Card Set Information
Does CO increase or decrease in geriatric patients?
Why do geriatric patients have an increased PVR?
Increased wall thickness & diameter
Stiffening of aorta & large arteries
Does geriatric patients have an impaired pump?
Why do you see left ventricle hypertrophy in geriatric patients?
Chronic increase in afterload d/t increased PVR
Is CAD a normal part of the aging process?
Does blood volume increase or decrease in geriatric patients?
What does prolonged circulation time and decreased perfusion of organs do to the onset of drugs?
Delays induction time & slows onset of drug action
Does lung compliance increase or decrease with age?
Does lung elasticity increase or decrease with age?
What causes a decrease in FEV1 & FVC in the elderly?
Does CC increase or decrease with age?
Does the A-a difference increase or decrease with age?
Does resting PaO2 increase or decrease with age?
Does FRC increase or decrease with age?
Increases d/t increased RV
Does VC increase or decrease with age?
Why does VC decrease in the aging adult?
d/t the decreased elastic recoil
Does the ventilator response to hypoxia/hypercarbia increase or decrease in the aging adult?
What kind of structural changes can cause a decrease in lung capacity of aging adults?
Why can’t the elderly tolerate the supine position?
Increased closing capacity
Is the CBF & CMRO2 increased or decreased in the elderly?
Do neurons decrease in size & complexity in the elderly?
Does the elderly have decreased receptors and neurotransmitters?
Does the elderly lose neurons?
Yes- 50,000 per day which decreases the makers neurotransmitters
Which brain mass declines more? Gray or white
Does the elderly have an increased or decreased deafferentation?
Does the elderly have an increase or decrease in adrenal mass?
What does a decrease in adrenal mass for the elderly mean?
Decrease cortisol/sympathetic response
As brain mass declines, what increases to compensate?
Does the elderly increase or decrease their CSF?
Does the elderly have an increased or decreased baroreceptor response?
Decreased – less tachycardia IRT hypotension
Does the elderly have an increased or decreased end-organ responsiveness to neurotransmitters?
Does the elderly have an increased or decreased chrono/inotropic response to agonists such as Atropine & antagonists such as propranolol?
What does the “endogenous beta-blockage of aging” mean?
That the elderly have 2-4 times higher plasma epi/norepi levels that have a less effect
Is the CBF autoregulation & cerebral vasoconstrictive response to hyperventilation intact in the elderly?
Does the elderly have an increase or decrease rate of gastric emptying?
What type of lung pathophysiology does the aging lungs reflect?
How do you determine the resting arterial oxygen tension PaO2?
PaO2= 100 – (0.4x age in years) mm Hg
What happens to the SNS and PSNS in geriatrics?
Increased SNS activity & decreased PSNS
Are plasma drug levels increased or decreased in the elderly?
Increased d/t contracted blood volume (decrease TBW d/t increase fat)
How is IH affected by the aging adult?
Decreases 4% each decade of life after the age of 40
How is IV anesthetic agents affected by the aging adult?
Decreased doses with slow titration
Which IV induction agent might be the most appropriate for the elderly?
Etomidate d/t the cardio-protectant qualities
How is the dosing of narcotics affected by the aging adult?
Doses decreased d/t the decreased Vd & protein binding
Is the elimination half-life of narcotics increased or decreased in the aging adult?
How is muscle relaxants affected by the aging adult?
Same dose d/t them being highly polarized, relatively fat insoluble
Increased elimination half-life (pick a short to intermediate acting)
How does aging affect the kidneys?
Decreased urine concentration
Decreased drug excretion
Decreased ability to reabsorb glucose
How much RBF do you lose after the age of 30?
1% per year after the age of 30
How much GFR do you lose per year?
Is creatinine clearance increased or decreased in the elderly?
If the CC is decreased in the elderly, what happens to the serum creatinine levels?
Stable d/t the amount of creatinine produced (less)
Why is it important to maintain a UO of >0.5ml//kg/hr in the perioperative period?
D/T ARF being responsible for a high mortality rate
Why does the elderly have a decreased hepatic blood flow?
Does the aging process decrease the actual size of the liver?
Yes – 40 to 50% by the age of 80
How does again affect hepatic biotransformation of drugs?
Decreases which causes vulnerability to cumulative drug effects
Is hypercoagulability & peripheral thrombosis part of the aging process itself?
How does aging affect the body’s response to anemia?
d/t bone marrow mass & spleen size decreasing, the hematopoetic response is decreased
Does aging have an effect on RBC, WBC, the # or FX of platelets or coagulation?
Is there a decrease in the erythrocyte life expectancy in the elderly?
No – only increased fragility
Is anemia or disorders of hemostasis in the elderly part of the physiologic process of again?
Nope – only d/t DZ
Is the Vd for lipophilic drugs increased or decreased in the elderly?
Is the Vd for hydrophilic drugs increased or decreased in the elderly?
Decreased d/t the decrease of TBW
What is the beta elimination half-life of Valium in hours equal to?
Patient’s age in years
What are 3 major risk factors for mortality in elderly patients?
Need to perform emergency surgery
Site of surgery
Physical status of the Pt at the time of surgery
What can anticholinergic drugs do to the elderly if there is no change to onset or peak?
Increased cardiac arrhythmias if CV dz
What happens to the heart conducting system in the elderly?
With a decrease in CO, does the elderly have an increased or decreased systolic BP?
Is an elderly Pt’s able to reach a maximum Hr?
Might the elderly have a normal CO at rest?
Does a slower HR speed up or slow down an IH induction?
Would a slow HR speed up or slow down an IV induction?
Does hypothermia slow down emergence?
How much decline does organ dysfunction go through after the age of 30?
1% each year after the age of 30