Dr Fanani Aspek Geriatri Pada Radiologi

7/25/2019 Dr Fanani Aspek Geriatri Pada Radiologi

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Aspek Geriatri Pada Radiologi

Dr. Fanani, Sp.Rad


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Pengaruh Penuaan

Fisik

Kognitif

Psikososial

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Slide 2


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Perubahan Fisik Akibat Penuaan

Kel'(an kese(atan yang paling sering pada lansia ) Penamba(an berat badan Fatig'e Massa t'lang berk'rang Kekak'an sendi Kesepian

*ati(an adala( k'n%i 'nt'k meng'rangi empat

kel'(an pertama pada daftar Keseimbangan, koordinasi, kek'atan dan ke%epatan

reaksi men'r'n bersama dengan penamba(an 'sia


Slide !


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Perubahan Fisik Akibat Penuaan

Pengli(atan, pendengaran, pen%i'mandan indra perasa +'ga men'r'n dengan

bertamba(nya 'sia ant'an yang dapat diberikan )

erikan instr'ksi sat' per sat'

K'rangi kebisingan di sekitarnyai%arala( dengan pelan, +elas dan langs'ngpada pasien

Ses'aikan vol'me s'ara dengan

pendengaran pasienMosby items and derived items 200, 200!,"### by Mosby, $n%., an affiliate of &lsevier $n%. Slide -


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Efek Kognitif

Penyakit l/(eimer adala( bent'k

dementia yang paling sering didapatkanpada lansia

Dementia gangg'an kognitif yang

progresif yang pada ak(irnya akanmempengar'(i f'ngsi se(ari1(ari


Slide


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Efek Psikososial

" dari orang ber'sia 34 ta('nmen'n+'kkan tanda1tanda depresi klinis

each elderly person is unique anddeserves respect


Slide 4


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Top 10 Chronic Conditions of 6!

rt(ritis

5ypertension

5earing impairment

5eart disease 6atara%ts

Deformity or

ort(opedi% impairment

6(roni% sin'sitis

Diabetes

7is'al impairment

7ari%ose veins


Slide


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Aging of "rgan #$ste%s

$nteg'mentary system disorders

8ervo's system disorders

Sensory system disorders

M's%'loskeletal system disorders

6ardiovas%'lar system disorders

9astrointestinal system disorders


Slide :


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;(en an e


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Changes Associated &ith Aging

?lder ad'lts may (ave nonspe%ifi%

symptoms s'%( as)

Di//iness Falls for no apparent reason

$nfe%tions =it(o't fevers

@rinary $n%ontinen%es a radiograp(er, yo' m'st be able to

differentiate =(at is a normal from =(at

is pat(ologi%al.


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'ntegu%entar$ #$ste%

8ormal 6(anges >(e skin =rinkles, be%omes la


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'%plications for the Radiographer

>(e skin of t(e geriatri% is fragile and

t('s more easily tra'mati/ed.

o' m'st ens're t(at t(e skin of t(eelderly patient is not damaged d'ring

t(e e


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Changes in the (ead and )eck

8ormal 6(anges of ging >(ere is mild loss of vis'al a%'ity,

parti%'larly BPresbyopiaC >ear prod'%tion is eit(er red'%ed or

in%reased

Sensory, ne'ral, and %ond'%tive %(angeso%%'r in t(e ear

5earing loss is %ommon

>(ere is loss of m's%le mass in t(e ne%k

Kyp(osis


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ssist t(e patient at all times. S'dden

%(ange in lig(ting may %a'se

momentary blindness. o' m'st as%ertain t(at t(e patient is

able to (ear yo'r dire%tions and speak

lo'dly eno'g( for t(e patient to'nderstand.

e espe%ially %aref'l to %learly state

instr'%tions and %(e%k for


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Pul%onar$ #$ste%

8ormal 6(anges of ging *'ng %apa%ity diminis(es

>(e %o'g( refle< be%omes less effe%tive >(e normal respiratory defense me%(anism

lose effe%tiveness


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Patients =it( %(roni% p'lmonary disease

%annot be e


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The Gastrointestinal #$ste%

8ormal 6(anges of ging9astri% se%retion, absorption and motility

de%reases >(e abdominal m's%les =eaken

Many patients are edent'lo's =it(o't

teet(G, (ave dent'res or partial plates&sop(ageal motility de%lines


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D'e to patient fasting, s%(ed'le t(e

e


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The Patient *ho (as (adArthroplastic #urger$

>otal +oint repla%ement (as be%ome a

%ommon pro%ed're in (ospitals t(ro'g(o't

t(e @nited States

rt(roplasty is indi%ated for patients for t(e

follo=ing reasons)Severe degenerative +oint disease

Hoint deformities

>ra'ma


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Cont+

Most %ommon rt(roplasty in geriatri%s)

5ip and Knees

>ake e


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Cultural Considerations and

Aging

?ne m'st take %'lt're differen%es =(en

imaging patients.

Some elderly patients are a%%epting of=(atever treatment is offered, =(ereas

ot(ers reA'ire a detailed e


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Elder Abuse

$t is estimated one o't of every 20seniors e(e negle%t,

mistreatment or e


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Recogni,ing the *arning #igns

of Abuse

P(ysi%al ab'se

Se


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A-oiding Elder Abuse or )eglect

.uring '%aging Procedures

void pin%(ing patientIs skin =(en moving

or transferring t(e patient from g'rney or

=(eel%(air onto t(e radiograp(i% table. ;(en immobili/ing elderly patients, 'tili/e

t(e standards of %are for immobili/ing t(e

geriatri% patient as pres%ribed by yo'rinstit'tion d'ring radiograp(i% pro%ed'res.

ssist t(e geriatri% patient =(en t(ey ask for

(elp.


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Patient Care of Elderl$/ uick Tips

&d'kasi pasien dan kel'argaMeng'rangi stress dan kegelisa(an pasien

Meningkatkan kepat'(an dan kep'asan

i%ara lebi( pelan dan lebi( dekat

Treat patient with respect and dignity

Kom'nikasi dengan (angat, empati, dansikap positif

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Sediakan =akt' istira(at antar

pengambilan gambar dan prosed'r

tindakanMeng'rangi vertigo dan resiko +at'(

5indari pengg'naan pita perekat

M'da( menyebabkan ker'sakan k'lit 9'nakan alas me+a pengambilan

gambar dan tempat pegangan tangan

Meningkatkan kepat'(an dan kenyamananMosby items and derived items 200, 200!,"### by Mosby, $n%., an affiliate of &lsevier $n%. Slide 24


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Sediakan selim't, spons dan alat bant'

lainnya 'nt'k pengat'ran posisi

Meningkatkan kenyamanan danmeng'rangi resiko injury

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Carefully check patient history before

contrast administration

Meng'rangi efek samping, sepertide(idrasi, gagal gin+al

daka( kes'litan menelan

erikan %airan dengan posisi tegak 'nt'kmeng'rangi resiko aspirasi

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CA(" Criteria

ge1spe%ifi% %ompeten%y for all (ealt(

%are professionals reA'ired

ge1related %are spe%ifi%s in%l'deassessment of7is'al or (earing impairments

Digestive and esop(ageal problems9rief %on%erns

Provision of =armt( and safety aids

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CA(" Criteria

ppropriate age1spe%ifi% %omm'ni%ation

skills are reA'ired

Kno=ledge of age1related %(anges anddisease pro%esses assist radiograp(ers

in providing needed %are to elderly

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Radiographer2s Role

dapt pro%ed'res to a%%ommodate

disability and disease

@nderstanding of p(ysiology andpat(ology of aging

=areness of so%ial, psy%(ologi%al,

%ognitive, and e%onomi%s of aging


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Radiographic Positioning for Geriatric

Patients

6(est For P, =rap arms aro'nd 'prig(t devi%e to

in%rease s'pport and se%'rityProvide s'pport and stability in moving

arms 'p and for=ard for lateral

Perform e


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Patients

Spine@se sponges and table pad

@prig(t more %omfortable for t(ose =(o areable

Seated position may be 'sed for

e


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Patients

PelvisJ5ip Fra%t'res %ommon do not rotate limb 'ntil

fra%t're (as been r'led o't6ross1table lateral often more %omfortable

$n nontra'ma patients, sandbags 'sef'l to

s'pport rotation of limbs


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Patients

@pper e


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Patients

*o=er e


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Patients

>e%(ni%al fa%tors (ave to be ad+'sted to

a%%ommodate disease and normal age1

related %(anges >o make %orre%t te%(niA'e ad+'stment

for diseases and age1related %(anges,

radiograp(ers m'st kno= =(et(erdiseaseJ%(ange is additive or

destr'%tive


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Dr Fanani Aspek Geriatri Pada Radiologi