Module 3: Geriatrics
Module Authors
Patty Tompkins, BSN, RN-CS, C-ANP, C-HHC
Adult Nurse Practitioner
The Tompkins Group, Inc., Vista, CA
Freddi Segal-Gidan, PA, PhD
Assistant Professor, Departments of Family Medicine and Neurology
USC School of Medicine, Los Angeles, CA
Gerontologist, Physician Assistant
Rancho Los Amigos Medical Center, Downey, CA
Tina M. Meyer, PA-C
Clinical Consultant and Adjunct Professor
Western University of Health Sciences, Pomona, CA
Review Concepts
Review Concept 1: General Considerations with Geriatric Patients
By the end of this Review Concept you should be able to:
- Describe four principles of physiology in aging
- State six principles of geriatric medicine
- Identify seven characteristics of the elderly at risk for functional deterioration and illness.
- List the Five I's that describe geriatric dysfunction syndromes
- Describe seven methods of improving the outcome of the screening history of a geriatric patient
- State the components of a routine screening physical examination of a geriatric patient
- Identify screening tests routinely given to geriatric patients and the three expected variations from younger patients
Review Concept 2: Health Promotion, Disease Prevention, and Ethical Considerations with Geriatric Patients
By the end of this Review Concept you should be able to:
- State four goals of care for geriatric patients that are different from the goals for younger patients
- Describe health promotion and disease prevention interventions for geriatric patients including routine immunizations, lifestyle modifications and safety precautions.
- State three factors necessary for an individual to give informed consent.
- Differentiate between a Living Will and a Durable Power of Attorney for Health Care.
Review Concept 3: Intellectual Impairment Syndromes that Affect the Elderly
By the end of this Review Concept you should be able to differentiate dementia, delirium, and depression in terms of:
- Their clinical presentation, clinical course, and prognosis
- Underlying diseases and other etiologic factors
- Recommended procedures for diagnostic workup and clinical management
Review Concept 4: 04 Incontinence, Instability, and Iatrogenic Drug Problems
By the end of this Review Concept you should be able to:
- List five components of the work of incontinence
- Differentiate acute from persistent urinary incontinence in terms of epidemiology and etiology.
- State the four most common causes of acute reversible incontinence
- Differentiate stress, urge, overflow, and functional persistent incontinence in terms of presentation and treatment
- List and discuss three underlying causes of instability/falls in the elderly
- List and discuss the areas for evaluation of the person who has fallen
- Discuss the multidisciplinary management of the person who has fallen
- Discuss three reasons why geriatric patients are more likely to have an adverse drug reaction
- Describe the most common presentations of adverse drug reactions in the elderly
- Discuss five types of drug-drug interactions
- List the precautions to take when prescribing pharmacological therapy for a geriatric patient
Review Concept 5: Osteoporosis, Pressure Ulcers, Elder Abuse, and Death and Dying
By the end of this Review Concept you should be able to:
- Define osteoporosis and list 7-10 risk factors
- Describe two sequelae of untreated osteoporosis
- Describe management of osteoporosis with diet, exercise, HRT, and non-HRT drug therapy
- Define pressure ulcer and list three risk factors
- List identifying characteristics of Stage 1, 2, 3, and 4 pressure ulcers
- Outline recommendations for pressure ulcer management
- Define elder abuse and the responsibility of health care providers
- Identify four types of elder abuse
- List six risk factors for elder abuse
- Define terminal care
- Describe the rules of pain management
- Describe the WHO step-wise approach to pain management
- Describe the goals and settings for hospice care
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