EMS Chapter 35 Geriatric Emergencies
The purpose of the GEMS diamond is to:
help EMS personnel remember what is different about elderly patients.
A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:
pneumonia.
When in doubt about the actions you should take when presented with advance directives, your best course of action is to?
take appropriate resuscitative action
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.
Atherosclerotic disease affects more than___ % of people older than 65 years.
60
In contrast to delirium, dementia:
is usually considered irreversible.
The rate of filtration by the kidneys decreases an average of____% between the ages of 50 and 90 years
50%
Of the total number of hypothermia deaths for all ages, what percentage involve elderly adults?
About half
The aging process starts in the late 20s and early 30s. At which of the following ages is the rate of aging the greatest? 35 years 85 years 55 years
All are the same
The largest component of the urinary system is the kidneys. Age-related changes in the kidneys changes in the kidneys include? a reduction in renal function a reduction in renal blood flow tubule degeneration
All of these answers are correct
Which of the following can predispose older people to being struck by a vehicle? Changes in hearing Changes in posture Changes in vision
All of these answers are correct
Why are older people more likely to experience burns? Inattention Compromised neurologic status Altered mental status
All of these answers are correct
Why is the risk of serious injury or death more common in elderly patients who experience trauma? They have limited physiologic reserves they have slower homeostatic compensatory mechanisms They often have existing medical issues
All of these answers are correct
Studies indicate that which of the following contributes to the onset of significant depression? Isolation Chronic medical conditions Substance abuse
All of these answers are correct.
A "living will" is also referred at as?
An advance directive
____ is an abnormal, blood-filled dilation of the wall of a blood vessels that is commonly seen in geriatric patients.
An aneurysm
Which of the following is NOT a leading cause of death in patients older than 65 years of age?
Asthma
Which of the following assessment findings could be unreliable in the geriatric patient?
Capillary refill
Age-related changes in respiratory function in geriatric patients can cause lower pulse oximetry readings. Which of the following receptors is responsible for monitoring oxygen and carbon dioxide levels in the blood?
Chemoreceptors
Pressure ulcers or bedsores are also known as?
Decubitis ulcers
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is called?
Dementia
What is widespread in the geriatric population and contributes to nutritional and digestive problems?
Dental loss
Which of the following is the LEAST common cause of death in patients older than 65 years of age?
Drug overdose
The "E" of the GEMS diamond stands for?
Environmental assessment
What is the leading cause of injury in geriatric patients?
Falls
Many older patients are unable to develop?
Fever
Patients who have a fever and right upper quadrant pain that radiates to the shoulder may have?
Gallbladder disease
Thyroxine is a thyroid hormone that affects the body's metabolism, temperature, growth, and_______
Heart rate
The endocrine system uses___ to control physiologic processes.
Hormones
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.
What is a big issue that is seen in patients who take warfarin or heparin/
Inability to clot normally
Which of the following statements about delirium is NOT true?
Long-term memories fade
Tubule degeneration means?
Loss of functioning nephron units.
Which of the following infections is primarily spread by broken skin-to-skin contact and by touching objects that have the bacteria on them
MRSA
Which of the following is NOT a physiologic factor for an older patient falling/
Medication interaction
Which of the following statements regarding suicide in the older patient is correct?
Older patients tend to use more lethal means than younger patients.
A drop in blood pressure with a change in position is called?
Orthostatic hypotension
Which of the following conditions makes the elderly patient prone to fractures from even minor trauma?
Osteoporosis
You are called to the home of a 84-year-old who shows signs of poor diet and malnutrition. If he was abused, this would be classified as what type of abuse?
Physical
To obtain a SAMPLE history, if possible, the EMT should check the patient's?
Pill sorter
You respond to a suicide attempt by a 78-year-old male. Which of the following is not a risk factor for suicide in this population?
Preparing for the birth of a grandchild
As a person ages, the heart may enlarge as a result of:
chronically increased afterload.
Assessments of the geriatric population are challenging due to communication issues, hearing and visual deficits, and complicated medical history. What other factors can alter the EMT's assessment findings/
Previous injuries or illnesses not associated with the current problem
Which of the following infections is typically seen in children?
RSV
What symptoms differentiates a pulmonary embolism from an infection like pneumonia?
Shortness of breath
Which of the following is NOT an activity of daily living that is assessed under the social assessment of the GEMS diamond?
Sleeping
According to the GEMS diamond, a person's activities of daily living are evaluated during the?
Social assessment
What can change an older patient's baseline LOC and neurologic status?
Stroke
A geriatric patient who has a history of long-term alcohol abuse or who is taking blood thinners has a greater chance of sustaining which of the following injuries during a fall?
Subdural hematoma
Which of the following choices is NOT a common stereotype of older patients?
The patient prefers to be left alone
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.
What is ageism?
The stereotyping of older peple
When speaking to an older patient, which of the following should you do?
Try to talk in a lower tone.
With age, the immune response becomes less effective at fighting infection. Besides pneumonia, which other type of infection is common in bedridden patients?
Urinary tract infections
Osteoporosis is defined as:
a decrease in bone mass and density.
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.
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.
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.
Syncope in the older patient is:
caused by an interruption of blood flow to the brain.
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.
Good general communication techniques with the elderly include:
frequently asking the patient if he or she understands.
Polypharmacy is a term used to describe patient who takes?
multiple medications
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.
In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:
the patient develops cardiac arrest.
