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Flashcards in Failure to Thrive Deck (34)
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1
Q

Define Frailty

A

State of age-related physiologic vulnerability resulting from impaired homeostatic reserve & a reduced capacity to withstand stress
-Syndrome that results from a multi-system reduction in reserve to the extent that a number of physiological systems are close to or past the threshold of symptomatic clinical failure

2
Q

Characteristics of Frailty

A

Extremes of old age
Unstable disability
Function fluctuates with minor stressors
Multiple chronic diseases and/or geriatric syndromes

3
Q

Important Questions for Osteoporotic Fractures

A

Weight loss of 5+% over 2 years
Inability to stand 5 times without help from arms
Negative response to “do you feel full of energy”

4
Q

Outcome Risks of Frailty

A
Falls
Acute illness
Hospitalizations
Disability
Dependency
Institutionalization
Death
5
Q

Key Components of Frailty

A

Musculoskeletal function
Cognitive/integrative neurological function
Nutritional reserve: maintaining weight
Aerobic capacity

6
Q

Signs/Symptoms of Frailty

A
Weight loss or malnutrition
Decreased muscle mass
Decreased bone mass
Anemia
Weakness
Fatigue
Anorexia
Inactivity
7
Q

Contributing Factors to Frailty

A
Heavy drinking
Cigarette smoking
Physical inactivity
Depression
Social isolation
Multiple chronic medical problems
Poor perceived health
8
Q

Events that May Trigger Frailty

A

Chronic disease
Inactivity
Infection
Hip fracture

9
Q

Evens that May Block Recovery Time

A
Depression
medication interactions
Malnutrition
Fear of falling
Underlying cognitive status
Underlying functional status
10
Q

Define Failure to Thrive

A

Near irreversible end of the natural history of the syndrome of frailty

11
Q

What does failure to thrive mean?

A
Stop eating
Immobile
Losing muscle mass & weight
Stiff
Going down hill
Depressed 
Not taking medications
12
Q

What is the pathogenesis of failure to thrive?

A

Progression of aging with organs & medical problems getting worse

13
Q

What are the signs & symptoms of failure to thrive?

A
Weight loss
Loss of muscle mass
Increased weakness
Increased ability to walk steadily
Increasing SOB due to CHF or COPD
HTN
14
Q

H&P & Failure to Thrive

A
Decreased ROM & strength
Mini mental exam
Heart
Lungs
Abdomen
Senses
15
Q

Labs for Failure to Thrive

A

CBC
CMP
TSH

16
Q

Treatment for Failure to Thrive

A

Ensure
Social support
Evaluate for depression

17
Q

Components of Failure to Thrive

A

Physical frailty
Disability
Impaired neuropsychiatric function

18
Q

National Institue of Aging Definition of Failure to Thrive

A

Syndrome of weight loss, decreased appetite, poor nutrition, & inactivity often accompanied by dehydration, depressive symptoms, impaired immune function, & low cholesterol

19
Q

Define Disability

A

Difficulty or dependency in completing tasks essential for self-care & independent living

20
Q

Objective Assessment of Disability

A

ADLs

IADLs

21
Q

Katz Index of Independence in ADLs

A
Bathing
Dressing
Toileting
Transferring
Continence
Feeding
22
Q

Lawton IADLs Scale

A
Ability to use telephone
Shopping
Food preparation
Housekeeping
Laundry
Mode of transportation
Responsibility for own medications
Ability to handle finances
23
Q

Impaired Neuropsychiatric Function

A

Delirium
Depression
Dementia

24
Q

What can impaired neuropsychiatric function result from & contribute to?

A

Result of medical co-morbidities
Medication effects
Contribute to development of disability, malnutrition, & frailty

25
Q

Sarcopenia & Failure to Thrive

A
Contributor to failure to thrive
Loss of muscle with age
Loss of lean body mass
Diminishes the acute phase response to physiological stress
Decreases immune competence
26
Q

Signs & Symptoms of Failure to Thrive

A

Impaired physical functioning
Malnutrition
Depression
Cognitive impairment

27
Q

3 Criteria of the Working Definition of Failure to Thrive

A

Biopsychosocial failure
Weight loss or undernutrition
No immediate explanation for the condition

28
Q

Underlying Principles of Failure to Thrive

A

Baseline data is the foundation of elder care
Function declines at a variable rate predictably over time
Occur from organic or non-organic causes

29
Q

History for Failure to Thrive

A

Provided by patient and CAREGIVER
Helps with onset of condition & uncovering potential triggers
Drug review: prescriptions, OTC, ETOH
Psychosocial history: increases memory loss, change in social structure

30
Q

Physical for Failure to Thrive

A
R/O infection, constipation, exacerbation of chronic diseases (CHF, COPD, CAD, CA, TB, uncontrolled endocrine disorder, dementia, depression)
Vitals
HEENT
JVD
Breast mass
Abdominal exam
Skin
Motor
Mental status
Labs: CBC, CMP, Albumin & cholesterol, TSH, fecal occult blood, U/A, Vitamin B12 & D levels, ESR, PPD
31
Q

Importance of CBC in Failure to Thrive

A

Anemia
Vitamin deficiency
Infection
Hematopoietic or lyphoprolieferative disorder

32
Q

Importance of CMP in Failure to Thrive

A
Hyper/hyponatremia
Acid-base disorder
Osmolality
Renal function
Dehydration
Diabetes
Hypoglycemia
LFTs
33
Q

Assessment & Plan for Failure to Thrive

A

Assess life expectancy
Symptoms/conditions reversible
Risk/benefit assessment
Provider, patient, & family collaboration
Palliative measures initiated
Maintain therapeutic relationship with patient & family

34
Q

Team Approach to Failure to Thrive

A

Address advance directives
Medication reconciliation
Consultation with PharmD
Social services
Caregiver education & support/respite
Concerns about abuse/neglect discussed openly & frankly
Nutritional consult