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The Older Adult - Coggle Diagram
The Older Adult
Respiratory
Normal Aging
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reduced secretions from submucosal gland- making mucus thicker and harder to expel- leading to cough
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Pathologies
Asthma
B/c of added stress on heart, older asthmatics have risk of developing complications like cardiac issues
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Emphysema
Symptoms are slow in onset and may resemble age-related changes, so late detection often happens
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Gastrointestinal
Normal Aging
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Pathologies
Hiatal hernia
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2 types: rolling, sliding- manage with small meals & bland diet
Colorectal cancer
common S&S include sense of incomplete emptying, hx of polyps, change in bowel habits
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Reduced pepsin & hydrochloric acid cause- interference with vitamin B12, calcium, iron, folic acid, and protein absorption
Slower peristalsis, inactivity, reduced food/fluid intake, drugs, low fiber diet- increase risk of constipation
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Cardiovascular
Normal Aging:
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-Myocardial muscle less efficient (decreased contractile strength)- leading to decreased ability to meet activity demands
-Diminished peripheral pulses, strong arterial pulses
Pathologies:
Hypertension:
high BP: evaluation of blood pressure at least 2 occasions (systolic >140, diastolic >90)
Pulmonary Emboli:
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detection & diagnosis challenging, may present with confusion/apphrension
Risk factors: fractured hip, CHF, immobilzation
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Sensory
Normal Aging
Touch: reduction in number of/structural integrity of receptors. Tactile sensation is reduced- leading to reduced ability to pressure, pain and temp differences
Vision: Presbyopia (inability to focus on close objects), decreased ability to adapt to light, pupil size decreases and less responsive to light, depth perception distortion
Hearing: Presbycusis (progressive hearing loss due to loss of hair cells, decreased blood supply, reduced flexibility of basilar membrane), cerumen increases, altered equilbirium
Taste & Smell: decrease number of sensory cells in nasal lining, taste acuity dependent on smell, atrophy of the tongue
Pathologies
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Detached retina
forward displacement of retina, need treatment to prevent more damage
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Nervous
Normal Aging
Number and sensitivity of sensory receptors, dermatomes, and neurons decrease
loss of nerve cell mass, causes atrophy of brain and spinal cord- brain weight decreases
Demyelination- results in slower nerve conduction and result and reaction time, weaker reflexes
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plaques, tangles, atrophy occur
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slowed central processing, but verbal skills intact until age 70
Pathologies
Parkinson's Disease
chronic, progressive disease affecting motor ability; tremors and shuffling gait are key characteristics
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Less time in REM due to less total time in sleep, Sleep is less sound, delay in onset of sleep, more time in stages I and II less time in stages II and IV
Reproductive
Normal Aging
Male:
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-Fibrosis, epithelial thinning, thickening of basement membrane, and lumen narrowing
Pathologies
Prostate Cancer
often asymptomatic, need a digital rectal exam
Erectile Dysfunction
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Causes: certain meds (antidepressants, anticholinergics)
Female:
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-drier, less elastic vaginal canal (which can lead to some discomfort during intercourse)
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-fallopian tubes shorten, thicken, and become straighter
Pathologies:
Dyspareunia
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Painful intercourse that needs an exam to identify possible causes: lesions, dryness, infection
Endometrial cancer
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High risk in those who have been infertile, late periods, or hx of HNPCC
Perineal Herniation
result of tearing of muscle during childbirth and weakened muscles (cystocele, rectocele, prolapsed uterus)
Even though the reproductive organs of males and females change with aging, sexuality must still be viewed in the context of individuals lives and nurses must acknowledge that the general pattern of sexual behavior remains constant throughout life.
Endocrine
Normal Aging
thyroid gland atrophy and decreased activity- lower metabolic rate, iodine reuptake, less secretion/release of thyrotropin
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ACTH secretion decreases- which in turn reduces secretion of hormones (estrogen, glucocorticoids)
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Pathologies
Diabetes Mellitus:
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Older adults with uncontrolled diabetes can develop neuropathies which is nerve cell damage from high blood glucose- symptoms like tingling or pain occur
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Urinary
Normal Aging
Hypertrophy and thickening of bladder muscle- decreases ability to expand (capacity decreases in half)
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Ineffective neurological control of bladder emptying and weaker bladder muscles (increased retention- for females from fecal impaction & for men from PH)
GFR decreases due decreased renal blood flow & functioning glomeruli- affects drug elimination & slowed organ function
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Pathologies
Urinary Tract Infections
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high risk in those with diabetes, older women with prolapse, catheterized clients
Glomerulonephritis
early S&S of chronic form- blood or protein in urine, high BP, ankle swelling
Late stage S&S: cerebral edema, convulsions, confusion
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Musculoskeletal
Normal Aging
Reduced muscle mass, strength and movement
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Pathologies
Osteoarthritis
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Used to thought to be from wear and tear, but now understood to be due to a disequilibrium between destructive and synthetic elements leading to a lack of homeostasis to maintain cartilage
Rheumatoid Arthritis
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affected joints become painful, stiff, swollen, and warm
Decreased vision and adaptiveness to light can increased risk of falls, combined with increased for fractures can cause injury
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Integumentary
Normal Aging
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Pathologies
Skin cancer
3 major types later in life: basal cell carcinoma, squamous cell carcinoma, and melanoma.
Frequent skin assessment is very important: help teach patient about ABCD for detecting unhealthy moles that could be possible skin cancer.