The physical or clinical sphere

The valuation of this sphere is the most complex due to the fact that the elders fall ill with major frequency and with atypical presentations in some cases it is realized by a functional examination.

The above mentioned valuation must include a clinical interview, a pharmacological history, another nutritional history, a physical exploration, request of complementary explorations and social evaluation. Sometimes these interviews are laborious and complex for the problems of communication that they can present for sensory or cognitive deficits. For them it will be better than the interviews be short and frequent, to speak to him slow and loudly.

Some of the big geriatric syndromes are:

- Unlucky (situation of terminal illness)

- Immobility.

- Sensory Insufficiency (Deterioration of the sight / ear)

 - Upset Intelligence (Dementia and Confusion)

The anamnesis; it is to say, the interview must include:

1.      Personal Precedents: Valuation of past and present diagnoses, hospitable income, etc …

2.      Review for devices and symptoms to detect the geriatric syndromes or using a model of infirmary as that of Virginia Henderson.

3.      Pharmacological History: treatments received in the last year, time of administration of every medicament, etc ..

4.      Nutritional History: habitual diet, number of show restraint a day, etc … carried out by the Mini Nutritional Assessment (MNA) with a maximum of 30 points; if the patient this one below 17 points thinks that it has a been nutritional evil.

5.      Organic Changes associated with the aging: prevalence of pathologies, psychic problems, etc..

The physical exploration must include:

- Mouth Exploration: dental State, absence of dental pieces.

- Rectal Tact: to reject haemorrhoids, tumours.

- Extremities: Limitations and deformities.

- Neurological State: speech, quake, function motorboat.

- Constants: Arterial Tension, weight and height.

- Skin: To look for dermal injuries and sores for pressure.

- Head and neck: To feel temporary arteries and visual keenness.

- Thorax: respiratory Boss and aptitude to cough and expand the thoracic cavity.

- Abdomen: To reject masses and mealiest.

- Laboratory test: blood test, biochemistry, glucose, etc ...

- Technologies of secondary prevention of the disease: Blood conceals in dregs, thyroid function, ECG.

To conclude I would like to indicate that in this sphere they take charge of the physical part of the person, without seeing beyond because of it is necessary to complement it with the following spheres that we will see later; since overcoat in the elder to my way of seeing is the least important.

BIBLIOGRAPHY:

- Cathy Jo Cress; Handbook of geriatric care management;2ª Ed.;US; Jones and Bartlett Publishers;2007

- HOFFMAN, Gloria Basic Geriatric Nursing 5th Edition. Elsevier 2012.