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Older Adult (Common Changes of Aging and Physiological Balance…

- - - - Influenza and Pneumonia Vaccines
      - Deep Breathing Exercises
      - Stop Smoking
    - - Increased Dyspnea
      - Delayed response to low levels of oxygen and carbon dioxide
      - Decreased strength of respiratory muscles
    - - Asthma
        
        higher risk of mortality in older adults in relation to increased chance of cardiac problems
      - Chronic Bronchitis
        
        unrelenting cough with sputum, shortness of breath, wheezing, respiratory infections
        
        Excessive production of mucus can lead to dyspnea
      - Emphysema
        
        caused by pollutants and morphologic changes (expanding alveolar sac, reducing surface area)
        
        Leads to severe dyspnea and cough
        
        Tx includes postural drainage, medications, cough and deep breathing,
    - - Encourage fluid intake; encourage cough and deep breathing exercises; postural drainage; assess vital signs frequently;
  - - - Ventricular and Atrial Hypertrophy
      - Decreased Cardiac Reserve
      - Increased Risk of Hypertension
    - - Follow proper diet; encourage stress management and exercise;
    - - Most prevalent cardiac disease
      - 140, >90
      - older adults should make sure to rest, follow a proper low sodium diet, and lose weight
      - Hypertensive medications can lead to adverse effects such as hypotension so advise client to change positions slowly
    - - CAD is the cause for most cases of CHF
      - Link to Hypertension as a cause as well as decreased cardiac reserve
      - Symptoms: shortness of breath, confusion, depression, weight gain caused from edema
    - - Link: CAD can lead to CHF
      - Build up of plaque in arteries that can cause ventricular hypertrophy (link) and can decrease tissue perfusion
  - - - Link: Problems with the GI system can lead to malnutrition and dehydration leading to various safety implications
  - - - decreased lubrication
      - ovarian cancer
        
        patients should get pap smears
    - - decreased sperm count
      - erectile dysfunction
        
        Often caused by medications
      - BPH
- - - - With advancing age there is a higher risk of delirium
      - Onset is rapid and treatment depends on the cause of the delirium
      - Common causes include fluid and electrolyte imbalances, medications, stress, pain, malnutrition, and trauma
    - - Can effect memory, language, and problem solving
      - Care of patient with dementia
        
        use items to trigger memory, cleaning products and harmful chemicals should be locked up, coverings placed over sockets, allow patients to wander
  - - - self-care capacity
        
        Educate about disease and what interventions need to be performed to improve or maintain condition
      - High quality of life
        
        spiritual, emotional, family, sexual needs should be met to the best of their ability
        
        Palliative care can assist patients in pain relief
      - Easy Death
        
        Relief from pain and maintaining comfort
        
        Hospice Care can assist with this process
    - - Assist patients in selecting health care providers
        
        Accepts insurance, location and availability, interpersonal communication
      - Educate patients on disease processes
      - Assist patients in exploring support groups and alternative therapies
        
        Community Resources
      - Assess caregivers' abilities
- - - - Strong Assessment of symptoms is needed especially when related to common changes of aging
        
        Physical examinations and ongoing assessments help manage symptoms
        
        Questions requiring more than yes or no answers give a more in depth assessment into symptoms, thus leading to better pain management
    - - Nociceptive, Somatic, Visceral, Acute, Neuropathic, Nociceptive, Persistent
        
        A thorough pain assessment is needed to determine the type of pain and which pharmaceutical and alternative therapies could potentially help alleviate pain
        
        Unrelieved pain may lead to the development of other negative health effects such as pressure ulcers from immobility caused by back pain
    - - Complementary Therapies
        
        educating patients on various types of alternative therapies is an important nursing role
      - Medications
        
        higher risk of adverse effects
        
        Begin with smallest dose and gradually increase medications
        
        acetaminophen is the preferred drug for mild pain
  - - - Less lean body mass
      - BMR declines
      - Typically a lower activity level
      - These changes cause a decrease in caloric needs
      - decreased thirst sensation, incontinence, GI distress, little motivation to drink fluids
    - - Fat intake should be 30% of dietary intake and protein should be 10 to 20%
      - Vitamins and Minerals need to be present in diet
    - - Water constitutes only 50% of body weight in older adults, contributing to increased risk of dehydration
      - Older adults should consume 2.7-3.7 liters of fluid a day depending on male or female.
  - - - Changes related to aging can contribute to a decrease quality of sleep and can lead to negative health effects and added stress to the individual.
    - - older adults fall asleep and wake up earlier
      - Decline in stages III and IV sleep, leading to lower quality sleep
      - 50% of older adults complain about sleep
        
        Insomnia
        
        Restless Leg Syndrome
        
        Sleep Apnea
    - - Pharmacologic Measures-- Sedatives
      - Activity spread throughout the day
      - Carbohydrates promote sleep
      - Stress Management
  - - - Changes of the musculoskeletal system increase risk of falls
    - - smoke detectors, night lights, railings, no scatter rugs, room temperature above 75 degrees, etc.
        
        All of these things can reduce the risk of falls
    - - Nurses and Physicians should consult BEERS criteria to avoid adverse reactions
- - - - Connecting patients with these resources can assist in pain management (palliative care) or assist with easing the dying process for patient and family members (Hospice Care)
      - A peaceful death includes pain and comfort measures
        
        Palliative care assists with pain management for patients living with chronic illness
        
        Hospice care assists with pain and comfort measures at the end of a patient's life
    - - decreased blood pressure, Cheyne Stokes Respirations, decreased urinary output, cold, mottling of skin
        
        Being familiar with these signs can help ensure family members are there as the patient passes