1
NR I601 IMidterm IReview IWeeks I1-4 INotes:
CGA
• Purpose: IPhysical Ihealth Iis Ir/t Ipsychosocial Ifunctional Iability Iand Isafe Ienvironment.
o helps Iin Idx Iconditions Iand Iimprove Ioutcomes
o identify Ipotential Ipreventable Iconditions
o patient-centered Icare
• Most Ibeneficial Ifor Ithe Ivulnerable, Iolder Iadults Ibut Ishould Ibe Icompleted Ifor Iall Iolder Iadults.
• Domains: IPhysical Ihealth, Ifunctional Ihealth, Ipsychological Ihealth, Isocioenvironmental Isupport I& Iquality
Iof Ilife Imeasures.
o Physical Ihealth
▪ Medical Ihistory, IPE I(abnormals-differentials), IROS, Idiagnostics,
▪ Nutritional Iassessment-
• Assessment Itool: Imini Inutritional Iassessment Iinstrument
• Food Idiary
• Phys Iassessment Iwith Imeasurements
• Biochemical Imarkers
▪ Medication Ireview I(Beers Icriteria)
▪ Functional Ihealth- Igoal Iis Ito Iimprove Ifunction Iand Iprevent Idecline
▪ ADLs- IKatz IADLs Iscale
▪ IADLs- ILawton I& IBrody IScale Ifor IIADLs
▪ Ask Ipatients Ito Idemonstrate Ior Iexplain Ihow Ithey Icomplete Iadls
▪ Psychological Ihealth I(cognition Iand Imood)
▪ DSM-5 I(delirium Ivs Icognitive Iimpairment)
▪ MMSE
▪ CDT, Iword Irecall
▪ Mini-Cog
▪ SLUMS
▪ Confusion IAssessment IMethod I(CAM)
▪ Geriatric IDepression IScale- IPHQ-9
▪ HOPE, IFICA, ISPIRIT
▪ Socioenvironmental
▪ Social Inetwork/support
▪ Social Iisolation Iassessment I(lubben Isocial Inetwork Iscale)
▪ Living Isituation I(housing, Itransportation
▪ Environmental I( Iutilities, Iheat, Iwater)
▪ Economic I(income, Iassets, Iafford Imeds Iand Ihealthcare)
▪ Quality Iof Ilife
Imedical Ioutcomes Istudy
▪ Physical/social Iconditions
▪ Personal Iresources
▪ Preference Iof Icare I(advance Idirective)
Age Irelated Ichanges: IPhysiological
▪ Skin-
▪ decrease Idermal Ithickness/elasticity I= ISBD Irisk
,2
▪ Decrease Ivascularity= Iless Isweat, Iodor, Iheat Iloss= Ialtered Itemp Iregulation, Irisk Iof Iheat
Istroke, Ichange Iin Ifluid Ineeds
▪ Resp:
decreased Ivital Icapacity I= Idecreased Igas Iexchange Iprocesses
▪ Cilia Iatrophy=increase Iinfection Irisk
▪ Decreased Iresp Imuscle Istrength=risk Ifor Iatelectasis
o CVD:
▪ fibrosis Ito Iheart Ivalves= Ireduced ISV, ICO= Idecreased Istress Iresponses
▪ Fibroclastic ISA Inode Ithickens= Islower IHR=increased Iarrhythmias
▪ Decreased Ibaroreceptors Isensitivity=decreased Isense Ito Ibp Ichanges I= Imore Ifalls, Iinjuries
o GI:
o liver Ismaller=decreased Istorage
▪ Decreased Imuscle Itone=altered Imotility
▪ Decreased Imetabolism=need Ifor Iless Icalories
Lab Iresults: Inormal Ilevels Ivary Iwith Iage, Isex, Irace I(don’t Iassume Iabn Ilab Iresult Iis Ipart Iof Iaging Iprocesses)
o Decreased ICrCl, IGFR: Inephrotoxic Idrugs
▪ Digoxin
▪ H2 Iblockers
▪ Lithium
▪ Water-soluble Iatb- Iceftriaxone, Ipiperacillin, Igentamycin, Ivanco
▪ Review Ipage I1285 Itable(Dunphy)
Atypical IPresentations
Acute Iabd Iillness Vague Isx, Iacute Iconfusion, Iconstipation,
mild Idiscomfort, Itachypnea,
Depression Anorexia, Ivague Iabd Icramps, Inew
Iconstipation, Iagitation, Iinsomnia, Ilack Iof
sadness
Hyperthyroidism Apathetic Ithyrotoxicosis- Ifatigue, Iweak,
Iwt Iloss I(not Igain), Ipalpitations,
tachycardia, Inew Iafib Ionset, I HF Iif Iundx
Hypothyroidism Confusion, Iagitation, Icardiac
Imanifestations, Inew Ianorexia, Iwt Iloss,
arthralgia
Malignancy New/worse Iback Ipain I2nd Ito Imets Iform
Islow Igrowing Ibreast Imasses Ior Isilent
Ibowel Imasses
Jaundice-GB Idisease
MI No Ichest Ipain, Ifatigue, Inausea,
Idecreased Ifunction Iand Icognition,
Iclassic: Idyspnea, Iepigastric Ipain,
Iweakness, Inv, Ihx Iof Icardiac Ifailure
Higher Iin Ifemales: Inon-Q-wave IMI
Infectious Idisease Low Igrade Ifever Ior Inone, Imalaise, Isepsis:
Iw/o Ileukocytosis Ior Ifever
Falls, Inew Iconfusion, Ior IAMS
, 3
Decreased Ifunction, Ianorexia
Peptic Iulcer Dyspepsia, Iearly Isatiety
IPainless, Ibloodless Istool
INew Iconfusion
Tachycardia, Ihypotension
Pna Mild Icough Iwithout Icopious Isputum, Ino
Ifever Ior Imild, Iconfusion
Tachycardia, Itachypnea, Ianorexia,
malaise
Pulmonary Iedema Lack Iof Iparoxysmal Inocturnal Idyspnea,
IInsidious Ionset Iof Idecreased Ifunction,
appetite, Ifluids, Iconfusion
TB Hepatosplenamegaly, Iabn Iliver Itests,
anemia
UTI No Ior Imild Ifever, Iworse Icognition,
dizziness, Ianorexia, Ifatigue, Iweakness
Geriatric ISyndromes- Imultifactorial: Isx Iseen Iin Ielderly Ithat Iare Ir/t Icombo Iof Idiseases
o SPICES I(assessment Itool)
o Sleep Idisturbance
o Problems Ieating Ior Ifeeding
o Incontinence
o Confusion
o Evidence Iof Ifalls
o SBD
Categories Iof IAging
o 65-74 = Iyoung Iold
o I 75-84 = Iold
o 85-older = Ioldest
Causes Iof Idelirium
o Drugs
o Electrolyte Iimbalance
o Lack Iof Idrugs I(w/d, Iuncontrolled Ipain)
o Infection
o Reduced Isensory Iinput I(vision/hearing)
o Intracranial I(CVA, ISDH)
o Urine Iretention, Iimpaction
o Myocardial/pulmonary Iconditions
Exercise Iin IOlder IAdults- Irecommended Imoderate- Iintensity Iaerobics I30min Ix5 Idays Ia Iweek, Ior Ivigorous
Iintensity Iaerobic I20 Imin Ix I3 Idays Ia Iweek( Ican Ibe Iintermittent Ithroughout Ithe Iday)
o Barriers Ito Iexercise
NR I601 IMidterm IReview IWeeks I1-4 INotes:
CGA
• Purpose: IPhysical Ihealth Iis Ir/t Ipsychosocial Ifunctional Iability Iand Isafe Ienvironment.
o helps Iin Idx Iconditions Iand Iimprove Ioutcomes
o identify Ipotential Ipreventable Iconditions
o patient-centered Icare
• Most Ibeneficial Ifor Ithe Ivulnerable, Iolder Iadults Ibut Ishould Ibe Icompleted Ifor Iall Iolder Iadults.
• Domains: IPhysical Ihealth, Ifunctional Ihealth, Ipsychological Ihealth, Isocioenvironmental Isupport I& Iquality
Iof Ilife Imeasures.
o Physical Ihealth
▪ Medical Ihistory, IPE I(abnormals-differentials), IROS, Idiagnostics,
▪ Nutritional Iassessment-
• Assessment Itool: Imini Inutritional Iassessment Iinstrument
• Food Idiary
• Phys Iassessment Iwith Imeasurements
• Biochemical Imarkers
▪ Medication Ireview I(Beers Icriteria)
▪ Functional Ihealth- Igoal Iis Ito Iimprove Ifunction Iand Iprevent Idecline
▪ ADLs- IKatz IADLs Iscale
▪ IADLs- ILawton I& IBrody IScale Ifor IIADLs
▪ Ask Ipatients Ito Idemonstrate Ior Iexplain Ihow Ithey Icomplete Iadls
▪ Psychological Ihealth I(cognition Iand Imood)
▪ DSM-5 I(delirium Ivs Icognitive Iimpairment)
▪ MMSE
▪ CDT, Iword Irecall
▪ Mini-Cog
▪ SLUMS
▪ Confusion IAssessment IMethod I(CAM)
▪ Geriatric IDepression IScale- IPHQ-9
▪ HOPE, IFICA, ISPIRIT
▪ Socioenvironmental
▪ Social Inetwork/support
▪ Social Iisolation Iassessment I(lubben Isocial Inetwork Iscale)
▪ Living Isituation I(housing, Itransportation
▪ Environmental I( Iutilities, Iheat, Iwater)
▪ Economic I(income, Iassets, Iafford Imeds Iand Ihealthcare)
▪ Quality Iof Ilife
Imedical Ioutcomes Istudy
▪ Physical/social Iconditions
▪ Personal Iresources
▪ Preference Iof Icare I(advance Idirective)
Age Irelated Ichanges: IPhysiological
▪ Skin-
▪ decrease Idermal Ithickness/elasticity I= ISBD Irisk
,2
▪ Decrease Ivascularity= Iless Isweat, Iodor, Iheat Iloss= Ialtered Itemp Iregulation, Irisk Iof Iheat
Istroke, Ichange Iin Ifluid Ineeds
▪ Resp:
decreased Ivital Icapacity I= Idecreased Igas Iexchange Iprocesses
▪ Cilia Iatrophy=increase Iinfection Irisk
▪ Decreased Iresp Imuscle Istrength=risk Ifor Iatelectasis
o CVD:
▪ fibrosis Ito Iheart Ivalves= Ireduced ISV, ICO= Idecreased Istress Iresponses
▪ Fibroclastic ISA Inode Ithickens= Islower IHR=increased Iarrhythmias
▪ Decreased Ibaroreceptors Isensitivity=decreased Isense Ito Ibp Ichanges I= Imore Ifalls, Iinjuries
o GI:
o liver Ismaller=decreased Istorage
▪ Decreased Imuscle Itone=altered Imotility
▪ Decreased Imetabolism=need Ifor Iless Icalories
Lab Iresults: Inormal Ilevels Ivary Iwith Iage, Isex, Irace I(don’t Iassume Iabn Ilab Iresult Iis Ipart Iof Iaging Iprocesses)
o Decreased ICrCl, IGFR: Inephrotoxic Idrugs
▪ Digoxin
▪ H2 Iblockers
▪ Lithium
▪ Water-soluble Iatb- Iceftriaxone, Ipiperacillin, Igentamycin, Ivanco
▪ Review Ipage I1285 Itable(Dunphy)
Atypical IPresentations
Acute Iabd Iillness Vague Isx, Iacute Iconfusion, Iconstipation,
mild Idiscomfort, Itachypnea,
Depression Anorexia, Ivague Iabd Icramps, Inew
Iconstipation, Iagitation, Iinsomnia, Ilack Iof
sadness
Hyperthyroidism Apathetic Ithyrotoxicosis- Ifatigue, Iweak,
Iwt Iloss I(not Igain), Ipalpitations,
tachycardia, Inew Iafib Ionset, I HF Iif Iundx
Hypothyroidism Confusion, Iagitation, Icardiac
Imanifestations, Inew Ianorexia, Iwt Iloss,
arthralgia
Malignancy New/worse Iback Ipain I2nd Ito Imets Iform
Islow Igrowing Ibreast Imasses Ior Isilent
Ibowel Imasses
Jaundice-GB Idisease
MI No Ichest Ipain, Ifatigue, Inausea,
Idecreased Ifunction Iand Icognition,
Iclassic: Idyspnea, Iepigastric Ipain,
Iweakness, Inv, Ihx Iof Icardiac Ifailure
Higher Iin Ifemales: Inon-Q-wave IMI
Infectious Idisease Low Igrade Ifever Ior Inone, Imalaise, Isepsis:
Iw/o Ileukocytosis Ior Ifever
Falls, Inew Iconfusion, Ior IAMS
, 3
Decreased Ifunction, Ianorexia
Peptic Iulcer Dyspepsia, Iearly Isatiety
IPainless, Ibloodless Istool
INew Iconfusion
Tachycardia, Ihypotension
Pna Mild Icough Iwithout Icopious Isputum, Ino
Ifever Ior Imild, Iconfusion
Tachycardia, Itachypnea, Ianorexia,
malaise
Pulmonary Iedema Lack Iof Iparoxysmal Inocturnal Idyspnea,
IInsidious Ionset Iof Idecreased Ifunction,
appetite, Ifluids, Iconfusion
TB Hepatosplenamegaly, Iabn Iliver Itests,
anemia
UTI No Ior Imild Ifever, Iworse Icognition,
dizziness, Ianorexia, Ifatigue, Iweakness
Geriatric ISyndromes- Imultifactorial: Isx Iseen Iin Ielderly Ithat Iare Ir/t Icombo Iof Idiseases
o SPICES I(assessment Itool)
o Sleep Idisturbance
o Problems Ieating Ior Ifeeding
o Incontinence
o Confusion
o Evidence Iof Ifalls
o SBD
Categories Iof IAging
o 65-74 = Iyoung Iold
o I 75-84 = Iold
o 85-older = Ioldest
Causes Iof Idelirium
o Drugs
o Electrolyte Iimbalance
o Lack Iof Idrugs I(w/d, Iuncontrolled Ipain)
o Infection
o Reduced Isensory Iinput I(vision/hearing)
o Intracranial I(CVA, ISDH)
o Urine Iretention, Iimpaction
o Myocardial/pulmonary Iconditions
Exercise Iin IOlder IAdults- Irecommended Imoderate- Iintensity Iaerobics I30min Ix5 Idays Ia Iweek, Ior Ivigorous
Iintensity Iaerobic I20 Imin Ix I3 Idays Ia Iweek( Ican Ibe Iintermittent Ithroughout Ithe Iday)
o Barriers Ito Iexercise
