geriatrics! #logan. ger·i·at·ric ˌ jerē ˈ atrik/ adjective 1. of or relating to old people,...
TRANSCRIPT
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GERIATRICS!#Logan
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• ger·i·at·ric
• ˌjerēˈatrik/
• adjective
1. of or relating to old people, especially with regard to their health care.
• noun
1. an old person, especially one receiving special care
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OVERVIEW
• Describe six physiological changes that occur with aging.
• Describe effective methods for communicating with geriatric patients.
• Describe the effects of the following illnesses and diseases on geriatric patients: • Cardiovascular and respiratory disease; • Neurological diseases; • Gastrointestinal diseases;• Altered mental status.
• Describe four trauma considerations that are unique to geriatric patients.
• Describe the general management of geriatric patients.
• Describe how to manage a geriatric patient with advanced directives.
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SEVEN PHYSIOLOGICAL CHANGES THAT OCCUR WITH AGING
1. Sagging, stooping, drooping, not pooping
2. Neurological: brain changes, AMS and clinical depression common
3. Cardiovascular: Hypertension, changes in <3 rate and rhythm
4. Gastrointestinal: constipation, impaired swallowing, liver inefficiency
5. Musculoskeletal: Osteoporosis, arthritis common
6. Respiratory: cough power diminished, increased tendency for infection
7. Skin: Perspire less, tears easily, heals more slowly
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EFFECTS OF THE FOLLOWING ILLNESSES AND DISEASES ON GERIATRIC PATIENTS:
• Cardiovascular and respiratory disease: hypertension, myocardial infarction, congestive heart failure.
• Neurological diseases: syncope, stroke.
• Gastrointestinal disease: abdominal emergencies, aneurysm, bowel obstruction, GI bleeding, peritonitis.
• Altered mental status: caused by infection, head injury, stroke, transient ischemic attack (TIA), and hypoglycemia.
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MEDICATIONS
• SAMPLE
• Beta-blockers
• Calcium-channel blockers
• Diuretics
• Blood thinners
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FOUR TRAUMA CONSIDERATIONS THAT ARE UNIQUE TO GERIATRIC PATIENTS
1. Falls: very common MOI (also slips, trips, stumbles, tumbles and eating sh*t)
2. Hip and pelvic fractures: often related to osteoporosis, significant associated bleeding common
3. Traumatic brain injury: concussions much more common, but often symptoms are hidden, so pay attention to LOR
4. Cervical spine injury: fracture patterns in the spine in seniors and especially C1-C2 injuries common, especially associated with head trauma
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EFFECTIVE METHODS FOR COMMUNICATING WITH GERIATRIC
PATIENTS• Speak loudly and clearly
• Relate to them – topical suggestions?
• Avoid demeaning nicknames
• Be understanding, patient, normal
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GENERAL MANAGEMENT OF GERIATRIC PATIENTS
Geriatric patients are typically more challenging to manage than younger patients because:
• Medical histories
• Use of multiple medications
• Age-related physiological changes
• General fragility and occasionally poor attitude
Also:
• delays in treatment may cause their condition to worsen more than would be expected for younger patients. As a result, geriatric patients often require more aggressive treatment to mitigate complications related to poor cardiac output, respiratory distress, blood loss, and/or shock.
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QUESTIONS?