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Older Adult - Coggle Diagram

- - - - Interferes with absorption of calcium, iron, folic acid, and vitamin B12
      - Increases in incidence of gastric irritation
    - - Interferes with absorption of protein
  - - - Cancer of the colon or rectum
      - 45% are rectal or sigmoid, 25% new cecum or sending colon, 30% are the remainder
      - S/S include a change in bowel habits, a sense of incomplete evacuation, abdominal pain, n/v, weight loss, cachexia, abdominal distention, family hx, hx of polyps
      - Diagnosied with a fecal occult blood test, Cologuard, CBC and colonoscopy
      - Tx includes a colon resection
      - Causes are not fully known, there is some contribution to modifiable lifestyle factors such as diet, smoking, obesity, alcohol
      - Cross link to musculoskeletal system in that it can be caused by lack of mobility
    - - Can be partial or complete
        
        Large intestine: cancer, Small intestine: adhesions and hernia
      - S/S depend on the site of the obstruction and cause
      - Can be caused by a tumor, intersession or stool impaction
      - Tx inclused medical and surgical management
      - Linked to atrophy of intestines, increased risk of constipation, fewer intestinal wall cells,
- - - - Plaques and tangles
  - - - CNS is affected leading to a change in control of body movements
      - S/S include tremor at rest, increased muscle rigidity, bradykinesia, postural instability, stooped posture, shuffling gait, drooling, mask like facial expression
      - Chronic and progressive; debilitates neurologic disease of the basal ganglia and substantial nigra
      - Tx includes anticholinergic meds and technologies that help improve symptoms, and Antiparkinsonian drugs which help the imbalance between acetylcholine and dopamine. Symptom control is helped by a dopamine precursor, such as levodopa.
      - Goal is to keep maximum level of independence
      - Linked to older adult change of nerve cell damage/change and demyelination
    - - 2 types; ischemic and hemorrhagic
      - S/S vary depending on the location of the brain that is affected
      - Caused by a loss of blood flow to the brain, which damages brain tissues. Typically caused by a blood clot in the brain or a broken vessel.
      - Linked to older adult changes of fatty deposits in blood vessels, chronic psychological stress, and cross linked to changes in cardio system, leading to blood clots
- - - - Gradual damage of alveoli
        
        Leads to reduced gas exchange surface area, increased air trapping, decreased capillary network, increased work, and increased oxygen consumption.
      - Assessment reveals barrel chest, "pink puffer", distant, quiet breath sounds, wheezes, pulmonary blebs on x-ray, S/S develop slowly; pursed lip breathing, dyspneic, prolonged expiration
      - Caused by chronic bronchitis, chronic irritation, morphologic changes in the lung, and smoking
        
        This links to the older adult changes pertaining to changes in the lung shape, function, and rigidity.
      - Treatment includes postural drainage, bronchodilators, avoiding stress, and breathing exercises
    - - Inflammation of the lower respiratory tract; classified by the causative agent
        
        Agents include bacterial, viral, fungal, or chemical
        
        Caused by aspiration, inhalation, or hematogenous spread
      - Pt may be at high risk if there are debilitated lung secretions, smoking, immobile, immunosuppressed, depressed gag or cough, sedated, have a neuromuscular disorder, NG, or are a hospitalized client
        
        Cross links to immune system (those who are immunosupressed have an increased risk of pneumonia)
      - S/S include, tachypnea, rapid, bounding pulse, fever with shaking/chills, productive cough, confusion, lethargy, anorexia, rapid rest rate, tachycardia, bronchial breath sounds with crackles and tactile remits, infiltrates with consolidation on a chest x-ray, elevated WBC, and decreased O2 saturation
      - Treatment includes humidified air, deep breathing every 2 hours, chest physiotherapy, 3L of fluid/day, assessment of sputum and lung sounds, anti-infective agents prescribed, monitoring of ABG's
- - - - Affects ability to eliminate drugs
      - Slowed organ function
        
        Causes potential for adverse drug reactions
  - - - Infection or inflammation at a site in the urinary tract, commonly caused by E.coli
      - Those at high risk include those with diabetes, pregnancy, prostatic hypertrophy, those who are immunosuppressed, catheterized pts, urinary retention, older women with bladder prolapse
        
        Cross link to repro and immune system section; their pathologies can lead to a UTI
        
        Link to older adult change of change in bladder size and shape
      - Tx with anitbiotics for the infectious agent, med regimen, 3L of fluid/day, mild analgesics, voiding every 2-3 hrs, removing indwelling catheters within 24-48 hrs, and peri hygiene
- - - - An irregular heart beat
      - Causes include digitalis toxicity, hypokalemia, acute infections, hemorrhage, angina syndrome, and coronary insufficiency
      - S/S include weakness, fatigue, palpitations, confusion, dizziness, hypotension, bradycardia, and syncope
      - Tx includes anti-arrhythmic drugs, digitalis, potassium supplements, and cardio version
      - Should teach pt to modify diet, quit smoking, decrease alcohol, and increase physical activity
      - Linked to older adults change of reduced cardiac output caused by the loss of efficiency and contractile strength of the heart muscle
    - - The heart is not able to pump enough blood to meet the tissue's oxygen demands
        
        L-sided failure
        
        Causes pulmonary edema, leading to pulmonary congestion because the L ventricle is unable to pump blood to the periphery
        
        S/S include dyspnea, crackles, cough, tachycardia, fatigue, anxiety, restlessness, confusion
        
        R-sided failure
        
        Causes peripheral edema, leading to peripheral congestion because the R ventricle is unable to pump blood out to the lungs
        
        Could be caused by L-sided HF or pulmonary disease
        
        S/S inclue peripheral edema, weight gain, distended neck veins, anorexia, weakness, hepatomegaly, ascites
      - Linked to the older adult change of less efficient use of oxygen demands, and loss of contractile strength in the heart muscle
- - - - Hypofunction of the thyroid gland with insufficiency of thyroid hormone
      - Diagnosis includes Low T3 and T4, and the presence of T4 antibody
      - S/S include fatigue, weakness, lethargy, anorexia, weight gain, puffy face, impaired hearing, periorbital/peripheral edema, myalgia, paresthesia, ataxia, dry skin/hair, husky voice, slow speech
      - Pt should be educated on medication regimen (including side effects), follow-up for serum hormone levels, and have a bowel elimination plan
      - Tx includes replacement of thyroid hormone
      - Linked to older adult changes of thyroid gland atrophy with decreased activity
    - - Glucose intolerance; impairment of how the body uses glucose d/t a decreased amount of insulin from the body
      - Diagnosis includes 1 of the following 3;
        
        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
      - Educate on disease process, healthy diet, increased exercise, meds, knowing s/s, monitoring with finger stick blood sugar, A1c, and triglyceride levels (below 150 mg/dL)
      - Tx with drug therapy
        
        Main med to know is insulin; it resembles the body's natural actions to reduce hypoglycemic events
      - Linked to older adult change of insufficient release of insulin and decreased sensitivity to insulin
- - - - Autoimmune disease that can cause pain to joints and damage to the body (link to immune system)
      - Usually happens on both sides of the body
      - S/S include pain, swelling, and stiffness, loss of function and deformities
      - Treatment includes dietary changes, exercise and diet, there is no specific cure
        
        Meds are used to decrease pain and inflammation
- - - - Inability to focus on close objects clearly
    - - Light perception threshold decreases
      - Dark and light adaptions takes longer
      - Difficulty with vision at night
  - - - Progressive loss of hearing
  - - - Caused by loss of cells in the olfactory bulb
    - - Caused by decreased saliva, poor oral hygiene, and meds
    - - Altered sweet and salty flavors
  - - - Damage to optic nerve from an above normal intraocular pressure
      - Often leads to blindness, need early treatment
      - S/S include severe eye pain, headache, n/v, increase in tension and edema
      - Diagnose with tonometry to measure IOP
      - Need to avoid situations that increase IOP and avoid emotional stress
      - Linked to older adult change of vision
- - - - Nocturnal Myoclonus and Restless Leg Syndrome
        
        Jerking legs during sleep
        
        Nocturnal Myoclosis is 5 leg jerks or movements per hour during sleep
        
        Cross linked to the renal system, as renal failure can cause this, and neuro, because restless leg syndrome is a neurological condition
        
        Restless leg syndrome: neurological condition of urge to move the leg
        
        Can be caused by iron deficiency anemia, Parkinson's disease, rheumatoid arthritis, diabetes, and neurological lesions
- - - - Inflammation presents atypically
  - - - Acquired viral infection that destroys WBC's and weakens the immune system
      - Linked to older adult change of a weakened immune system
        
        This disease takes advantage of a weakened immune system
      - People with this become seriously ill and are unable to fight off infections
- - - - Injuries to skin and underlying tissue caused by prolonged pressure
      - Can happen to anyone, but those who are immobile are at an increased risk
      - Linked to all integumentary changes, these can all put a pt at an increased risk fro pressure ulcers
      - Categorized by their stage
- - - - Results in reduced muscle mass, energy, strength, and stamina
  - - - Vulva atrophies
      - Labia flattens
      - Loss of subQ fat and hair
    - - Reduction in collagen and adipose tissue
      - Shortening and narrowing of the canal
      - Less lubrication
        
        Could cause discomfort during intercourse
      - More alkaline vaginal pH as a result of lower estrogen changes
  - - - Decreased capacity to retain fluids
        
        Seminiferous tubule changes
  - - - Inability to attain or maintain erection for sexual intercourse
      - May be caused by atherosclerosis, diabetes, hypertension, MS, thyroid dysfunction, alcoholism, renal failure, structure abnormalities, meds, and psychological factors
        
        Cross link to almost all other systems and the pathologies that they create, leading to ED
        
        Link to structural change of the male reproductive system as aging occurs
    - - Linked to older adult change of increased vaginal fragility which increases the risk of irritation, leading to vaginitis
      - Occurs in post menopausal women
      - Leads to painful intercousrse and urinary symptoms
      - Thinning, drying, and inflammation of the vaginal walls