EMT Chapter 35- Geriatric emergencies

Right sided heart failure

1. Jungular Vein Distention 2. Ascending Dependent Edema 3. Weight Gain 4. Hepatomegaly (Liver Enlargement) occurs when the fluid backs up into the body. Right sided heart failure is often caused by left-sided heart failure

pulmonary embolism

A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow in the veins that lead to the pulmonary Artery

Osteoporosis

A condition in which the body's bones become weak and break easily.

Hyperosmolar hyperglycemic nonketotic syndrome HHNS

A diabetic complication and older people and occurs most often in people with type two diabetes. Unlike diabetic ketoacidosis, the resulting high blood glucose levels does not cause ketosis, instead it leads to osmotic diuresis and a shift of fluid to the intravascular space that results in dehydration

arteriosclerosis

A disease that causes the arteries to thicken, harden, and calcify. contributes to systolic hypertension

Respiratory Syncytial Virus

A highly contagious virus that causes an infection of the upper and lower respiratory system.

Stroke (cerebrovascular accident)

A rapid loss of brain function due to disturbance in the blood supply to the brain that lasts longer than 24 hours.

aneurysm

Abnormal, blood filled dilation of the wall of a blood vessel. Severe blood loss can occur when an aneurysm rupture's. Results in higher systolic blood pressure. Left ventricle becomes thicker and eventually loses elasticity

Atherosclerosis

Accumulation of fat and cholesterol in the arteries. Major complications of atherosclerosis include myocardial infarction and stroke

Peptic Ulcer Disease

An abrasion of the stomach or small intestine.

elder abuse

Any action on the part of an older persons family member, caregiver or other associate a person that takes advantage of the older persons person, for example physical abuse, property, emotional state

deep venous thrombosis

DVT; deep clot in the extremity deep vein thrombosis is a serious concern because it could lead to pulmonary embolism. People with venous stasis usually exhibit edema or swelling of the legs and ankles

Left sided heart failure

Fluid backs up into the lungs. Causes pulmonary edema, shortness of breath, hypoxia, crackles in the lungs

GEMS

Geriatric Environmental, Medical, Social - Assessment

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

Human resource agencies fail to investigate.

Venus stasis

Loss of proper function of the veins, motionless state. Creates problems such as blood clots in these superficial veins and in the deep veins

Which of the following statements regarding suicide in the older patient is correct?

Older patients tend to use more lethal means than younger patients.

Abdominal Aortic Aneurysm

P-Lifting heavy weights straining Q-tearing knife like R- pain on Abdomen but boring through the back S very severe, and hits maximum at onset T Sudden onset tends to develop in people who have a history of hypertension and atherosclerosis

DKA vs. Hyperosmolar hyperglycemic state

Symptoms that overlap our hyperglycemia, polydipsia or thirst, polyuria or urination, polyphagia or hunger, dizziness, confusion, altered mental status and possibly seizures. HHNS typically has a glucose level of 600 or higher, another assessment difference would be that patient with DKA present with Kussmaul respirations are labored deep breathing while HHNS Patience will not treatment should include airway, ventilatory, circulatory support

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

The process of aging is gradual, and the rate at which a person loses functions does not increase with age.

Polypharmacy

The use of many different drugs concurrently in treating a patient, who often has several health problems.

jugular vein distention

Visual bulging of the jugular vein in the neck

Osteoporosis is defined as:

a decrease in bone mass or density

Dementia

a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes

Vancomycin Resistant Enterococcus (VRE)

a strain of enterococcus that cannot be controlled with antibiotics; it is spread through direct and indirect contact

Methicillin-resistant Staphylococcus aureus (MRSA)

a strain of the bacterium Staphylococcus aureus that has become resistant to the antibacterial action of the antibiotic methicillin, a form of penicillin

You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:

a subdural hematoma.

ascites

abnormal accumulation of fluid in the abdomen

orthostatic hypotension (postural hypotension)

abnormally low blood pressure when the person suddenly stands up

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

accuse a caregiver of physical abuse.

presbycusis

age related hearing loss

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

an aortic aneurysm

decubitus ulcer

bed sore

melena

black, tarry stools; feces containing digested blood

Syncope in the older patient is:

caused by an interruption of blood flow to the brain.

As a person ages, the heart may enlarge as a result of:

chronically increased after load

Cateracts

clouding of the lens

hemoptysis

coughing up blood

advanced directive (living will)

details the conditions under which life support measures should be used

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. You should:

determine the patient's baseline mental status.

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way but did not move her. When you gently tap the patient, she does not respond. You should:

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.

Kyphosis

excessive outward curvature of the spine, causing hunching of the back.

syncope

fainting or sudden loss of consciousness caused by lack of blood supply to the cerebrum

Good general communication techniques with the elderly include:

frequently asking the patient if he or she understands

The purpose of the GEMS diamond is to:

help EMS personnel remember what is different about elderly patients.

pneumonia

inflammation of the lungs caused primarily by bacteria, viruses, and chemical irritants

urinary tract infection (UTI)

invasion of pathogenic organisms (commonly bacteria) in the urinary tract, especially the urethra and bladder; symptoms include dysuria, urinary frequency, and malaise

In contrast to delirium, dementia:

is usually considered irreversible.

delirium

mental disorder marked by confusion; uncontrolled excitement; ADJ. delirious

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

pneumonia

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called:

polypharmacy

When performing your secondary assessment on an older patient who has been injured, it is important to:

recall that it will take a less severe mechanism of injury to cause significant injuries.

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:

she became dizzy or fainted before falling.

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

the injury may have been preceded by a medical condition.

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:

the patient develops cardiac arrest