Traumatic Injury Management in Older Adults, Exams of Nursing

Download Traumatic Injury Management in Older Adults and more Exams Nursing in PDF only on Docsity! Maryville NURS 623 Exam 4 What is important to note when a patient has traumatic injury Correct answer- If taking Blood Thinners Define delirium Correct answer- Underlying acute cause, abrupt onset, hours to days, reversible, hallucinations, incoherent speech, confusion Define Dementia Correct answer- Various causes, gradual change with mental status, months to years, progressive to irreversible (speech, memory, mood, judgment) An older adult with delirium would present with what type of behaviors? Correct answer- Agitation and restlessness At the onset of alzheimers, what category of medications should be initiated? Correct answer- Cholinesterase inhibitors what factors contribute to a patient being high risk for falls? Correct answer- History of falls medications vision impairment heart rate/rhythm abnormalities footwear issues home environment gait/mobility issues poor reflexes What is the primary reason people have long term effects after a Stroke Correct answer- living at home and calling PCP instead of 911 leads to prolonged stroke symptoms and long term effects S/S of an Absense Seizure Correct answer- Blank stare (upward rotation of eye) Red Flags of back/neck pain Correct answer- Incontinence Fever Cancers Unexplained wt loss Long term steroids Trauma IV drug abuse Intense local pain No comfy Position Diagnosing of Alzheimer's Correct answer- Impaired ability to learn new info along with a disturbance in language, function, or perception S/S of Alzheimer's Correct answer- *C/O memory problems * ↑ cognitive difficulty * ↑ slow response to cognitive challenge *Word-finding difficulty * ↑ difficulty with simple tasks cardinal features of Parkinson's (TRAP)? Correct answer- *T-remor at rest (or pill rolling) *R-igidity *A-kinesia/Bradykinesia *P-ostural Disturbances What disease is "freezing phenomenon" a characteristic of? Correct answer- Parkinson's A 62 y/o patient calls and c/o of a headache what statement would cause the most concern? Correct answer- It's the worst headache I've ever had the headache from a subdural hematoma is of venous origin, typically resulting from ahead injury that is usually mild and easily forgotten by the patient. Correct answer- Temporal arteritis s/s of temporal (giant cell) arteritis Correct answer- * unilateral HA (temporal artery, orbital) * jaw claudication (pain with chewing) * temporary blindness (Medical Urgency) Polymyalgia rheumatica (pain/stiff muscles shoulders and hips) What age group is at higher risk for temporal arteritis Correct answer- >50 Clinical manifestations of Articular disorders? Correct answer- *characterized by deep or diffuse pain, pain or limited ROM on active and passive movement Was is an important step during examination of an ortho complaint to be able to have a comparative value of both extremities Correct answer- always exam the non-effected side and then effected side for comparison What medications cause a patient to be at risk for developing osteoporosis? Correct answer- • Glucocorticoids • Excessive thyroxine • Long-term phenytoin What populations are at risk for developing osteoporosis? Correct answer- • Age (65+) * medications • Family history • Menopause • Genetics In a patient who is elderly and falls (does not remember the fall), but there is no clear cause of falls, what should your workup center around? Correct answer- syncope associated with Cardiac and neurologic causes If a patient is alert and oriented and refuses to give consent for a procedure, how do you move forward as a provider? Correct answer- Respec their wishes, Discuss risks of NOT having procedure, abort procedure, document refusal In elderly patients, what factors can contribute to loss of appetite and malnourishment? Correct answer- *Diminished taste/smell/vision *dry mouth *poor dentition *chronic illness *meds *pain *depression *loneliness How would you assess for a suspected meniscal tear with a physical exam? Correct answer- McMurray circumduction test. Which test assesses the integrity of the anterior cruciate ligament? Correct answer- Lachman Which test assesses for De Quervain's Tenosynovitis? Correct answer- Finkelstein's Pt education for Carpal Tunnel Syndrome Correct answer- * prevent flexion and extension movements of the wrist. * Thumb Spika 24/7 x 3 weeks *ergonomic Modifications Patients who would like to incorporate non-traditional therapies for treatment of pain- how do you respond? Correct answer- Educate on efficacy of other treatments but ultimately allow them and support them on their own decision as long as the cessation of pharmacological intervention is not detrimental In terms of physical activity in a patient with Osteoporosis, what would encourage Correct answer- *Muscle strengthening activities (Weight Bearing) *Heat followed by ice *Physical therapy In terms of physical activity in a patient with Osteoporosis, what would Discourage Correct answer- strenuous activity Patient education for Osteoporosis Correct answer- * Home environment Safety * Adequate nutrition (Vit D, calcium, Protein) * Vit D & Calcium Supplements *Weight bearing exercises Nodes on (distal) DIP joints secondary to osteoarthritis Correct answer- Heberden's nodes bony nodes at the proximal interphalangeal joints associated with OA Correct answer- Bouchard's nodes Inflammation of the tendon sheath, also called "mommy thumb" Correct answer- DeQuervains Tenosynovitis Use Finkelstein test (tuck thumb, abduct wrist) Type of fracture secondary to systemic disease Correct answer- Pathologic fracture an injury to the bone caused by overuse Correct answer- Stress fracture Common cause of posterior knee pain Correct answer- Bakers cyst Secondary to other process - osteoarthritis #1 A distressing Unilateral, painful electric shock sensation (cranial nerve V) AKA: tic douloureux (unbearable painful twitch). Correct answer- Trigeminal Neuralgia Differentiate between dizziness and vertigo Correct answer- *Dizziness - sensation of unsteady, feeling of movement in the head *Vertigo - feeling of spinning when you are not moving involves vestibular system, most common causes are benign positional vertigo, vestibular neuritis, Meniere disease, Imbalance mild to moderate, able to walk, Latency usually 20 minutes Correct answer- Peripheral Vertigo result from lesions affecting the brainstem and cerebellum, imbalance severe cant walk, Latency usually 5 minutes Correct answer- Central vertigo What is used to treat edema in the labyrinth with Peripheral Vestibular Disease? Correct answer- Diamox What antibiotic would not require adjusting in the elderly? Correct answer- Tobramycin What is considered a normal age-related lab change Correct answer- Increased ESR