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Older Adult
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Older Adult
Alicia Shepard-
Nervous System
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reduction in neurons, sensory receptors, and dermatomes
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Cardiovascular System
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aorta becomes dilated, myocardial muscle less efficient
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Respiratory System
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increased residual capacity, reduced vital capacity
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Urinary System
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inefficient neurological control of bladder emptying and weaker bladder muscle, increased risk for reflux of urine in uterus
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nursing interventions: bladder-training program, avoid caffeine, kegel exercises, and void at first urge
Reproductive System
effects of male reproductive system: muscle tissue replaced with connective tissue, decreased capacity to retain fluids, atrophy of the testes, ejaculation fluid contains less live sperm
effects of female reproductive system: vaginal epithelium thins, more alkaline vaginal PH, lower estrogen levels, fallopian tubes become shorter and straighter, retraction of nipples
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Integumentary System
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difficulties with assessing for touch, vibration, heat, cold
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Pathologies
Esophageal Cancer
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greater with increased age, alcohol intake, smoking
causes: poor oral health, irritation
signs/symptoms: weight loss, excessive salvation, anorexia, anemia
diagnosis: biopsy, barium swallow, esophagoscope
tx: surgical resection, radiation, chemotherapy
Dysphagia
interventions: aspiration prevent, adequate nutritional status
causes: GERD, storke, structural disorder
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Diverticular Disease
diverticulitis: left lower quadrant pain, rectal bleeding, increased flatus
causes: chronic constipation, obesity, atrophy of intestinal wall muscles
obstruction: fever, abdominal distention, anorexia, constipation and diarrhea
Colorectal Cancer
signs and symptoms: change in bowel habits, abdominal pain, nausea, vomiting, sense of incomplete evacuation
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Pathologies
congestive heart failure
monitor weight, avoid salt, light activity, repositioning
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hypertension
systolic BP greater than or equal to 140, diastolic BP greater than or equal to 90
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Pathologies
Emphysema
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causes: chronic bronchitis, chronic irritation, cigarette smoking
Chronic Bronchitis
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chronic hypoxemia, increase in mucus, increase in bronchial wall thickness
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Interventions: lowest fi02 possible to prevent co2 retention, watch for fluid overload signs, maintain adequate fluid intake, remove bronchial secretions
Asthma
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Interventions: administer bronchodilators, administer fluids and humidification, ABG'S, C-PAP
Pathologies
Diabetes Mellitus
Type 2: glucose intolerance, diagnosis of diabetes in the older adult, symptoms are nonspecific
Type 1: childhood diabetes, insulin dependent, pancreas produces little to no insulin
Screening: fasting blood sugar recommended every 3 years for adults over the age of 45, most effective test is glucose tolerance test
oral anti diabetic drugs: sulfonylureas (metformin), thiazolidinediones
Hypothyroidism
symptoms: fatigue, increased sensitivity to cold, muscle weakness, slowed heart rate, impaired memory
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Pathologies
Parkinson Disease
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tremor at rest, increased muscle rigidity, slowness in movement (bradykinesia), postural instability
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treatment: anticholinergic medications, technologies to control symptoms
assessment: masklike facial expression, tremors at rest, stooped posture, drooling
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Dementia
irreversible and affects judgement, memory, thinking, behavior
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limited attention span, confusion, anxiety, depression
Pathologies
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Rheumatoid Arthritis
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joints are extremely painful, stiff, swollen, red, and warm to the touch
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Osteoarthritis
progressive deterioration and abrasion of joint cartilage with formation of new bone at joint surface
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Pathologies
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hodgkin lymphoma
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signs/symptoms: fever, night sweats, weight loss, itching
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Pathologies
Perineal Herniations
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types: cystocele, rectocele, prolapsed uterus
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Pathologies
Urinary Tract Infections
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can be caused by poor hygiene, improper cleansing after bowel elimination, catheter associated infections
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symptoms include burning, itching, tingling
assessment: signs of infection, hematuria, pain at costovertebral angle, elevated serum WBCs, confusion, disorientation
interventions: antibiotics, instruct client to appropriate medication regimen, 3000 ml fluid/day, intake & output, voiding every 2 to 3 hours, routine perineal hygiene
Urinary Incontinence
Established: chronic and persistent, causes are stress, urgency, overflow, neurogenic, functional, and mixed incontinence
Transient: acute and reversible, can be caused by infections
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Pathologies
osteoprosis
common site is the hip, wrist, spine
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lack of calcium, being underweight
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Pagets disease
most commonly occurs in the spine, skull, pelvis
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some symptoms include bone deformities, broken bones, and pain in affected areas
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Pathologies
Melanoma
risk factors include UV exposure, moles, family history
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ABCDE rule: asymmetry, border, color, diameter, evolving
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