Chapter 11



Handout 24-1 Student’s Name ________________________Chapter 24: Special Considerations for the Geriatric Patient--QuizCircle the letter of the best answer to each multiple-choice question.1.Which of the following is a common change due to aging?a.More efficient digestionb.Lower blood pressurec.Increased lung capacityd.Weakened bone structure2. Depression is ________ in the elderly.a.often monc.untreatabled.rare3.In general, the force needed to cause injury in the elderly is ________ the force needed to cause injury in younger people.a.less thanb.the same asc.more thand.unable to be compared to4.Burns, falls, and vehicle crashes are the most ________ mechanisms of injury in the elderly.a.rareb.mond.often imaginary5. Because sensitivity to pain is ________ in the elderly, suspect a serious illness or injury in any elderly patient’s complaint of pain.a.nonexistentb.increasedc.unchangingd.decreased6.Fainting or near-fainting is ________ in the elderly.a.often monc.untreatabled.rare7. Which of the following statements about assessment of an elderly patient is true?a.Address the patient as “dear” b.Speak to the patient, not a family member, when possiblec.Take a position above the patient’s eye leveld.Ask, “What’s wrong?” in order to get a concise response8. The Emergency Medical Responder physical exam of an elderly patient ________ the physical exam for a younger adult.a.is the same asb.requires more documentation thanc.is more thorough thand.is less thorough than9. Which of the following statements about the assessment of an elderly patient is NOT true?a.Poorly functioning heating devices may create problems b.Curvature of the spine makes it easy to position the patient’s headc.Properly fitted false teeth can stay in place for artificial ventilationd.A patient’s lack of self-care should be noted10.A beta-blocker, a type of medication that the elderly frequently take, is meant to:a.increase blood pressure. b.increase heart rate.c.decrease heart rate.d.decrease respiratory rate. ?2012 by Pearson Education, Inc.EMR 9Handout 24-2 Student’s Name ________________________The Call: An Elder’s EmergencyRead the scenario. Then, in the space provided, answer the questions that follow.You have responded to an elderly patient who is having difficulty breathing. When you arrive, you stop at the doorway for a moment to notice the condition of the apartment. It appears to be neat and well cared for. The patient is a 67-year-old male who is sitting upright in a chair. He has rapid respirations and wheezing. You ask why he has called EMS; he responds in short sentences, telling you that he is having trouble catching his breath and that he may be having an asthma attack. Your partner tells the patient that she wants to give him oxygen. While she is setting it up, you perform an initial assessment.1. What is your priority for this patient’s care? Explain. 2.Why should you note the condition of the apartment?3.While your partner takes the patient’s vital signs, you gather a SAMPLE history. While doing so, you ask him if he is taking any medications. He responds, “Can you speak, up, please? I don’t hear so well.” What can you do to solve this problem?4. When you ask the patient what medications he takes, he says, “I don’t remember.” What can you do to find out this information??2012 by Pearson Education, Inc.EMR 9Handout 24-3 Student’s Name ________________________Chapter 24 ReviewIn the space provided, write the word or words that best complete each sentence. 1. Common medical complaints in the elderly include chest _____________________, _____________________ breathing, fainting, and _____________________ mental status.2. Fainting in the elderly may be due to a variety of causes, including the _______________ _______________ of medication, heart problems, internal _____________________, or changes in the blood vessels that supply the brain with _____________________.3. The most common mechanisms of injury in the elderly are _______________, _____________________, and vehicle _____________________.4. An older adult with a substance-abuse problem, mental illness, or a condition such as Alzheimer’s disease may become _____________________. Be sure to keep safety a priority at all times.5. During assessment, take a position at the elderly patient’s _______________ level. It is less intimidating than towering over him. You also might offer a handshake to establish rapport and at the same time note his skin _____________________, his ability to _____________________, and his ability to _______________ _______________.6. For your general impression, be sure to note whether or not the elderly patient appears to be _____________________ , well groomed, and cared for.7. Keep in mind that an elderly patient who has had a stroke may have difficulty _____________________, _____________________, or clearing the airway of secretions.8. Correct positioning of the _______________ and _______________ for airway care may be a challenge due to a _____________________ of the spine that occurs with aging.9. For artificial ventilation of an elderly patient, it may be easier to form a mask seal if you leave properly fitting _____________________ in place.10. Bleeding control in the elderly patient may be more __________________ if the patient is taking ___________________ or other blood-thinning medications.?2012 by Pearson Education, Inc. EMR 9Handout 24-4 Student’s Name _________________________True or FalseIndicate if each of the following statements is true or false by writing T or F in the space provided.________ 1. Perspiration decreases in older adults, which can contribute to heat-related emergencies.________ 2.The ability of the heart to contract with force increases with age.________ 3.If an elderly patient’s mental status decreases in the level of responsiveness, it may be the first indication of shock.________ 4.Elderly women are less susceptible to infections of the urinary tract than are younger women.________ 5.Fever will always be present as a sign of infection in elderly patients.________ 6.Clues that the Emergency Medical Responder may observe in a depressed elderly patient include poor hygiene, poor eating habits, and a disorderly living situation. ________ 7.The Emergency Medical Responder should confront the suspected abuser of an elderly person. ________ 8.Increased sensitivity to pain is a function of the aging process.________ 9.When approaching an elderly patient, focus on her rather than on a caregiver or family member.________ 10.Bleeding control in the elderly may be more difficult if the patient is taking aspirin or other blood-thinning medications. ?2012 by Pearson Education, Inc.EMR 9Answer Key Handout 24-1: Chapter 24 Quiz1.d2.b3.a4.c5.d6.b7.b8.a9.b10.cHandout 24-2: The Call: An Elder’s Emergency1.Your priority is the patient’s airway. You should ensure an open airway and then assess the need for ventilator assistance and oxygen therapy.2.The condition of the apartment could provide clues to the patient’s ability to take care of himself. This observation can give hospital personnel clues to the patient’s physical and mental conditions.3.You may need to speak a bit louder than normal, but don’t shout. It may help the patient if he can see your mouth while you speak, so position yourself in front of him. Also, since higher-pitched tones may be less easily heard by an elderly patient, someone with a deep voice may be more successful at communicating. You might also try writing your questions.4.Ask the patient where he keeps his medications; then read the labels yourself. Make note of each one and include the information in your handoff report. Handout 24-3: Chapter 24 Reviewpain, difficulty, alteredside effects, bleeding, oxygenfalls, burns, collisions (crashes)violenteye, condition (temperature), move, follow directions (respond appropriately)cleanchewing, swallowinghead, neck, curvaturedentures (false teeth)difficult, aspirinHandout 24-4: True or FalseTFTFFTFFTT ?2012 by Pearson Education, Inc.EMR 9 ................
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