Physical Examination of Older Adults

• Dowager’s hump 


  Age-related postural Hyperkyphosis
• Xerostomia


  dryness of the mouth due to decrease salivary gland function (could lead to fissures in the mouth and tongue; tongue can stick to buccal mucosa)
• enophthalmos


  Gradual sinking of eye backward into the orbit
• Pseudoptosis


  apparent drooping of the eyelid
• Entropion


  inversion of lower eyelid margin
• Ectroprion


  eversion of lower eyelid margin
• Arcus Senilis


  white ring at the limbus
• Slower response to light 


  due to the weakening of eye muscles
• 16 - 25


  Normal respiratory rate
• diaphragmatic breathing


  Breathing method
• cough


  Ask the client to _____ while in the lithotomy

  position.
• Auscultate 


  the scrotum if a mass is detected; otherwise palpate the right and left testicle using the thumb and first two fingers.
• 3 to 5 seconds


  Observe the client’s posture and balance

  when standing, especially the first _____
• Get Up and Go 


  Test to observe the client’s gait
• Morse Fall Scale


  a rapid and simple method of assessing a patient's likelihood of falling
• 0


  No risk for falls
• <25


  low risk for fall
• 25 - 45


  Moderate risk for fall
• >45


  High risk for fall
• Romberg test


  Assess positional sense using _____
• Instrumental activities of daily living 


  used to measure abilities associated with living

  independently in the community.
• 0 to 8


  total score range for instrumental ADL
• KATZ INDEX OF INDEPENDENCE IN ACTIVITIES OF DAILY LIVING


  Clients are scored yes/no for independence

  in each of six functions.

  • Bathing
  • Dressing
  • Toileting
  • Transferring
  • Continence
  • Feeding
• 6


  Score for full function in Katz index
• 4


  #score for moderate impairment for Katz index
• 2 or less 


  Score for severe functional impairment in Katz index
• Barthel Index


  Consists of 10 items that measure a person's

  daily functioning specifically the activities of

  daily living and mobility.

  1. Feeding

  2. Bathing

  3. Grooming

  4. Dressing

  5. Bowels

  6. Bladder

  7. Toilet Use

  8. Transfers ( Bed to chair and Back)

  9. Mobility (On Level Surfaces)

  10.Stairs
• Beers criteria 


  New medications to avoid in any older adult
• gugging swallowing screen 


  GUSS stands for?
• gugging swallowing screen 


  aims at reducing the risk of aspiration