Geriatric Patient Care

13%\

22%\

Caregiving often falls to family and friends.\

Advance directives, durable power of attorney, and do-not-resuscitate orders.\

Bereavement, loneliness, isolation, and feeling unproductive.\

After growth peaks in the late 20s and early 30s.\

Approximately 5–10% per decade.\

Respiratory, cardiovascular, renal, nervous, and musculoskeletal systems.\

No, most maintain independent lives.\

It generally declines as lung tissue ages.\

Changes in lung and chest wall compliance.\

It becomes stiffer as the bony thorax becomes more rigid.\

It decreases.\

It increases.\

They tend to collapse.\

It increases.\

It decreases.\

Up to 50%.\

Up to 60%.\

It slowly decreases.\

It generally stays the same.\

There is a loss of cilia.\

It becomes diminished.\

It becomes impaired.\

They impair defenses against inhaled bacteria and particulate matter.\

Their respiratory defense mechanisms decline.\

Reduced respiratory defense mechanisms impair clearance of infection.\

It declines.\

Nonischemic physiological changes and a high incidence of atherosclerotic coronary artery disease.\

It diminishes.\

Stress, exercise, and catecholamines.\

It decreases.\

It becomes prolonged.\

Approximately 30%.\

Myocardial hypertrophy, coronary artery disease, and hemodynamic changes.\

Myocardial hypertrophy, coronary artery disease, and hemodynamic changes.\

Sudden cardiac arrest.\

It hypertrophies.\

It declines.\

Hardening of the arteries.\

Cells in the SA node, AV node, and other conduction pathways lose function.\

Dysrhythmias.\

Atrial fibrillation.\

Sick sinus syndrome, bradycardias, and heart blocks.\

They can contribute to decreased cardiac output.\

It progressively increases.\

Significant reduction in organ perfusion.\

Regular exercise, healthy diet, avoiding smoking, and managing health conditions.\

Diabetes, high cholesterol, and hypertension.\

Smoking, drinking, poor diet, and sedentary lifestyle.\

It causes deconditioning.\

Disabilities and psychological factors.\

An average of 50%.\

Their number decreases.\

It decreases.\

They respond sluggishly.\

Severe dehydration and overhydration.\

No.\

Urinary leakage associated with physical stress or pressure.\

Urinary leakage associated with a sudden urge to urinate.\

Significant social and emotional effects.\

Inability to empty the bladder adequately.\

Benign prostatic hyperplasia (BPH).\

Approximately 1 in 12.\

Approximately 1 in 2.\

More than 8 in 10.\

Adverse drug event.\

Harmful reactions or interactions involving medications.\

They are a common cause of hospital admission, morbidity, and death.\

More than 80%.\

Yes, many are predictable and potentially avoidable.\

Cardiovascular medications, diuretics, nonopioid analgesics, and hypoglycemics.\

Increased blood-brain barrier permeability and reduced acetylcholine levels.\

Decreased cerebral blood flow and changes in neurotransmitter locations and amounts.\

Thinking speed, memory, and postural stability.\

Responses may be slower, and questions may need repeating.\

Up to 10%.\

It decreases.\

No, the brain has enormous reserve capacity.\

Both become diminished.\

Cataracts, glaucoma, and decreased visual acuity.\

It can impair independence, reading, and driving.\

Age-related hearing loss.\

It decreases their ability to communicate.\

Weakness, paralysis, poor hearing, and brain damage.\

The body's ability to sense position and maintain postural stability through receptors.\

It may decline, making patients less steady on their feet.\

An increased tendency to fall.\

It decreases.\

Changes in motor or position sense.\

It becomes slower.\

Decreased visual acuity, reduced auditory keenness, and sleep changes.\

Liver, kidney, and lung failure.\

Pneumonia, CHF, dysrhythmias, infections, and tumors.\

They shrink.\

They may calcify.\

They become thinner.\

Osteoporosis.\

Approximately 68%.\

An exaggerated forward curvature of the upper spine, producing a humpback posture.\

Extra padding under the head to allow the patient to lie flat.\

Wear-and-tear damage to joint cartilage.\

Bones grind directly against each other, causing pain and restricted movement.\

An autoimmune disease in which the immune system attacks the synovial membrane.\

It becomes inflamed and swollen.\

Joint cartilage and bone.\

It decreases.\

Approximately 2–3 inches.\

They become widened and weakened.\

It can impair mobility and alter balance.\

Walkers and canes.\

Remove throw rugs and secure loose carpeting.\

Items that may cause tripping and general clutter.\

They provide support during movement.\

It improves visibility and helps prevent tripping.\

To allow easy and unobstructed walking.\

Nonslip decals.\

Bathtubs, showers, and commodes.\

Whether medication changes are appropriate.\

Up to 25%.\

Up to 35%.\

They can change the required dosage and administration frequency.\

There is a larger fat reservoir for drug accumulation.\

Total body water decreases.\

The body's ability to maintain normal temperature declines.\

Around age 30.\

Hypothermia, heat exhaustion, and hyperthermia.\

They can easily become malnourished.\

Dehydration, hypoglycemia, and other complications.\

Depression and suicide assessment and management.\

Multiple illnesses, chronic conditions, and altered responses to illness or injury.\

Chronic symptoms may be confused with acute symptoms.\

It can alter or diminish typical responses.\

It may be diminished or absent.\

The patient or paramedic may underestimate condition severity.\

Fear of losing autonomy, fear of hospitals, and financial concerns.\

They may fear losing independence or autonomy.\

Financial concerns.\

Age, chronic illness, medication use, sensory impairments, fatigue, and distractibility.\

Hearing loss and visual impairment.\

Identify themselves.\

So the patient can see them while communicating.\

Hearing aids, eyeglasses, and dentures.\

To help patients with visual impairment.\

Slowly, distinctly, and respectfully.\

By surname unless the patient requests otherwise.\

Listening closely, being patient, and using gentleness.\

To verify their medication list, compliance, and number of prescribing physicians.\

Older adults may fatigue easily.\

Multiple layers worn for warmth may hamper examination.\

The patient's modesty and need for privacy, unless care is affected.\

It is especially important for patients with diminished sight.\

Fear of becoming bedridden, institutionalized, or losing independence.\

Symptoms of chronic disease versus acute problems.\

Alcohol or medication use, food availability, housing condition, and personal hygiene.\

General health and ability to care for themselves after hospital release.\

Friends or family members.\

It helps identify acute changes.\

Advance directives and initiation of care.\

Obtain them and communicate the information to medical direction.\

Gently, with appropriate padding for comfort.\

Bacterial pneumonia, COPD, and pulmonary embolism.\

Bacterial pneumonia.\

It is often fatal.\

Bacteremia.\

Gram-negative bacilli.\

It impairs respiratory tract clearance.\

They can travel from the throat or be aspirated.\

Decreased lung function.\

Institutional environments, feeding tubes, chronic diseases, and compromised immunity.\

Its presentation may be atypical.\

Typical congestion findings may be absent.\

Fever, productive cough, and pleurisy.\

Altered mental status.\

Altered mental status, cough, variable fever, shortness of breath, tachycardia, and tachypnea.\

They may be too weak to cough.\

Weakness and decreased respiratory function.\

Preexisting emphysema or chronic CHF.\

Tachycardia and tachypnea.\

Manage life threats, maintain oxygenation, and transport for physician evaluation.\

Antibiotics.\

They have a high rate of serious complications.\

A history of smoking.\

Diseases that result in reduced expiratory airflow.\

An acute respiratory infection.\

Airway edema, bronchial smooth muscle irritability, and increased mucus secretion.\

Limited airflow and increased work of breathing.\

Dyspnea, ventilation-perfusion mismatch, and hypoxemia.\

Respiratory acidosis.\

Hemodynamic compromise.\

Anxiety, cyanosis, wheezing, diminished breath sounds, dyspnea, and accessory muscle use.\

Paradoxical breathing.\

Dysrhythmias and jugular vein distention.\

It may decrease.\

Previous intubation and steroid therapy.\

Aggressive airway management.\

Correct life-threatening hypoxemia and improve airflow.\

Airway and ventilatory support with supplemental oxygen.\

Inhaled or injected bronchodilators.\

Progressive patient deterioration.\

Withholding nebulized salbutamol in all cases.\

In mild-to-moderate respiratory distress unless distress becomes severe with no cough.\

Using tidal breathing with five normal breaths.\

Five.\

Severe respiratory distress with cough in a known asthma patient, per directive.\

Two doses.\

Five minutes.\

A life-threatening cause of dyspnea caused by a pulmonary blood vessel obstruction.\

Venous stasis, heart failure, COPD, malignancy, and immobilization.\

The veins of the legs.\

Through the femoral veins, inferior vena cava, and heart.\

Its clinical presentation is often misleading.\

Unexplained tachycardia.\

Left ventricular failure with sudden tachypnea or atrial fibrillation.\

Calf discomfort without tenderness.\

Mild calf or ankle edema.\

Increased warmth.\

Dilation of superficial veins in one foot or leg.\

Congestive heart failure.\

Bacterial pneumonia.\

Airway, ventilatory, and circulatory support.\

12-lead ECG.\

Rapid transport for physician evaluation.\

It becomes less frequent.\

Approximately 45%.\

They may not experience typical chest pain.\

Previous MI, angina, diabetes, hypertension, high cholesterol, and smoking.\

Dyspnea.\

Dyspnea, abdominal or epigastric distress, and fatigue.\

An MI occurring without typical symptoms such as chest pain.\

Decreased visceral sensory function or mental deterioration.\

Fatigue, breathlessness, nausea, and abdominal pain.\

A high index of suspicion for MI.\

A 12-lead ECG.\

Whether the patient has used a PDE5 inhibitor.\

Phosphodiesterase type 5.\

Typical chest pain may be absent.\

Analgesics, bed rest, IV fluids, vasopressors, thrombolytics, and anticoagulants.\

To support blood pressure and stabilize hemodynamics.\

To lyse the thrombus.\

To prevent further emboli.\

10%.\

Heart failure.\

A condition in which ventricular output cannot meet the body's metabolic demands.\

Yes, it has a significant incidence of noncardiac causes.\

Ischemic heart disease, valvular disease, cardiomyopathy, dysrhythmias, hyperthyroidism, and anemia.\

Dyspnea.\

Fatigue.\

Shortness of breath when lying flat.\

From dry, hacking cough to productive cough with frothy sputum.\

Right-sided heart failure.\

Excessive urination at night.\

Anorexia, hepatomegaly, and ascites.\

Reverse the condition quickly and help prevent cardiac damage.\

Oxygen, ECG monitoring, intubation, IV therapy, and medications.\

Nitroglycerin, morphine, and furosemide.\

They cause venodilation, decreasing preload.\

Its diuretic action removes excess water.\

Hypertensive heart disease.\

Any condition that decreases blood flow to the heart.\

They are common.\

Atrial fibrillation.\

Electrolyte imbalances.\

Falls from cerebral hypoperfusion, transient ischemic attacks, and heart failure.\

Airway, ventilatory, and circulatory support.\

As needed.\

Transport for evaluation.\

Approximately 2–4%.\

A high mortality rate.\

According to rupture location or extent of dissection.\

Pain relief and immediate transport.\

Airway, ventilatory, and circulatory support.\

Gently and with reassurance to reduce anxiety.\

As needed.\

No, restrict fluids unless severe hypotension is present.\

Obtain IV access but restrict fluids unless severe hypotension occurs.\

According to medical direction.\

Occult bleeding, including hematuria or gastrointestinal bleeding.\

No, if trauma has been dressed and controlled.\

No.\

Neurological impairment caused by ischemic or hemorrhagic interruption of blood supply to the brain.\

Third leading cause of death in most countries.\

Brain injury.\

Ischemic and hemorrhagic.\

Smoking, hypertension, diabetes, atherosclerosis, hyperlipidemia, polycythemia, and heart disease.\

Exact time of symptom onset.\

To establish the reliability and timing of symptom onset.\

A stroke centre.\

Neurology consultation.\

There is limited time to initiate treatment.\

Often less than six hours from symptom onset.\

Airway, breathing, circulation, and vital sign monitoring.\

Identifying the patient as having a stroke.\

As rapidly as possible.\

Stroke treatment.\

Poor stroke awareness, failure to recognize an emergency, waiting for symptoms to improve, and impaired thinking.\

Stroke-related cognitive impairment may affect their ability to seek help.\

Abrupt disorientation to time and place.\

Illusions and hallucinations.\

It may be incoherent.\