Geriatrics Overview and Physiology Changes
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Questions and Answers

What is a common challenge in assessing geriatric patients?

  • Their social networks are too extensive.
  • They often over-report symptoms.
  • They may have communication problems. (correct)
  • They respond better to verbal prompts.

Which factor can complicate the assessment of chronic problems in geriatric patients?

  • Lack of medical history.
  • Improved clarity of symptoms.
  • Aging changes in their responses to illness. (correct)
  • Increased physical strength.

What is an appropriate approach when communicating with a geriatric patient?

  • Speak quickly to enhance engagement.
  • Assume they may not understand at all.
  • Shout to ensure clarity.
  • Speak slowly and directly at the patient. (correct)

What signs should a caregiver look for during a scene size-up of a geriatric patient?

<p>Signs of drug or alcohol abuse. (C)</p> Signup and view all the answers

Which of the following is true about the initial assessment of geriatric patients?

<p>Excessive clothing may impede assessment. (D)</p> Signup and view all the answers

What is the most common finding indicating potential abuse in elderly patients?

<p>Unexplained trauma (C)</p> Signup and view all the answers

What percentage of prescription medications are taken by the elderly?

<p>25% (A)</p> Signup and view all the answers

Which of the following is NOT a common issue related to medication in the elderly?

<p>Excessive energy (A)</p> Signup and view all the answers

How does neglect in the elderly population differ from abuse?

<p>Neglect is more common (B)</p> Signup and view all the answers

Which of the following is a recommended action for EMS to expand their role?

<p>Home surveys (C)</p> Signup and view all the answers

What factor significantly influences an elderly person's care needs?

<p>Chronic diseases (A)</p> Signup and view all the answers

What is a key goal of expanding the role of EMS in patient care?

<p>To access information not known to providers (C)</p> Signup and view all the answers

What is a common cause of hospital admissions related to medication?

<p>Drug-induced illnesses (D)</p> Signup and view all the answers

In assessing geriatric patients, which aspect is crucial to consider?

<p>Their medications (C)</p> Signup and view all the answers

Which one of these statements is true regarding trauma in elderly patients?

<p>Trauma is often related to falls (A)</p> Signup and view all the answers

What is a common cause of trauma in the elderly?

<p>Motor vehicle crashes (D)</p> Signup and view all the answers

What physiological change in the elderly can lead to an increased risk of head bleeds?

<p>Loss of elasticity of blood vessels (A)</p> Signup and view all the answers

What is a significant risk factor associated with psychiatric disorders in older adults?

<p>Isolation from family (D)</p> Signup and view all the answers

What makes the assessment of elderly patients particularly challenging?

<p>It is difficult to distinguish aging effects from disease consequences (A)</p> Signup and view all the answers

Which emergency related to thermoregulation is a concern for the elderly?

<p>Heat stroke (A)</p> Signup and view all the answers

Which of the following factors may blunt the normal response to trauma in elderly patients?

<p>Decreased muscle mass (B)</p> Signup and view all the answers

What is a common atypical presentation of pneumonia in the elderly?

<p>Generalized weakness and decreased appetite (A)</p> Signup and view all the answers

What type of assessment might be necessary due to the complexity of geriatric health?

<p>Comprehensive multi-system evaluation (D)</p> Signup and view all the answers

Which of the following is a major risk associated with musculoskeletal system changes in the elderly?

<p>Change in posture leading to falls (B)</p> Signup and view all the answers

What percentage of brain cells may be lost in areas responsible for higher function due to aging?

<p>40%-45% (A)</p> Signup and view all the answers

What is the chief complaint in elderly patients often characterized as?

<p>Nonspecific and confusing (C)</p> Signup and view all the answers

Which of the following conditions is a common cardiovascular emergency in the elderly?

<p>Atrial fibrillation and other rhythm disturbances (D)</p> Signup and view all the answers

What type of trauma is difficult to diagnose in elderly patients?

<p>Cervical spine injury (D)</p> Signup and view all the answers

What mental health issue is often a concern in elderly populations?

<p>Depression (A)</p> Signup and view all the answers

How does aging affect the renal system's ability to function?

<p>Decreased ability to regulate fluid and electrolyte balance (B)</p> Signup and view all the answers

Which statement about gastrointestinal changes due to aging is true?

<p>Reduction in salivary volume by one-third (D)</p> Signup and view all the answers

What is a common neurological emergency related to CNS disease in the elderly?

<p>Dizziness and seizures (D)</p> Signup and view all the answers

Which of the following is a common misconception regarding transport of elderly patients?

<p>They are easy to transport (A)</p> Signup and view all the answers

What is the leading cause of death in the geriatric population?

<p>Cardiovascular Disease (B)</p> Signup and view all the answers

Which factor contributes to the increasing life expectancy in the elderly population?

<p>Improved healthcare (D)</p> Signup and view all the answers

What common medical emergency is particularly concerning in elderly patients?

<p>Fractures (A)</p> Signup and view all the answers

What is a major challenge when assessing geriatric patients?

<p>Communication barriers (D)</p> Signup and view all the answers

Why is trauma particularly dangerous for elderly patients?

<p>Decreased bone density (D)</p> Signup and view all the answers

What can be a mental health issue prevalent in the elderly?

<p>Anxiety Disorders (D)</p> Signup and view all the answers

What special consideration should be taken when treating elderly patients?

<p>Potential drug interactions (D)</p> Signup and view all the answers

What is a common misconception about elderly patients' recovery from trauma?

<p>They require more time to recover (A)</p> Signup and view all the answers

What is a key aspect of assessment for geriatric patients experiencing medical emergencies?

<p>Considering cognitive impairment (A)</p> Signup and view all the answers

What primary factor accounts for the rising percentage of the elderly population?

<p>Better healthcare and vaccinations (C)</p> Signup and view all the answers

Flashcards

Geriatric Transport Challenges

Elderly patients are harder to transport than other patients due to multiple medical problems, communication difficulties, changing anatomy and physiology with age, and social factors.

Respiratory System Aging

The respiratory system's vital capacity decreases significantly with age, leading to reduced breathing capacity, oxygen uptake, and exercise tolerance.

Cardiovascular System Aging

The cardiovascular system shows declines in stroke volume, contractility, and conduction system function, leading to potential dysrhythmias and variations in heart rate.

Renal System Aging

The kidneys lose functional units causing a decrease in renal blood flow. This impacts the body's ability to manage fluids and electrolytes.

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Nervous System Aging

The nervous system experiences substantial decline, including a reduction in brain cells, brain weight, blood flow to the brain, and nerve conduction.

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Musculoskeletal Aging

Aging leads to changes in stature, gait, and ambulation. This often increases fall risk.

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Gastrointestinal Aging

Aging affects saliva production and esophageal motility, potentially leading to digestive issues and constipation.

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Atypical Presentation of Illness

Elderly patients often display less obvious or different symptoms compared to younger patients when experiencing common conditions such as pneumonia, cardiovascular problems, or strokes. They might appear weak, have less energy, or not eat.

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Blood loss impact

Blood loss can lead to additional medical problems.

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Environmental emergencies risk

Older adults are more vulnerable to issues from environmental factors, like temperature extremes.

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Geriatric trauma causes

Falls, car accidents, and violence are common causes of trauma in older adults.

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Elderly blood vessel elasticity

Older adults have less elastic blood vessels, making them more prone to tearing.

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Head bleeds concern

Blood vessel changes in the elderly increase the risk for head bleeds from traumas.

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Cervical spine injury

Cervical spine injuries are common in elderly trauma cases, tough to diagnose.

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Geriatric trauma care

Trauma care for the elderly is similar to that for other patients, but age-related changes must be accounted for.

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Geriatric assessment complication

Assessing elderly patients is complex, separating age effects from illnesses is challenging.

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Nonspecific complaints in elderly

Elderly patient symptoms can be confusing and nonspecific, making diagnoses difficult.

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Drug-Induced Illnesses in Elderly

More than 30% of hospital admissions for elderly patients are due to adverse reactions from medications.

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Medication Side Effects in Elderly

Elderly patients are more susceptible to side effects from medications due to changes in metabolism and organ function.

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Medication Interactions in Elderly

Taking multiple medications increases the risk of interactions, potentially leading to serious adverse effects.

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Medication Toxicity in Elderly

Elderly patients are more vulnerable to medication toxicity due to slower drug elimination and decreased organ function.

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Neglect vs. Abuse in Elderly

Neglect is more common than abuse, often occurring due to caregiver overload or limitations.

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Signs of Abuse in Elderly

Unexplained trauma, injuries, and behavioral changes are indicators of potential abuse.

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EMS Role in Home Surveys

Paramedics can conduct home safety surveys to assess potential hazards and identify needs for elderly patients.

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EMS Immunization Programs

EMS can play a role in providing or facilitating community immunization programs, especially for seniors.

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EMS Social Service Referrals

EMS personnel can identify elderly patients who need social services and connect them with appropriate resources.

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Atypical Presentation of Illness in Elderly

Elderly patients might exhibit different symptoms compared to younger individuals when experiencing common illnesses.

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Why are older patients often hard to diagnose?

Elderly patients might not exhibit typical symptoms of illness, making it difficult to determine the underlying cause of their discomfort.

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What makes communication with older patients challenging?

Age-related changes in senses, like hearing and vision, can make communication difficult. Additionally, conditions like dementia can further complicate understanding.

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How does routine affect older adults?

Older individuals often have established routines and are sensitive to disruptions, which can impact their physical and mental well-being.

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Why is a good medical history essential for older patients?

Understanding a patient's previous health conditions and medication history is crucial for making accurate diagnoses and interventions.

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What are some factors to consider when assessing an older patient?

Assessing older patients involves paying attention to potential signs of neglect or abuse, drug or alcohol use, and their ability to care for themselves.

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Why is geriatrics important?

Understanding the unique health needs of the elderly is crucial because they're the fastest-growing population segment.

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Life expectancy change

People born in the 20th century have seen a significant increase in lifespan due to advancements in healthcare and preventive measures.

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Geriatric population growth

The percentage of the population aged 65 and over is growing steadily.

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Main causes of death in elderly

Cardiovascular disease, heart attack, stroke, and cancer are the leading causes of death in older adults.

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Causes of longer lifespans

Better healthcare and vaccination programs have contributed to increased lifespans in the elderly.

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Trauma in elderly

Falls, car accidents, and violence are common causes of trauma in older adults.

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Blood vessel changes in elderly

Older adults have less elastic blood vessels, making them more prone to tearing and head bleeds during trauma.

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Cervical spine injury in elderly

Cervical spine injuries are common in elderly trauma cases, and they can be difficult to diagnose.

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Geriatric assessment challenges

Assessing elderly patients is complex, as age-related changes can be hard to distinguish from illnesses.

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Study Notes

Geriatrics Overview

  • Geriatrics is the study of the elderly
  • The elderly are the fastest-growing segment of the population
  • A child born in 1900 could expect to live just 49 years
  • A child born in 1976 could expect to live almost 73 years and this continues to increase
  • The increase in the elderly population is due to better healthcare and decreased rates of preventable illness

Anatomy and Physiology

  • Changes occur in all body systems as people age
  • There is a general decline in bodily function, starting early (as young as 30s)
  • The changes may not be observed until a problem emerges in another system
  • Respiratory system
    • Vital capacity decreases by 50%
    • Air moved in one breath is less than normal
    • Maximum breathing capacity decreases by 60%
    • Maximum oxygen uptake decreases by 70%
    • Limits exercise and exertion
    • Prohibits rapid bursts of activity
  • Cardiovascular system
    • Decrease in stroke volume
    • Decrease in contractility
    • Degeneration of the conduction system
    • Dysrhythmias are more common
    • Variations in rate from minute to minute seen
    • Irregularities are observed
    • Hypertrophy of the heart muscle
    • Creates more area for the coronary arteries to supply
    • Inability to vasoconstrict quickly
    • Dizziness on standing
  • Vascular Problems
    • Varicose veins
    • Peripheral arterial disease
  • Renal system
    • Decrease in functional units of the renal system by 30%-40%
    • Renal blood flow decreases by 50%
    • Cannot produce very diluted or very concentrated urine
    • Limits ability to react to fluid or electrolyte changes
    • Alters blood chemistry
  • Nervous system
    • 45% reduction in brain cells in areas responsible for higher function
    • 6%-7% decrease in brain weight
    • Decreased cerebral blood flow
    • Decreased nerve conduction velocity
  • Musculoskeletal system
    • Changes in stature
    • Changes in gait
    • Ability to ambulate reduced
    • Predisposes patients to falls
    • Decrease in height of 2-3 inches
    • Posture changes
    • Kyphosis
  • Gastrointestinal system
    • 1/3 reduction in the volume of saliva
    • Decreased esophageal motility
    • Results in bowel disorders and constipation

Common Medical Emergencies

  • Management is similar to other adult patients
  • Respiratory distress
    • Frequently have underlying pulmonary diseases
    • May present in an atypical manner
    • Pneumonia may present as not eating or generalized weakness
  • Cardiovascular conditions
    • Related to progression of atherosclerosis
    • Syncope (fainting)
    • Rhythm disturbances
    • Atypical presentations
  • Acute neurological changes
    • Seizures related to CNS disease
    • Stroke
    • Transient Ischemic Attack (TIA)
    • Dizziness
    • Dementia
    • Organic brain syndrome
  • Gastrointestinal bleeding
    • Upper more common coffee ground emesis
    • Blood loss can precipitate other issues
  • Environmental emergencies
    • Poor thermoregulation
    • More at risk than other adults
  • Psychiatric disorders
    • Alcoholism
    • Risk of suicide
    • Depression

Trauma

  • Serious problem in the elderly
  • Common causes
    • Falls
    • Motor vehicle crashes
    • Violence
  • Physiologic changes
    • Loss of elasticity of blood vessels
    • More subject to tearing
    • Concern for head bleeds
    • Cervical spine Injury
      • Common
      • Difficult to diagnose
      • Positioning and immobilization may need to be modified

Assessment of the Geriatric Patient

  • Complicated process
    • Difficult to separate the effects of aging from the consequences of disease
    • Often suffer from more than one disease at the same time
  • Chief complaint may appear nonspecific, confusing.
  • May be the underlying reason for the real problem
  • Often fail to report important symptoms
  • Chronic problems make it difficult to sort out the original problem
  • Aging changes an individual's response to illness or injury
  • Sensitive to changes in their routines
  • Rely on a social network for services
  • ICU psychosis
  • Communication problems are common
    • All senses on a gradual decline
    • Complicated by diseases such as dementia
  • History taking is critical
    • Be aware of communication problems
    • Do not assume deafness
    • Do not shout
    • Speak slowly and directly at the patient
  • Scene size-up
    • Be alert for clues at the scene
    • Can they care for themselves?
    • Look for signs of drug or alcohol abuse
    • Look for signs of elder abuse
  • Initial assessment
    • Peripheral pulses may be difficult to evaluate
    • Focused exams
    • Patient may tire quickly from physical exam
    • Excessive clothing may hamper assessment
    • Explain what you are doing
    • Be alert for changes that are related to aging vs. changes that are related to a medical problem

Medication Considerations

  • More than 25% of all prescription meds are taken by the elderly
  • More than 30% of all hospital admissions are for drug-induced illnesses
  • Side effects
  • Interactions
  • Reactions
  • Toxicity

Abuse and Neglect

  • Neglect more common than abuse
  • No socioeconomic boundaries
  • Average age is 80
  • Often have multiple chronic diseases
  • Require extensive care
  • Unexplained trauma is the primary finding

Expanding the Role of EMS

  • Evaluating ways to capitalize on our role and ability to enter patient homes
  • Allows for access to information physicians and other providers don't know
  • Promote health and prevent illness
  • Examples
    • Home surveys
    • Immunization programs
    • Social service referrals

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Related Documents

Chapter 26 Geriatrics PDF

Description

This quiz explores the field of geriatrics, focusing on the changes in anatomy and physiology as individuals age. Learn about the impact of aging on various body systems, including respiratory and cardiovascular functions. Understand the importance of better healthcare and its role in increasing life expectancy among the elderly.

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