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older adults - Coggle Diagram

- - - - orientation
      - reasoning
      - memory
      - attention
      - language
      - problem solving
    - - new meds
      - pain
      - hypernatremia/hyponatremia
      - dehydration
      - hypoxia
      - infection
  - - - shuffled gait
      - bradykinesia
      - rigidity
      - tremors
      - pill rolling
    - - technologies to control symtpmoms
      - anticholinergic medications
  - - - neural plaque formation
      - neurofibril tangles
      - loss or degeneration of neurons and synapses
      - changes in neurotransmitters
    - - antiinflammaotries
      - folic acid
      - antioxidants
      - gene therapy
      - B12 nad B6
- - - - PVD
      - edema
      - CAD
      - acute coronary insufficiency
      - MI
  - - - dash diet
      - control cholesterol below 300mg/dl
  - - - coughing
      - syncope
      - Indigestion
      - vague discomfort under sternum
      - confusion
      - sweating
  - - - falls
      - stroke
      - syncope
  - - - diastolic >90
      - systolic >140
  - - - decrease blood pressure
      - SOB
      - confusion
      - elevated sedimentation rate
      - elevated temp
  - - - peripheral edema
        
        weight gain
        
        distended neck vein
        
        peripheral edema
        
        anorexia
    - - pulmonary edema
        
        cough
        
        fatigue
        
        crackles
        
        dyspnea
- - - - calcification of costal cartilage and trachea
    - - decrease cough reflex
  - - - Is an intermittent disease with reversible airflow obstruction and wheezing due to a variety of stimulants
    - - administer bronchodilator
      - administer fluids and humidification
      - ABGs
      - C-Pap or Bi-Pap
  - - - R heart failure
      - JVD
      - "blue bloater"
      - persistent predictive coughing
      - wheezing
      - recurrent respiratory infection
      - SOB
    - - Lowest FIO2 possible
      - watch for signs of fluid overload
      - remove bronchial secretions
      - prevent airway obstruction
  - - - "pink puffer"
      - quiet breath sounds
      - barrel chest
      - pulmonary bleb on x ray
      - wheezes
    - - bronchodilators
      - avoid stress
      - postural drainage
      - coughing and deep breathing
  - - - immobility
      - Immunosuppression
      - smoking
      - depressed gag or cough
      - debilitated by accumulation of lung secretions
      - sedatied
      - neuromuscular disorder
      - NG
    - - abrupt fever with chills
      - productive cough
      - rapid bounding pulse
      - bronchial breath sounds/crackles/tactile fermitus
      - tachypnea
      - elevated wbc
      - decreased O2 sat
    - - lethargy
      - anorexia
      - confusion
      - rapid resp rate
      - tachycardia
- - - - fasting blood glucose >126
      - random glucose concentration > 200
      - 2 hour fasting blood glucose >200
    - - medications
      - healthy nutrition
      - physical activity
      - insulin
      - weight loss
  - - - heat intolerance
      - shiny hair with areas of thinning
      - weight loss
    - - antithyroid drugs
      - surgical removal of thyroid
  - - - dry skin and hair
      - cold intolerance
      - weight gain
      - decrease metabolism
      - fatigue
    - - levothyroxine
      - synthroid
      - armor thyroid
- - - - exercise tolerance
      - decrease in grip strength
      - muscle wasting
      - frequent falls
      - weight loss
      - immobility
      - weakness
      - instability of chronic illness
      - sarcopenia and osteopenia
    - - pro-coagulation
      - pro-inflammatory status
      - Immuno-aging
      - hormonal dysregulation
  - - - average of 6 diagnosis
      - malnourishment
      - mean age of 79
      - dehydration
      - skin ulcers
      - falls
      - cognitive difficulties
- - - - prevent aspiration
      - promote adequate nutriton
    - - GERD
      - structural disorders
      - stroke
  - - - heart burn
      - belching
      - abdominal discomfort
    - - obesity
      - large volumes of food
      - increase abdominal pressure
    - - avoid meals at bedtime
      - bland diet
      - small meals
      - sleep in partial recumbent
  - - - diverticulitis
        
        increase flatus
        
        LLQ pain
        
        rectal bleeding
      - Obstruction
        
        anorexia
        
        abd distention
        
        fever
        
        constipation alternating with diarrhea
    - - obesity
      - atrophy of intestinal wall muscle
      - chronic constipation
- - - - urinary frequency, urgency, and nocturia
    - - decrease elimination of medications
        
        potential for toxic effects
    - - nocturia
    - - decrease capacity by 50%
    - - proteinuria is more common
      - higher BUN
  - - - immunosupression
      - cathaterized patients
      - prostatic hypertrophy
      - urinary retention
      - pregnancy
      - older women with bladder prolapse
      - diabetes
    - - signs of infection
      - urinary frequency and frequency
      - hematuria
      - pain at costovertebral angle
      - dysuria
      - Disorientation and confusion
    - - Escherichia coli
  - - - cerebral edema leading to confusion and convulsions
    - - preoteinuria
      - hypertension
      - hematuria
      - edema in the ankles or face
    - - tiredness
      - difficulty sleeping
      - nausea and vomitiing
      - dry and itchy skin
      - lack of appetite
      - nighttime muscle cramps
  - - - overflow
      - neurogenic (reflex)
      - urgency
      - functional
      - stress
      - mixed
- - - - decreased strength
      - decreased energy
      - decreased stamina
      - Reduced muscle mass
  - - - MS
      - hypertension
      - thyroid dysfunction
      - diabetes
      - alcoholism
      - atherosclerosis
      - structure abnormalities
      - renal failure
      - medications
    - - unable to maintain or attain an erection
- - - - illness
      - stress
      - anxiety
      - changes in environment
    - - medications
      - substance abuse
      - Environmental factors
      - physical or mental illness
    - - difficulty falling or staying asleep or prematurely awakening
  - - - 5 leg jerks or movements per hour during sleep
    - - tricyclic antidepressants
      - renal failure
      - iron deficiency anemia
      - uremia
      - Parkinson's
      - rheumatoid arthritis
      - diabetes
      - neurological lesions
    - - neurological condition of urge to move leg
- - - - encourage regular breast examinations
    - - lumps
      - nipple discharge
      - invert nipples
      - discomfort
    - - second leading cause of cancer deaths
  - - - Reduction in collagen and adipose tissue
      - less lubrication
  - - - nocturia
      - decrease force of urinary stream
      - Hesitancy
      - prostate enlargement
    - - transurethral resection
      - medications
    - - all older men have it to some degree
- - - - sense of smell altered
      - decrease taste acuity
        
        decreased saliva, poor oral hygiene, and medication
    - - presbyopia
      - narrowing visual field and decreased peripheral vision
      - pupil size decrease and less reactive to light
      - depth perception distroted
      - decrease visual acuity
    - - reduced tactile sensation
      - decreased ability to sense pressure, discomfort, and change
    - - distortion of high pitched sounds
      - increased cerumen causing hearing altercations
      - alterations in equalibrium
      - presbycusis
    - - risk for social isolation
      - imbalanced nutrition
      - risk for pressure injury
      - risk for falls
  - - - blurred visions
      - cloudy lense
      - loss of transparency
    - - leading cause of low vision in older adults
    - - irritation
      - not using sunglasses
      - nutrient deficiencies
  - - - forward displacement of the retina
    - - feeling of film over the eyes
      - spots in the visual field
      - pain
- - - - uric acid accumulation in the blood leading to crystal deposits in the joints
      - treatment
        
        avoid alcohol
        
        colchicine or phenylbutazone
        
        low purine diet
      - symptoms
        
        swelling
        
        redness
        
        warmth
    - - progressive deterioration and abrasion of the joint cartilage
      - main symptoms
        
        herberden nodes on distal joints
    - - early menopause
      - NW European or British isles ethnicity
      - advanced age men over 80
      - advanced age women over 65
      - smoking
      - multiple pregnancies
      - high alcohol consumption
      - chronic corticosteroid, thyroid hormone, or anticonvulsant use
      - family history
- - - - older women 2x as likely compared to men
      - 2x more likely in whites
      - 30% older adults with GAD
    - - incidence increase with age
      - interventions: encourage independence, encourage personal grooming, promote sense of control
      - s/s: insomnia, fatigue, anorexia, weight loss, neglect of hygiene
    - - highest risk: older adult men over the age of 85
      - signs: giving away possessions, sudden change in affect (increase energy)
    - - most common prescription drug abuse: oxy, sedatives, stimulants
      - assessment findings for alcohol abuse
        
        morning drinking
        
        blackouts
        
        continuous drinking
        
        binge drinking
        
        hiding drinking patterns
      - most common: marijuana
- - - - somatic
      - visceral
- - - - compression of the cartilage between the vertebrae
    - - baggy eyelids
      - double chin
      - elongated ears
- - - - risk for infection becomes significant
      - T cell activity declines
      - inflammatory defenses decline
      - inflammation presents atypically
      - cell mediated immunity declines