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NURS |! 5432 |! GERIATRIC |!
PATIENT|! AND |! GI |! DISORDERS |! IN |!
PRIMARY |! CARE |! QUESTIONS |!
WITH |! CORRECT |! ANSWERS |! | |!
NEWEST |!
What |! is |! the |! mini |! mental |! evaluation? |! - |! correct |! answersA |! tool |! that |! can |! be |! used |! to |! thoroughly |! assess |! mental |! status. What |! areas |! does |! the |! mini |! mental |! exam |! assess? |! - |! correct |! answersIt |! test |! five |! areas |! of |! cognitive |! function: |! orientation, |! registration, |! attention |! and |! calculation, |! recall, |! and |! language. What |! is |! the |! Montreal |! cognition? |! - |! correct |! answersA |! rapid |! screening |! assessment |! used |! for |! mild |! cognitive |! dysfunction. What |! does |! the |! Montreal |! cognition |! test |! for? |! - |! correct |! answersAttention |! and |! concentration, |! executive |! functions, |! memory, |! language, |! visuoconstructional |! skills, |! conceptual |! thinking, |! calculations, |! and |! orientation. What |! is |! Delirium? |! - |! correct |! answersA |! sudden |! onset |! of |! clouded |! sensorium |! that |! can |! occur |! at |! any |! age |! associated |! with |! a |! physical |! stressor. What |! are |! the |! causes |! for |! Delirium? |! - |! correct |! answersToxins, |! alcohol/drug |!
abuse, |! trauma, |! Impactions |! in |! the |! elderly, |! poor |! nutrition, |! electrolyte |! imbalances, |! anesthesia |! and |! septicemia. What |! is |! the |! management |! of |! Delirium? |! - |! correct |! answersTreat |! the |! underlying |! cause |! What |! is |! Dementia? |! - |! correct |! answersA |! chronic |! progressive |! cognitive |! impairment What |! are |! the |! causes |! of |! Dementia? |! - |! correct |! answersAtherosclerosis, |! neurotransmitter |! deficits, |! cortical |! atrophy, |! ventricular |! dilation, |! loss |! of |! brain |! cells, |! possible |! viral |! causes, |! Alzheimer's |! disease, |! Lewy |! body |! dementia What |! are |! the |! first |! line |! treatment |! drugs |! used |! to |! treat |! Alzheimer's? |! - |! correct |! answersBest |! in |! mild |! to |! moderate |! disease; |! may |! be |! effective |! in |! Lewy |! body |! dementia. Donepezil |! (Aricept): |! Start |! at |! 5 |! mg/day |! PO; |! may |! increase |! to |! 10 |! mg/day |! after |! 1 |! month, |! may |! increase |! to |! 23 |! mg/day |! after |! 3 |! months |! if |! needed. |! Orally |! disintegrating |! tablets; |! generic |! available. |! Caution |! with digoxin |! or |! β-blockers |! (Donepezil |! may |! prolong |! PR |! interval.) Rivastigmine |! (Exelon): |! Start |! at |! 1.5 |! mg |! PO |! BID |! and |! increase |! by |! 1.5 |! mg |! BID |! every |! 2 |! weeks; |! maintenance |! 6 |! to |! 12 |! mg/day |! total |! Capsule, |!
What |! type |! of |! inhibitors |! are |! used |! to |! treat |! Alzheimer's |! - |! correct |! answersAcetylcholinesterase |! Inhibitors |! (ChEIs) What |! are |! the |! side |! effects |! of |! Alzheimer's |! drugs? |! - |! correct |! answersAll |! have |! potential |! for |! GI |! and |! other |! side |! effects, |! such |! as |! bradycardia/syncope. Neuropsychiatric |! symptoms: |! assessment |! and |! treatment |! for |! delirium, |! environmental |! modification, |! sleep |! hygiene, |! exercise, |! cognitive |! interventions, |! hearing/vision |! aids, |! and |! if |! necessary |! for |! moderate |! to |! severe |! symptoms, |! consider |! second-line |! care What |! are |! the |! second |! line |! drugs |! used |! to |! treat |! Alzheimer's? |! - |! correct |! answersFor |! moderate |! to |! severe |! depression: |! selective |! serotonin |! reuptake |! inhibitors |! (SSRIs) |! preferred Insomnia: |! Medications |! have |! little |! efficacy |! for |! sleep |! in |! AD. Avoid |! diphenhydramine |! and |! antihistamines |! in |! elderly |! due |! to |! negative |! side |! effects. If |! using |! low-dose |! risperidone, |! trazodone, |! or |! sleep |! aid |! (e.g., |! zolpidem), |! use
|! caution |! and |! lowest |! dose |! possible |! in |! elderly. Moderate |! agitation, |! anxiety/restlessness: |! first-line |! care; |! may |! consider |! low- dose |! risperidone |! or |! SSRIs |! (citalopram) Risperidone |! at |! low |! dose |! for |! severe |! psychosis |! and |! safety |! concern; |! treatment |! not |! usually |! required Precautions Avoid |! anticholinergic |! drugs |! when |! possible. Benzodiazepines |! may |! produce |! paradoxical |! excitation |! or |! daytime |! drowsiness. |! Triazolam |! (Halcion) |! can |! produce |! confusion, |! memory |! loss, |! and |! psychotic |! behavior. Donepezil: |! caution |! with |! anticholinergics, |! sick |! sinus |! syndrome, |! and |! history |! of |! peptic |! ulcers What |! is |! Gastroenteritis? |! - |! correct |! answersAcute |! diarrhea |! and/or |! vomiting |! lasting |! less |! than |! 14 |! days.
acute |! kidney |! injury |! and |! acidosis, |! and |! increased |! lactate |! would |! indicate |! hyper |! perfusion |! to |! the |! tissues |! and |! this |! is |! most |! commonly |! due |! to |! sepsis |! or |! ischemia. Liver |! function |! tests |! should |! be |! done. Lipase |! should |! be |! done |! to |! rule |! out |! pancreatitis. An |! upright |! abdominal |! plain |! film |! x-ray |! and/or |! abdominal |! pelvis |! CT |! scan |! with |! oral |! and |! IV |! contrast |! in |! adult |! patients |! should |! be |! done. |! You |! should |! consider |! abdominal |! ultrasound |! in |! infants |! and |! young children |! with |! projectile |! vomiting, |! current |! jelly |! stools, |! severe |! dehydration |! or |! clinical |! suspicion |! of |! a |! surgical |! abdomen. Ultrasound |! or |! MRI |! in |! pregnant |! patients |! with |! concern |! for |! appendicitis |! or |! surgical |! abdomen |! would |! be |! done. |! Stool |! cultures |! would |! be |! done |! in |! those |! that |! require |! admission |! for |! gastroenteritis, |! those |! residing |! in |! nursing |! homes, |! immunocompromised |! patients |! or |! if |! needed |! to |! investigate |! and |!
outbreak. What |! is |! the |! treatment |! for |! Gastroenteritis? |! (non |! pharmalogic) |! - |! correct |! answersFirst |! off, |! you |! want |! to |! correct |! the |! dehydration |! orally |! if |! possible. |! For |! mild |! dehydration, |! which |! is |! three |! to |! five |! percent |! volume |! loss, |! would |! require |! 50milliliters |! per |! kilogram |! or |! five |! tablespoons |! per |! pound |! over |! four |! hours. Moderate |! dehydration |! would |! be |! asix |! to |! nine |! percent |! volume |! loss |! and |! would |! require |! 100 |! milliliters |! per |! kilogram |! or |! 10 |! teaspoons |! per |! pound |! over |! four |! hours. |! Rehydrating |! with |! soft |! drinks, |! gelatin |! or
Bactrim |! or |! Ciprofloxacin. For |! shigella, |! Bactrim |! would |! be |! given |! twice |! daily |! for |! three |! to |! five |! days |! and |! if |! it's |! acquired |! outside |! of |! the |! United |! States |! the |! patient |! would |! get |! Ciprofloxacin |! for |! 10 |! days. E. |! coli, |! the |! patient |! would |! receive |! Bactrim |! twice |! daily |! for |! three |! days |! or |! Ciprofloxacin |! may |! be |! used |! in |! adults. |! Campylobacter |! would |! require |! Erythromycin |! four |! times |! daily |! for |! five |! days |! or |! Ciprofloxacin twice |! daily |! for |! seven |! days. Giardia |! is |! treated |! with |! Metronidazole |! 250 |! milligrams |! three |! times |! daily |! for |! five |! to |! seven |! days. The |! treatment |! for |! clostridium |! difficile |! is |! Metronidazole |! 500 |! milligrams |! three |! times |! daily |! or |! 250 |! milligrams |! four |! times |! per |! day |! and |! Vancomycin |! 125 |! milligrams |! four |! times |! daily. I What |! anti |! emetic |! is |! used |! for |! Gastroenteritis? |! - |! correct |! answersIf |! anti |! emetics |! are |! used, |! you |! can |! use |! Promethazine, |! for |! an |! adult |! they |! would |! receive |! 12.5 |! to |! 25milligrams |! every |! four |! to |! six |! hours. |! Pediatric |! patients |! would |! get |! 0.5 |! milligrams |! per |! kilogram |! at |! four |! to |! six |! hour |! intervals |! with |! a |! maximum |! of |! 25
milligrams. |! This |! should |! not |! be |! given |! in |! children |! less |! than |! two |! and |! it |! can |! cause |! fatal |! respiratory depression |! in |! children |! less |! than |! two, |! it |! can |! cause |! respiratory |! depression |! in |! adults |! when |! given |! with |! other |! central |! nervous |! system |! depressants. |! Promethazine |! is |! teratogenic |! and |! should |! be |! used cautiously |! in |! dehydrated |! patients |! and |! should |! be |! given |! deep |! IM |! if |! it |! is |! required |! to |! be |! given |! intramuscularly. Selective |! 4-HT3 |! receptor |! antagonists |! such |! as |! Ondansetron |! are |! much |! preferred |! over |! Promethazine. The |! side |! effect |! profile |! is |! much |! better. |! It |! is |! not |! recommended |! in |! children |! less |! than |! four |! but |! for children |! four |! to |! 11 |! they |! can |! have |! four |! milligrams |! every |! four |! hours |! Follow-up: |! You |! should |! contact |! these |! patients |! via |! telephone |! within |! about |! 24 |! hours |! and |! then |! again |! in |! about |! three |! days. What |! anti |! emetic |! is |! used |! for |! Gastroenteritis |! during |! pregnanc? |! - |! correct |! answers
