Flashcards in Failure to Thrive Deck (34)
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1
Define Frailty
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
Characteristics of Frailty
Extremes of old age
Unstable disability
Function fluctuates with minor stressors
Multiple chronic diseases and/or geriatric syndromes
3
Important Questions for Osteoporotic Fractures
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
Outcome Risks of Frailty
Falls
Acute illness
Hospitalizations
Disability
Dependency
Institutionalization
Death
5
Key Components of Frailty
Musculoskeletal function
Cognitive/integrative neurological function
Nutritional reserve: maintaining weight
Aerobic capacity
6
Signs/Symptoms of Frailty
Weight loss or malnutrition
Decreased muscle mass
Decreased bone mass
Anemia
Weakness
Fatigue
Anorexia
Inactivity
7
Contributing Factors to Frailty
Heavy drinking
Cigarette smoking
Physical inactivity
Depression
Social isolation
Multiple chronic medical problems
Poor perceived health
8
Events that May Trigger Frailty
Chronic disease
Inactivity
Infection
Hip fracture
9
Evens that May Block Recovery Time
Depression
medication interactions
Malnutrition
Fear of falling
Underlying cognitive status
Underlying functional status
10
Define Failure to Thrive
Near irreversible end of the natural history of the syndrome of frailty
11
What does failure to thrive mean?
Stop eating
Immobile
Losing muscle mass & weight
Stiff
Going down hill
Depressed
Not taking medications
12
What is the pathogenesis of failure to thrive?
Progression of aging with organs & medical problems getting worse
13
What are the signs & symptoms of failure to thrive?
Weight loss
Loss of muscle mass
Increased weakness
Increased ability to walk steadily
Increasing SOB due to CHF or COPD
HTN
14
H&P & Failure to Thrive
Decreased ROM & strength
Mini mental exam
Heart
Lungs
Abdomen
Senses
15
Labs for Failure to Thrive
CBC
CMP
TSH
16
Treatment for Failure to Thrive
Ensure
Social support
Evaluate for depression
17
Components of Failure to Thrive
Physical frailty
Disability
Impaired neuropsychiatric function
18
National Institue of Aging Definition of Failure to Thrive
Syndrome of weight loss, decreased appetite, poor nutrition, & inactivity often accompanied by dehydration, depressive symptoms, impaired immune function, & low cholesterol
19
Define Disability
Difficulty or dependency in completing tasks essential for self-care & independent living
20
Objective Assessment of Disability
ADLs
IADLs
21
Katz Index of Independence in ADLs
Bathing
Dressing
Toileting
Transferring
Continence
Feeding
22
Lawton IADLs Scale
Ability to use telephone
Shopping
Food preparation
Housekeeping
Laundry
Mode of transportation
Responsibility for own medications
Ability to handle finances
23
Impaired Neuropsychiatric Function
Delirium
Depression
Dementia
24
What can impaired neuropsychiatric function result from & contribute to?
Result of medical co-morbidities
Medication effects
Contribute to development of disability, malnutrition, & frailty
25
Sarcopenia & Failure to Thrive
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
Signs & Symptoms of Failure to Thrive
Impaired physical functioning
Malnutrition
Depression
Cognitive impairment
27
3 Criteria of the Working Definition of Failure to Thrive
Biopsychosocial failure
Weight loss or undernutrition
No immediate explanation for the condition
28
Underlying Principles of Failure to Thrive
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
History for Failure to Thrive
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
