Chapter 26: Geriatric Surgery

Chapter 26: Geriatric Surgery

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A number of screening tools have been developed to accurately establish biologic age. One tool, the Comprehensive Geriatric Assessment (CGA), is a multidimensional evaluation that scrutinizes medications, functional ability, co-morbid conditions, cognitive ability, mental function, nutritional status, and socioenvironmental factors. In geriatric medical studies, the CGA has been valuable in providing a metric for describing healthy aging and:

ANS:  B

The CGA may be used both to identify at-risk individuals and to guide interventions. In geriatric medical studies the CGA has been found to be potentially beneficial in reducing the incidence of hospitalization, falls, delirium, and readmission. It is predictive of both morbidity and mortality in older patients. When evaluated as a screening tool in the geriatric community, it has been shown to detect new and unsuspected problems in 76% of elderly persons living at home.

REF:   Page 1162

2. As a person ages digestive secretions decrease, mucus becomes thicker (causing dysphagia), and saliva becomes more alkaline. Decreased peristalsis and gastric motility, resulting in muscle tone loss, will cause delayed stomach emptying. What perioperative concern may be influenced by this age-related digestive condition?

ANS:  C

These factors are of particular importance for assessing the patient’s response to preoperative, anesthetic, and postoperative medications: relaxation of esophageal muscle tone, increasing the prevalence of esophageal reflux, decreased saliva production and gastric secretions, and bowel dysfunction from decreased peristalsis.

REF:   Page 1164

3. Age-related changes cause decreased blood flow to the kidneys with a resultant decrease in nephron function. What condition is created from the cumulative effect of the multiple drugs that the elderly patient will receive during the perioperative phase?

ANS:  A

During the perioperative phase of the patient’s hospital stay, the greatest number and variety of drugs are given; the cumulative effect increases the chances for adverse and consequential results.

REF:   Pages 1164-1165

4. Impaired nutritional status is highly prevalent among the elderly; as many as 12% of men and 8% of women in the healthy geriatric population are considered undernourished. During the preoperative assessment and interview, what information will the perioperative nurse review, in addition to a thorough assessment including body mass index and Mini Nutritional Assessment?

ANS:  B

Higher rates of surgical complications and increased postoperative mortality have been observed in patients with poor nutritional status, as determined by a low body mass index, weight loss, a low preoperative serum albumin level, or a low Mini Nutritional Assessment score.

REF:   Page 1162

5. Age-related skin changes include a thinning epidermis and decreased subcutaneous fat and elasticity. What special consideration will the perioperative nurse provide, in terms of additional attention and care, in one of the following nursing actions?

ANS:  D

The skin loses elasticity and subcutaneous fat and becomes more prone to shear force and pressure injury. Because of the thinness of the skin and small vessel fragility, bruising and hemorrhaging are quite common.