Clinics in geriatric medicine
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Generalized weakness in the geriatric patient is a vexing chief compliant to address in any setting, especially in the hectic emergency department. Studies suggest that it is associated with poor outcomes, although the ideal workup is elusive. A minimum of laboratory and imaging testing is recommended with the addition of neuroimaging if focal weakness is discovered. Considering a wide differential with attention to geriatric-specific concerns is labor intensive but necessary for this presentation.
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This article summarizes the current literature regarding the structural and functional changes of the aging kidney and describes how these changes make the older patient more susceptible to acute kidney injury and fluid and electrolyte disorders. It discusses the clinical manifestations, evaluation, and management of hyponatremia and shows how the management of hypernatremia in geriatric patients involves addressing the underlying cause and safely correcting the hypernatremia. ⋯ The management of severe hypercalcemia is discussed in detail. The evaluation and management of acute kidney injury is described.