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The Older Adult - Coggle Diagram

- - - - This can affect the digestion of fats and contribute to an intolerance of fatty foods
  - - - -This contributes to an increased incidence of gastric irritation later in life
        -the reduced presence of pepsin can interfere with the absorption of preotein
        -the decrease in hydrochloric acid can interfere with the absorption of calcium, iron, folic acid, and vitamin B12
- - - - The sum of these changes causes less lung expansion, insufficient basilar inflation, and decreased ability to expel foreign or accumulated matter
  - - - The thicker secretions are more difficult to remove and give the older person a sensation of nasal stiffness
  - - - -A pathologic diagnosis defined by permanent enlargement of airspaces distal to the terminal bronchioles (alveoli)
        -This causes a dramatic decline in the alveolar surface area available for gas exchange
        
        S/S
        -gradually increasing dyspnea
        -chronic cough
        -hypoxia
        -fatigue
        -anorexia
        -weight loss
        -weakness
        -recurrent respiratory infections
        -malnutrition
        NOTE:
        -the symptoms are slow in onset and initially may resemble age-related changes to the respiratory system
        -causes delayed identification of diagnosis and treatment
        
        Management
        -patients need lots of education
        -learn to pace activities
        -avoid extremely cold weather
        -administer medications correctly
        -be able to recognize symptoms of infection
    - - -This condition results from recurrent inflammation and mucus production in the bronchial tubes
        -Overtime, this produces blockage and scarring that restricts airflow
        -Episodes of hypoxia begin to occur because mucus obstructs the bronchial tree and causes carbon dioxide retention
        -As the disease progresses, emphysema may develop, and death may occur from obstruction
        
        S/S
        -persistent, productive cough
        -wheezing
        -recurrent respiratory infections
        -shortness of breath
        NOTE:
        -these symptoms may develop gradually, sometimes taking years for the full impact of the disease to be realized
        
        Management
        -aimed at removing bronchial secretions and preventing obstruction of the airway
        -older patients may need special encouragement to maintain good fluid intake
        -prevention of other respiratory infections
        -smoking cessation
- - - - This results in a lower basal metabolic rate, reduced radioactive iodine uptake, and less secretion and release of thyrotropin
  - - - ACTH secretion decreases with age, which in turn reduced the secretory activity of the adrenal gland
        
        This in turn, reduces the secretion of estrogen, progesterone, androgens, 17-ketostreoids, and glucocorticoids
  - - - -tt is thought that increased amounts of fat tissue in older adults who are obese and inactive are considered significant to the development of this condition
        -This may be a factor in the high incidence of diabetes throughout the general population
  - - - -The thyroid gland secretes excess amounts of thyroid hormone
        -less prevalent than hypothyroidism
        -A potential cause in older adults is related to the use of amiodarone
        
        S/S
        -diaphoresis
        -tachycardia
        -palpitations
        -hypertension
        -tremor
        -diarrhea
        -stare
        -lid lag
        -insomnia
        -nervousness
        -confusion
        -heat intolerance
        -increased hunger
        -proximal muscle weakness
        -hyperreflexia
        
        Management:
        -Tx depends on the cause
        -antithyroid medications or radioactive iodine
    - - -A subnormal concentration of thyroid hormone in the tissues
        -increases in prevalence with age
        -Production of T4 declines with age and thyroid gland atrophies
        
        S/S
        -Fatigue, weakness, and lethargy
        -depression and disinterest in activities
        -anorexia
        -weight gain and puffy face
        -impaired hearing
        -periorbital or peripheral edema
        -constipation
        -cold intolerance
        -myalgia, paresthesia
        -dry skin and coarse hair
        
        Management:
        -replacement of thyroid hormone
        -levothyroxine
- - - - Manifested by...
        -slower reflexes and delayed response to multiple stimuli
        -kinesthetic sense lessens
- - - - -A complex clinical syndrome in which the heart is unable to pump enough blood to meet the meet the body's requirements
        -"failure to meet the systemic demands of circulation"
        -It can be caused by any disorder that impairs ventricular filling or ejection of blood to the systemic circulation
        
        S/S
        -dyspnea on exertion
        -confusion
        -insomnia
        -depression
        -anorexia
        -nausea
        -weakness
        -SOB
        -wheezing
        -weight gain
        -bilateral ankle edema
        -moist crackles heard on auscultation
        
        Management:
        -bed rest
        -ACE inhibitors
        -beta-blockers
        -digitalis
        -diuretics
        -reduction in sodium intake
- - - - These changes make fractures a serious risk to the older adults
- - - - Therefore, urinary frequency, urgency, and nocturia are common in older adults
        
        Incontinence is NOT a normal part of aging
  - - - -affects the body's ability to eliminate drugs
        -increased risk for adverse drug reactions/drug toxicity
        -high blood urea nitrogen levels
- - - - -reduction of tactile sensation
        -reduced ability to sense pressure, discomfort, and changes in temperature
    - - Presbyopia: inability to focus on close objects clearly
        
        Reduced elasticity of the lens
        
        -characteristic of older eyes and begins in the fourth decade of life
        -stiffening of muscle fibers in the lens decreases the eyes ability to change the shape of the lens and to focus on near objects
        -decreased ability to to adapt to light
        
        Narrowing of the visual field
        
        -makes peripheral vision more difficult
        -there is difficulty maintaining convergence and gazing upward
        
        Hardening of the pupillary sphincter, size reduction of pupils, and decreased rhodopsin in the rods
        
        As a result, the light perception threshold increases and vision in dim areas or at night is difficult
        
        Distorted depth perception
        
        Results from a disparity between the retinal images caused by the separation of the two eyes
        
        Atrophy of the ciliary muscle
        
        The ciliary muscle gradually atrophies and is replaced with connective tissue
        
        Reduced lacrimal secretions
        
        May cause the eyes to look dry and dull
        
        Decreased visual acuity
        
        Due to decreased pupil size, scatter in the cornea and lens, opacification of the lens and vitreous humor, and loss of photoreceptor cells in the retina
    - - Presbycusis: progressive loss of hearing
        
        Age-related changes to the inner ear..
        -loss of hair cells
        -decreased blood supply
        -reduced flexibility of basilar membrane
        -degradation of spiral ganglion cells
        -reduced production of endolymph
    - - Reduction of the sense of smell
        
        Due to a decrease in the number of sensory cells in the nasal lining and fewer cells in the olfactory bulb of the brain
      - Reduction of the sense of taste
        
        -Most of the taste acuity is dependent on smell, the reduction in the sense of smell also effects taste
        -atrophy of the tongue with age can diminish taste sensations
        -the ability to detect salt is affected more than other taste sensations