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Aging and comorbidities related to aging - Coggle Diagram
Aging and comorbidities related to aging
immunesystem
changes related to age
reduced production of T and B cells in the bone marrow and thymus
reduced ability to tyo detect and correct cell defects making it likely that skin cancer will develop
connection
diminished function of mature lymphocytes in secondary lymphoid tissue
fewer immune cells present in the body
immune response becomes slower
disease processes
rheumatoid arthritis
S/S
stiffness in more than one joint
pain and aching in more than one joint
tenderness and swelling in more than one joint
the same symptoms on both sides of the body
weight loss
fever
fatigue, tiredness and weakness
nursing interventions
provide comfort measures
cold compress or heat
massage
position changes
supportive pillows
splints
adequate nutrition and hydration
encourage the patient to state when they are experiencing pain
treatment
methotrexate
first medication given
often given with DMARD and short course of steroid treatment
anti inflammatory
patho
an autoimmune disease
process is not completely understood but thought to involve dysregulated inflammation.
antigen presentation
T cell activation
autoantibody production
all creating mediators for the inflammatory process
arthralgia
swelling
swelling and redness
limited range of motion
HIV/AIDS
Disease process
HIV enters the white blood cell CD4 and enters it it makes a copy of itself then destroys the cell, this creates a cycle. HIV kills the immune system and the cells that help the body fight infections
stages of HIV
stage 1- Seroconversion Illness, short illness after contracting the disease, primary or acute infection, the person is at their most infectious
stage 2- the asymptomatic stage
stage 3- symptomatic the body is more prone to infection and developing cancer
stage 4- late stage HIV AIDs defining illness develop
aids defining illness
cancer
TB
pneumonia
S/S
early symptoms
flue like symptoms
night sweats
fatigue
sore throat
recurrent infections
treatment
Antiretroviral therapy, helps to reduce the amount of HIV in your body
nursing interventions
regular HIV testing for those at the highest risk
promote usual bowel movements
promote activities
provide education on prevention and proper use of prevention measures
pathology of aging
decreased ability to fight infections, dimminshed response to vaccinations, increased incidence of cancer, higher presence of autoimmune disorder, and low grade inflammation
unexpected changes and health problems
weakened immune system due to drug use such as smoking or drinking alcohol, and poor nutrition. AIDs/HIV .
frequent and recurrent infections, blood disorders, and digestive problems.
autoimmune diseases develop,
connection
nervous system
expected changes
intelligence will remain the same
slowing in central processing
verbal skills maintained until 70
number and sensitivity of sensory receptors, dermatomes, and neurons decrease
decline in the function of cranial nerves affecting taste and smell
loss of nerve cell mass
number of dendrites declines
demyelination
plaques, tangles atrophy of the brain
free radicals accumulate
decrease in cerebral blood flow
fatty deposits accumulate in blood vessels
ability to compensate declines with age
intellectual performance maintained until at least 80
unexpected changes
weakness, tremors, gait
history of falls
pain, H/A, ROM
Neuropathies
changes in vision
cognition
muscle weakness
depression
sleep pattern chnages
parkinson diseas
patho
affects ability of the central nervous system to control body movement
chronic, progressive, debilitating neurologic disease of the basal cell ganglia and substantia nigra
affecting motor ability
dopamine deficiency
s/s
decreased motor ability
tremor at rest
pill rolling
increased muscle rigidity
slowness in initiation and execution of movement
postural instability
mask like facial appearance, difficulty chewing, swallowing, and speaking
drooling
constipation
sleep disruptions
sexual disfunction
nursing interventions
Schedule activities later in the day so client has more time to get ready
encourage activities and exercise
soft diet which is easy to swallow
treatments
levodopa
dopamine promoter
antidepressant
anti-tremor
Alzheimer's disease
patho
potentially caused by genetics, environmental factors, free radicals, and slow acting virus
symptoms develop gradually
changes in brain- neural plaques containing beta-amyloid protein
neurofibrillary tangles in the cortex
loss or degeneration of neurons and synapses
changes in neurotransmitter systems
s/s
develop gradually and at different speeds for everyone
cognitive impairment
loss of memory
nursing interventions
promoting therapy and activity
supporting the family
provide physical care, bathing, eating and drinking
treatment
no treatment available
reproductive system
expected changes
hormonal changes
vaginal epithelium thins
cervix, uterus, and fallopian tubes atrophy
atrophy of testes
enlargement of the prostate gland
seminiferous tubule change
unexpected changes
spotting after menopause
erectile dysfunction
cancer
cancer of the prostate
patho
develops from the glandular part of the organ
cells multiply rapidly
may spread to other tissue
s/s
difficulty urinating
weak or interrupted flow of urine
trouble emptying the bladder
blood in urine or semen
nursing interventions
support therapies
pain control
promoting nutrition
Perineal Herniation
patho
damage to the muscle of fascia in the pelvic floor that causes it to weaken
s/s
lower aching
swelling by the rectum
constipation
nursing interventions
bathroom asistance
pain assistance
educate on diet
treatment
surgical repair
digestive system
pathology of aging
reduced appetite due to hormonal changes
alteration in smell and taste can also affect appetite
saliva production decreases making it harder to swallow
presbyesophagus results in weaker esophageal contractions and weakness of the sphincter
esophageal and stomach motility decreases
decreased elasticity of the stomach
stomach has a higher PH as a result of a decline in hydrochloric acid and pepsin
decreased enzyme production in the liver
slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet
unexpected changes
diarrhea
weight loss
constipation
anorexia
indigestion
anemia
disease process
esophageal cancer
disease process
when cells in the esophagus develop DNA changes. these changes make the cells grow and change rapidly
caused by poor oral hygiene
caused by irritation from alcohol and tobacco use
GERD is a precursor to barrett's esophagus which may go onto cause esophageal cancer. stomach acid changes cells permanitly
if not treated cancer can spread to other parts of the body and may lead to death
S/S
dysphagia
weight loss
excessive salvation
thirst
hiccups
anemia
nursing interventions
nutritional changes
elevating the head or walking after eating
encourage the patient to stop smoking or drinking alcohol
treatment
surgical resection
radiation
chemotherapy
laser therapy
photodynamic therapy
intestinal obstruction
s/s
small bowel
upper and mid pain in rhythmic recurring waves
past the Ileum - abdominal distension it raises diaphragm and can inhibit respirations. vomiting is more severe it is semi digested food and is watery.
colon- lower abdominal pain, altered bowel habits, distention, and a sensation to poop. Vomiting occurs later when distension reaches the small intestine
nursing interventions
giving IV fluids
monitoring I&O
decompression an NG tube is placed to decompress the bowel
treatment
Timely intervention is extremely important
medical management with NG tube- intestinal intubation
surgical intervention
respiratory system
expected changes with aging
lungs lose elastic recoil
upper airway paths, nose and trachea harden
reduced cough reflex
lung size and weight reduction
increased dead space in the lung
decrease in alveolar surface area
decreased reaction of peripheral and central chemoreceptors to hypoxia and hypercapnia
unexpected changes
confusion
reduced O2 capacity
changes in breathing pattern
Barrel chest
lungs for decreased breath sounds , congestion, crackles or atelectasis
Dyspnea
orthopenia
cough
sputum production
poor nutrition, weight loss
anxiety
disease process
chronic Bronchitis
s/s
Bluish fingernails, lips,and skin due to hypoxia
wheezing and crackling sounds
edema in the feet
heart failure
chronic sputum with cough production daily for a minimum of 3 months 2 consecutive years
increase in mucus and cilia projection
increased bronchial wall thickness
disease process
poorly reversible airflow obstruction and an abnormal inflammatory response in the lungs
The cells of the bronchial lining tissue are irritated and mucous membrane becomes hyperemic and edematous, diminishing bronchial mucociliary function
airpass becomes clogged by debris and increase irritation
nursing intervention
watch for signs of fluid overload
remove bronchial secretions
prevent obstruction of airway
maintain adequate fluid intake
lowest FiO2n possible to prevent CO2 prevention
treatments
bronchodilators
oral steroids and inhaled steroids
antibiotics
quit smoking and other lifestyle changes
asthma
S/S
shortness of breath
chest tightness and pain
wheezing when exhaling
trouble sleeping due to shortness of breath
patho
Inflammation on the airway leading to airway hyperresponsiveness, obstruction, mucus hypersecretion, and airway remodeling
can develop later in life
attach can be caused by environmental factors or exercise
nursing interventions
administer bronchodilators
administer fluids and humidification
ABG's
C-pap or Bi-pap
treatment
inhaled corticosteroids
albuterol inhaler
endocrine
expected changes
thyroid gland atrophies and activity decreases
diminished adrenal function
adrenocorticotropic hormone (ACTH) secretion decreases
volume of pituitary gland decreases
insufficient release of insulin and reduced tissue sensitivity to circulating insulin
unexpected chnages
intolerance to heat or cold
rapid weight loss or gain
water retention
vision changes
hearing changes
extreme metabolic changes
disease process
Diabetes Mellitus T2D
s/s
Glucose intolerance
increased thirst
frequent urination
increased hunger
unintended weight loss
fatigue
blurred vision
slow healing sores
frequent infection
patho
the body dose not produce enough insulin to meet the body's needs
the body is resistant to insulin
often associated with obesity and sedentary lifestyle
treatments
metformin, 1st line, oral antidiabetic agent
sulfonylureas, blocks ATP on pancreatic beta cells
Thiazolidinediones, increase insulin sensitivity ion target tissue cells
Insulin, injection
hypothyroidism
patho
hypofunction of the thyroid gland with resulting insufficiency of thyroid hormone
deficiency in T4 and T3
metabolism will slow down
s/s
Fatigue, weakness, letharg
anorexia and weightgain
Puffy face
impaired hearing
periorbital or peripheral edema
myalgia, paresthesia, ataxia
dry skin and dry hair
husky voice, slow speech
cardiac
expected changes
heart valves become thick and more rigid
aorta becomes dilated
myocardial muscle less efficient
calcification and reduced elasticity of vessels
less sensitive to baroreceptor regulation of blood pressure
dysrhythmias
bradycardia, tachycardia, atrial fibrillation, and heart block
TIAs
increased peripheral resistance
atreosclerosis
unexpected changes
hypertension
hypotension
congestive heart failure
pulmonary emboli
coronary artery disease
hyperlipidemia
arrhythmias
Peripheral vascular disease
congestive heart failure
patho
pressure and volume overload
loss of muscle
primary muscle disease or excessive peripheral demands
also caused by hypertension, diabetes, dyslipidemia, cardiomyopathy, sleep apnea, chronic kidney disease, illicit drugs, sedentary lifestyle, and stress
s/s
crackles
shortness of breath
dyspnea on exertion
cough
fatigue
restlessness
confusion
bilateral ankle edema
nursing interventions
monitor weight
low sodium diet
plan activities to be spread apart
monitor pulse
treatment
vasodilators
diuretics
ACE inhibitors
peripheral vascular disease
patho
Arteriosclerosis
macro and micro dysfunction
affects small blood vessels far from the heart
common in people with diabetes
s/s
change in the skin
weak pulse
gangreen
weak pulse in the legs and feet
hair loss in the legs
nursing interventions
encourage patient to quit smoking
dietary changes, reduce fat intake
treatment
statins
vasodilators
angioplasty