to pneumonia due to reduced lung capacity.
  • Symptoms like productive cough, fever, and chills may indicate pneumonia, especially in immunocompromised patients.

Aging and Functionality

  • As people age, the decline in vital organ functions is not linear; it worsens over time.
  • A 10% to 20% reduction in brain weight and volume increases the risk of head trauma.

Emergency Care for Geriatric Patients

  • Upon finding a patient unresponsive, stabilize the head and ensure airway patency.
  • Assess potential safety hazards in the patient’s living environment before starting the medical assessment.

GEMS Diamond and Elderly Care

  • GEMS provides reminders for understanding the unique needs of elderly patients.
  • Observations about living conditions can indicate underlying issues (e.g., malfunctioning heaters).

Elder Abuse

  • The extent of elder abuse is difficult to quantify due to victim hesitance to report, societal ignorance, and varied definitions of abuse.
  • Investigating elder abuse is key, and many agencies play a role in its identification.

Osteoporosis

  • Defined as a decrease in bone mass and density, leading to increased fracture risk, especially in the spine.
  • The stiffness and brittleness of the spine due to aging can cause compression fractures.

Atypical Presentations in the Elderly

  • Patients' cognitive skills may be impaired, leading to misunderstandings during communication about their care.
  • Always consider the patient's baseline mental status when assessing acute changes in behavior.

Important Symptoms and Signs

  • Signs like dizziness or fainting upon standing indicate significant dehydration in older patients.
  • Left-sided heart failure may present with paroxysmal nocturnal dyspnea and tachypnea.

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