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The Older Adult :star: - Coggle Diagram
The Older Adult :star:
Respiratory
Changes of Aging: Respiratory
-Calcification of costal cartilage, and trachea, increase risks for infection
Asthma: can occur as a person ages, puts pt at risk for bronchiectasis, and cardiac pr
What is bronchiectasis?-air ways and lungs become widened which can cause an excess of mucous which causes more risk of infection.
precautions to asthma?-evaluate adverse drug reactions
Chronic bronchitis: causes a persistant and productive cough, recurring infections, and shortness of breath
How to manage this?-provide airway clearance, maintain adequate fluid intake, remove secretions.
Lung cancer: This increases in pts 65 and older, smokers are two times at risk than those who do not smoke.
symptoms include: dyspnea, coughing, chest pain, fatigue, respiratory infections
treatments: surgery, chemotherapy, and radiation therapy
Lung abscesses: caused by pneumonia, tuberculosis, malignancy, and trauma
symptoms: anorexia, weight loss, elevated temperature, and cough
It is important that patients with respiratory disorders cough and deep breathe to remove secretions
Cardiovascular
Changes of Aging
-the valves of the heart become thick and rigid, blood vessels lose elasticity, oxygen is used less efficiently
dysrhythmias become more common in aging
bradycardia, tachycardia, atrial fibrillation, and heart blocks
increase in peripheral resistance
artherosclerosis can cause vascular problems
1.peripheral vascular disease, 2. Edema, 3. coronary artery disease
Coronary artery disease: can cause Angina and a myocardiac infarction
Peripheral vascular disease: affects smallest vessels away from heart, 95% of all cases caused by arterioscleroses
Hypertension- consistent blood pressure reading >140mm Hg systolic and >90mm Hg diastolic
symptoms of HTN: dull headache, impaired memory, disorientation, confusion, slow tremor
Heart disease becomes more common with aging, however can be mostly preventable
the steps for prevention of heart disease-alterations modified by lifestyle and diet, identify needs for education, proper diet, exercise, no smoking, manage stress
Control of cholesterol: reduce cardiovascular and cerebrovascular incidents
interventions for preventing and managing stress- relaxation exersices, yoga, meditation
Gastrointesinal system
Changes of Aging
There is a decrease in esophageal motility, atrophy of the small and large intestines, increased risk of aspiration, indigestion, and constipation
saliva production decreases this causes difficulty with swallowing
Xerostomia-dry mouth interventions are saliva substitutes, sipping water, sugarless candy, and gum
presbyesophagus- this results in weaker esophageal contractions and weakness of the spincter
esophageal and stomach motility decreases- this increases the risk for aspiration and indigestion
Decreased elasticity of the stomach-reduces the amount of food accommodation at one time
The stomach has higher pH as a result of decline in hydrochloric acid and pepsin
A decline in hydrochloric acid causes an increase in incidence of gastric irritation and it interferes with absorption of calcium, iron, folic acid, and vitamin B12
A decline in pepsin causes an interference of absorption of protein
There are fewer cells on the absorbing surface of intestinal wall
Results in an impact in absorption of dextrose, xylose, and vitamins B and D
slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low fiber diet
increase risk of constipation
sensory perception decreases
This may lead to constipation or incomplete emptying of the bowel
Bile salt synthesis decreases
This increases the risk of gallstone development and affects digestion of fats
Urinary and Renal System
Changes of Aging
: Decline of renal blood flow and glomerular filtration (50% by 90) , reduced bladder capacity
decrease in urine concentrating ability
changes in hormone levels
increase in Antidiuretic Hormone
causes increase in blood volume, and low blood sodium
increase in atrial natriuretic peptide
vasodilation is caused
decrease in aldosterone
causing low BP, increase in potassium levels, and lethargy
Decrease in glomerular filtration affects the body's ability to eliminate drugs.
This increases risk for adverse drug reaction or toxicity
Urinary tract infection: inflammation at any site of the urinary tract
Caused by the bacteria Escherichia coli
Signs and symptoms include fever, chills, urinary urgency, dsysuria, hematuria, disorientation or confusion
Treated with an antibiotic, and encourage pt to drink 3000mL of fluid/day, encourage voiding every 2-3 hours
Musculoskeletal System
Changes of Aging:
thinning of disks and shortening vertebrae, reduced muscle mass, strength and movement, increase risk fractures
bone mass decreases in age especially women after menopause
shortening of vertebrae occurs due to discs becoming thinner and losing fluid which causes them to thin
The foot arch becomes less which also causes a shortening in height
long bones of the arms and legs become more brittile, this is due to mineral loss.
The long bones do not shrink, but the trunk of the body does due to the changes in vertebrae. This makes arms and legs appear longer.
Osteoporosis is very common in older women causing compression fractures. This is when bones weaken caused by new bone creation not being able to keep up with old bone removal. The main cause of this is loss of calcium
osteoarthritis is a degenerative joint disease: caused by a break down of cartilage and causes pain in joints
CROSS LINK
brittle bones can also be caused by osteoporosis due to changes in the reproductive system such as a decrease in estrogen leading to and increase in bone resorption
Joints become more stiff due to cartilage rubbing together and causing wear and tear. Fluid in joints also decrease.
Finger joints begin to lose cartilage, and bones thicken
Lean body mass decreases due to loss of muscle
CROSS LINK
loss of muscle is also related to the reproductive system and how there is a decrease in testosterone levels (andropause)
Reproductive
Changes of Aging
: testosterone levels decrease in men, and women go through menopause-cessation of period
Andropause: testosterone levels in men decrease, this can cause reduction in muscle mass, energy, strength and stamina
Other changes: erectile dysfunction, breast enlargement, osteopenia, osteoporosis, and smaller testes
Erectile dysfunction caused by:atherosclerosis, diabetes, hypertension, multiple sclerosis, thyroid dysfunction, alcoholism, renal failure, structure abnormalities, medications, and psychological factors.
osteoposrosis is common after menopause due to a decrease in estrogen levels
more bone resorption is happening than formation leading to brittle bones (easier for fractures)
Age related changes and sexual responses: older adults are physically able to remain sexually active, age related changes have in impact on sexual function.
Barriers unavailability of a partner: Lack of partner this is more common for women to experience due to men marrying younger women. Most older men are married and most older women are widowed.
Psychological barriers: negative attitudes from society, fear of losing sexual abilities, negative body image, relationship issues, misconceptions by older adults.
Immune System
Changes of Aging
: Normal body temperatures are lowered, ability to respond to cold temperatures are reduced, and response to heat is altered
Three physiologic changes that are clinically significant and make older adults more vulnerable to injury and disease?
loss of compensatory reserve
progressive loss in efficiency of the body to repair damaged tissue
Decrease in function of the immune system
Integumentary System
Changes of Aging:
- thin skin, decreased ability to detect and regulate temp, dry skin, loss of elastine, increase in vascular fragility
-Having a thin skin barrier provides a less effective barrier
Older adults more prone to pressure ulcers
Why does skin become more dry?- due to the decrease in endocrine secretion
Skin cancer becomes more common: basal cell carcinoma, squamous cell carcinoma, melanoma
increase in appearance of age spots and raised skin lesions
this is seborrheic keratosis
Endocrine System
Changes of Aging:
- the thyroid gland atrophies and activity decreases, diminished adrenal function, ACTH secretion decreases, volume of pituitary gland decreases, insufficient release of insulin and reduced tissue sensitivity to circulating insulin
Type 2 diabetes mellitus: 7th leading cause of death in older adults, glucose intolerance, classic symptoms may not be present.
Screening: fasting blood sugar done every 3 years for persons over 45 years old, glucose tolerance is the most effective test
Diagnosis criteria: Symptoms and a random blood glucose concentration > 200 mg/dL, Fasting blood glucose concentration > 126 mg/dL, Blood glucose concentrations 2 hours after oral glucose intake >200 mg/dL
treatment includes many types of medication these include, sulfonylureas, thiazolidinediones, and insulin
InsulinBasal-bolus insulin regimens more closely resemble the bod’s natural actions, allow flexibility in meal times and reduce hypoglycemic events
Complications of DM: hypoglycemia which can cause ketoacidosis, Peripheral vascular disease, diabetic retinopathy, drug interactions
Hypothyroidism:insufficiency of the thyroid hormone
signs and symptoms: fatigue, weakness, lethargy, anorexia, weight gain/puffy face, periorbital and peripheral edema
treatment: give thyroxine or Synthroid, routine labs, symptom relief
Hyperthyroidism: secretions of excess thyroid hormone
Also known as Graves Disease or Goiter
signs and symptoms: diarrhea, diaphoresis, tachycardia, palpitations, increase in systolic BP, nervousness, insomnia, and heat intolerance
Treatments: Thyroid ablation, radioactive iodine therapy, thyroidectomy
Nursing interventions include observing for thyroid storm, teach daily hormone replacement, wear Med alert, high calorie, protein, low caffeine and fiber diets
CROSS LINK One of the factors that causes older adults thinner skin
Nervous System
Changes of aging:
Intelligence remains constant in the healthy older adult, slowing in central processing, number and sensitivity of sensory receptors, dermatomes, and neurons decreased, decline in function of cranial nerves
Taste and smell affected by the decline in function of cranial nerves
Demyelination causes slower nerve conduction, response and reaction time decreased, and reflexes become weaker
Parkinson Disease affects the central nervous system and the ability to control body movements
chracterized by tremor at rest, increase muscle (rigidity), bradykinesia, and postural instability.
Masklike facial expression causing difficulty in chewing, swallowing, and speaking.
Symptoms are tremors and shuffling gait.
Parkinson disease involves an imbalance between acetylcholine and dopamine. Symptoms can be controlled by a dopamine precursor known as levodopa
Neurocognitive Disorder: Dementia
Cognitive impairments characterized by gradual progressive onset. Irreversible and affects judgement, memory, abstract thinking, and social behavior
Personality changes, confusion, disorientation, deterioration of intellectual functioning, loss of memory, decline in ADLs, changes in mood or behavior.