Chapter 36- Geriatric Emergencies

The leading cause of death in the geriatric patient is: hypertension. heart disease. altered mental status. arthritis.

heart disease.

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you most suspicious for: emphysema. bronchitis. pneumonia. heart failure.

pneumonia.

Common causes of syncope in older patients include all of the following, except: vasoconstriction. acute hypotension. blood volume loss. venous pooling.

vasoconstriction.

A 75-year-old woman complains of shortness of breath. Which of the following findings should alert the EMT to the possibility of a pulmonary embolism? The patient's abdomen is swollen The patient is prescribed an inhaler Frequent urinary tract infections History of deep venous thrombosis

History of deep venous thrombosis

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: have minor abrasions to the head area. do not have deformities to the skull. Correct! are taking blood-thinning medications. have a history of Alzheimer disease.

Patients who have experienced even minor-appearing head injuries

A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension and takes beta-blockers. Because this patient is probably in shock, what is the most likely explanation for the absence of tachycardia? Failure of the parasympathetic nervous system Deterioration of the cardiac conduction system The effects of her antihypertensive medication Intrathoracic bleeding and cardiac compression

The effects of her antihypertensive medication

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold, and his respirations are rapid and shallow. The EMT should suspect: hypovolemic shock. a subdural hematoma. acute hyperglycemia. a systemic infection.

a systemic infection.

A 70-year-old man complains of a sudden onset of difficulty breathing. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should: suspect severe pneumonia. position the patient supine. apply a cold pack to his leg. administer high-flow oxygen.

administer high-flow oxygen.

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious but diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect: a strangulated bowel. acute appendicitis. myocardial infarction. an aortic aneurysm.

an aortic aneurysm.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should: perform a rapid assessment on all geriatric patients you treat. attempt to differentiate between chronic and acute problems. limit your physical examination to the area of pain or injury. rely exclusively on family members for the medical history.

attempt to differentiate between chronic and acute problems.

Clouding of the lenses of the eyes is called: glaucoma. retinitis. cataracts. conjunctivitis.

cataracts.

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular, and she is conscious and alert. The EMTs should suspect that the patient: has an abdominal aortic aneurysm. experienced a vasovagal response. took too much of her medication. has a gastrointestinal hemorrhage.

experienced a vasovagal response.

Good general communication techniques with the elderly include: using medical terms to ensure patient understanding. having at least two EMTs talk to the patient at a time. frequently asking the patient if he or she understands. explaining procedures while you are performing them.

frequently asking the patient if he or she understands.

An elderly patient might understate or minimize the symptoms of his or her illness because: of decreased perception of pain. the nervous system has deteriorated. of conditions such as dementia. he or she fears hospitalization.

he or she fears hospitalization.

Fractures of the pelvis in older patients often occur as the result of a combination of: osteoporosis and low-energy trauma. increased bone density and car crashes. acetabular separation and severe falls. arthritic joints and high-energy trauma.

osteoporosis and low-energy trauma.

Blood levels of medications might rise in the elderly, sometimes to toxic levels. This is most likely due to: renal insufficiency. intentional overdose. splenic dysfunction. pancreatic failure.

renal insufficiency.

In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because: their red blood cells are destroyed at a faster than normal rate. the body is less able to adapt the BP to rapid postural changes. the aging process results in an overall increase in blood volume. any change in position causes blood to be shunted to the brain.

the body is less able to adapt the BP to rapid postural changes.

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and is normally alert. When you assess this patient, it is important to note that: the patient is experiencing delirious behavior, which suggests a new health problem. because of her age and medical history, you should suspect Alzheimer disease. dementia typically presents as an acute onset of deterioration of cognitive function. her mental status is likely the result of hypoglycemia and you should give her sugar.

the patient is experiencing delirious behavior, which suggests a new health problem.

A "silent" heart attack occurs when: the usual chest pain is not present. a sudden dysrhythmia causes death. sweating is the only presentation. the patient minimizes the chest pain.

the usual chest pain is not present.

Many older victims of physical abuse might make false statements or lie about the origin of their injuries because: they fear retribution from the abuser. most elderly patients have dementia. they do not want to be bothersome. they are protective of the abuser.

they fear retribution from the abuser.