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21 Cards in this Set
- Front
- Back
timed “Up & Go” (TUG) test. The patient is asked to rise from a chair, walk 10 feet, turn around, walk back, and sit down again in the same chair
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The average healthy adult can complete the task in less than 10 seconds; those completing the task in more than 14 seconds are considered to be at high risk for subsequent falls
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The Institute of Medicine recommends a vitamin D intake of
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600 units/d for all men and women aged 51 to 70 years old and 800 units/d for men and women older than 70 years.
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The Mini–Mental State Examination (MMSE) has been the standard screening instrument for cognitive function, with a sensitivity of 76% and specificity of 88% for detecting cognitive impairment.
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Scores of 24 to 25 out of 30 suggest mild impairment, scores of 19 to 24 suggest mild dementia, and scores of 10 to 19 suggest moderate dementia
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Medical conditions associated with depression
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hypothyroidism, hyperthyroidism (“apathetic hyperthyroidism”), chronic pain, Parkinson disease, cancer, diabetes mellitus, vitamin B12 deficiency, alcohol abuse, and use of corticosteroids or interferon
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The most common cause of hearing loss
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presbycusis, or age-related hearing loss. Presbycusis results in high-frequency hearing loss, which typically impairs sound localization and hearing the spoken voice (particularly in noisy environments).
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Among the available screening tests, the whispered voice test,
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(examiner stands 2 feet behind a seated patient and assesses the ability of the patient to repeat a whispered combination of numbers and letters), or a single question about whether the patient has hearing difficulty seem to be nearly as accurate as hand-held audiometry or a detailed hearing loss questionnaire
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The most common causes of visual impairment in older persons
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refractive errors, cataracts, and age-related macular degeneration (AMD)
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The American Academy of Ophthalmology recommends comprehensive eye examinations
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every 1 to 2 years for persons 65 years or older who have no risk factors
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four medications were responsible for two thirds of emergency hospitalizations for adverse drug events.
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Hospitalizations involving three of them (warfarin, insulin, and oral hypoglycemic agents) were related to unintentional overdose. Warfarin was implicated most frequently, accounting for one third of emergency hospitalizations. The fourth class of drugs, oral antiplatelet agents, were implicated by acting alone or by interacting with warfarin
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Urinary incontinence is categorized as
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(1) urge incontinence (loss of urine accompanied by sense of urgency; caused by detrusor overreactivity); (2) stress incontinence (loss of urine with effort, coughing, or sneezing; caused by sphincter incompetence); (3) mixed urge and stress incontinence; and (4) overflow incontinence (caused by outlet obstruction).
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Functional incontinence
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not getting to the toilet quickly enough
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the two most effective behavioral therapies for incontinence
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Pelvic floor muscle training (PFMT, or Kegel exercises) and bladder training/urge suppression techniques are
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considered first-line therapy for patients with stress incontinence and is of likely benefit in patients with mixed urge and stress incontinence.
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pelvic floor muscle traiing
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effective in elderly nursing home residents with functional incontinence.
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Prompted voiding (periodically asking the patient about incontinence, reminding and assisting the patient to go to the toilet, and providing positive reinforcement for continence)
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In patients with stress incontinence for whom PFMT has not been successful, what is another option
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duloxetine a serotonin and norepinephrine reuptake inhibitor
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first line therapy for urge incontinence
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anticholinergic antimuscarinic medications are first-line therapy. Options include oxybutynin, tolterodine, fesoterodine, darifenacin, solifenacin, and trospium.
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Medications that have been found to be ineffective for incontinence
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pseudoephedrine (an α-agonist), oral estrogens (may worsen incontinence), and transdermal and vaginal estrogens
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Stage I ulcers treatment
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can generally be treated with transparent films and do not require debriding
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Stage II ulcers treatment
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occlusive dressing to keep the area moist. Wet-to-dry dressings should be avoided because debridement is usually unnecessary at this stage.
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Stage III and IV ulcers treatment
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generally require surgical or nonsurgical debridement, treatment of wound infection, and appropriate dressings based on the wound environment
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For nonhealing wounds that are stage III or higher
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imaging to rule out underlying osteomyelitis is indicated
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