Please enable JavaScript.
Coggle requires JavaScript to display documents.
Older Adult Care Map - Coggle Diagram
Older Adult Care Map
Lab Values
Sodium: 141 mEq/L
Potassium: 4.3 mEq/L
Chloride: 103 mEq/L
Carbon dioxide: 29 mEq/L
BUN: 18 mg/dL
Creatinine: 0.8 mg/dL
Glucose: 92 mg/dL
White blood cell count: 6.9 10,000/meters cubed
Hemoglobin: 8.2 g/dL
With low levels of hemoglobin, hematocrit and red blood cells, the patient could have a possible diagnosis of anemia
Hematocrit: 25.2%
Platelets: 245 150,000/meters cubed
Red blood cell count: 2.61 g/dL
Hypertension
Patho
Hypertension can occur due to increased peripheral resistance, cardiac output and stiffness of the blood vessel. Increased stiffness leads to increased peripheral resistance. Increased fluid retention leads to the increase of stroke volume and blood pressure. Overactivity of the sympathetic nervous system causes increased peripheral resistance, heart rate and blood pressure. The renin-angiotensin-aldosterone system can cause hypertension by the excess of angiotensin II causing vasoconstriction and excess of angiotensin causes increase aldosterone release, thus increased blood pressure.
Signs & Symptoms
Many patients can be asymptomatic; headaches, shortness of breath or nosebleeds; blood pressure was 149/70 mmHg and 139/56 mmHg
Risk Factors
Age, race (African heritage), family history, being overweight, not being physically active, tobacco use, high sodium diet, low potassium diet, alcohol abuse, stress, and chronic conditions such as diabetes and chronic kidney disease
Medications
Prescribed
Valsartan 80mg, oral, daily,
0800
Possible medications
Diuretics (ex. hydrochlorothiazide), ACE inhibitors (ex. lisinopril), Angiotensin II receptor blockers (ex. losartan, candesartan), Calcium channel blockers (ex. cardizem, triazec), Alpha blockers (ex. doxasin), Alpha-beta blockers (ex. carvedilol), Beta blockers (ex. atenolol), Aldosterone agonist (spironolactone), renin inhibitors (ex. aliskeran), vasodilators (ex. hydralazine), and central acting agents (ex. clonidine)
Treatment
Vitals taken at least q4 hours; low sodium and fat diet
Deep Vein Thrombosis
Patho
A thrombus or blood clot forms in one or more of the deep veins, usually in the legs. This can be due to a high fat or sodium diet, hypertension, and atherosclerosis or the build up of plaque within the blood vessels.
Signs & Symptoms
Pain, swelling, red/discolored skin, and warmth in the affected leg
Medications
Prescribed
Heparin
Risk Factors
Age, sedentary lifestyle, prolonged bed rest, paralysis, injury or surgery, pregnancy, oral contraceptives, smoking, cancer, heart failure, inflammatory bowel disease, family history of DVT or PE, or genetics
Treatment
Cessation of smoking, avoid long periods of sitting, exercise frequently, and weight loss
Multiple Sclerosis
Patho
Chronic autoimmune disease affecting the myelin sheath and slows down the conduction pathway of the central nervous system; can occur anywhere in the brain or spinal cord; leading cause of neurological disability in young adults; inflammatory response resulting in patchy areas of plaque in the white matter of the central nervous system; demyelization is the decrease of electrical conduction between brain, spinal cord and the rest of the body
Signs & Symptoms
Numbness/ tingling/ weakness/ pain in 1 or more limbs, partial or complete vision loss (often with pain during the movement of the eyes (optic neuritis is often an initial sign)), diplopia or blurred vision, electric shock sensations occurring with movement of the head, tremor, lack of coordination, unsteady gait, spasticity, fatigue, dizziness
Medications
Prescribed: Baclofen, 15 mg, BID, oral, @ 0900
Alternative medications: Antispasmotics (ditropan), antiepileptic (keppra, dlantin), analgesics (neurontin), NSAIDs, antidepressants, interferon beta-1a, interferon beta-1b (copaxone), methylprednisolone
Treatment
Adequate rest, exercise, healthy diet, relieving stress, physical and occupational therapy sessions, and an evaluation with speech therapy
Risk Factors
Age, sex, family history, certain infections, race, climate, vitamin D deficiency, smoking, and certain autoimmune diseases
Scoliosis
Patho
The sideways curvature of the spine. Most cases are mild, but the may worsen with age if left untreated. Severe scoliosis can disable an individual from physical activity. The curvature reduces the amount of space for the lungs and chest to expand, leading to diminished lung function
Signs & Symptoms
One shoulder blade appears to be more prominent than the other, uneven waist and shoulders, one side of the rib cage is more forward than the other, and a prominence on one side of the back when bending forward
Medications
Acetaminophen 650 mg, q6/PRN, oral,
0600
Analgesics and NSAIDs can be prescribed to relieve back pain
Risk Factors
Age, sex and family history
Treatment
Due to the patient's age and severity of the curvature, physical and occupational therapy are the only treatment interventions available for the patient
Asthma
Patho
Chronic airway reactivity triggered by allergens, drugs, irritants, stress, exercise, viral infections; Bronchial smooth muscle spasm and mucosal edema causes narrowed airways; lung hyperinflation leads to airway trapping; impaired gas exchange with ventilation-perfusion mismatch; airway inflammation with submucosal infiltration with WBC, mast cells, edema, and vascular congestion leads to lung cell changes and damage
Signs & Symptoms
Mild wheezing, shortness of breath, deep, slow respiratory pattern wiht prolonged expiration progressing to rapid, shallow breathing with respiratory grunting
Medications
Prescribed
Albuterol 90 mcg/actuation inhaler; 2 puffs; q4 by respiratory therapy/PRN; inhalation
0600
Mometasone-formoterol 100-105 mcg/actuation inhaler 2 puffs; q12 by respiratory therapy; inhalation
0600
Treatment
Avoid triggers and allergens; adequate hydration helps liquefy secretions; humidifiers help relieve symptoms; pursed-lip breathing; relaxation techniques to improve respiratory pattern; compliance of medications; monitor ABGs and electrolytes, especially sodium; Stop smoking and avoid secondhand smoke; stay inside when air quality is poor
Risk Factors
Having a family history of asthma or another allergic condition; being overweight; smoking; exposure to secondhand smoke or air pollutants; exposure to occupational triggers
GERD- Gastroesophageal reflux disease
Patho
Stomach acid frequently flow back into the esophagus from the stomach. This exposes the esophagus to irritating gastric and duodenal contents. The esophageal lining becomes inflamed and erodes. The pressure created by gastric volume or intra-abdominal pressure exceeds the pressure in the sphincter areas of the esophagus, allowing backflow of contents. The esophagus may have lower than normal pressure or the lower esophageal sphincter experiences excessive relaxation.
Signs & Symptoms
Heart burn, dyspepsia, night-time reflux, hypersalivation or sense of feeling in the throat, globus, adult-onset asthma, dental carries, coughing or wheezing at night, water brash, odynophagia, chest pain, belching, regurgitation
Medications
Famotidine 40 mg, daily at 2100, oral to block H2 receptors to decrease stomach acid production
Risk Factors
Fatty foods, chocolate, caffeine, nicotine, alcohol, hiatal hernia, pregnancy, obesity, loss of muscle tone, candidiasis of the esophagus, ng tube placement, large meals, ascites, and tight clothing around the stomach or waist
Treatment
Lifestyle modifications: small frequent, meals, avoid known triggers, avoid eating within 3 hours of bedtime, eat slowly, chewing thoroughly, remain upright after eating, elevate head of bed, avid tight clothing, and lose weight if overweight
Thyroid Disease
Patho
The thyroid does not produce enough thyroid hormone. This can occur due to autoimmune disease, hyperthyroidism treatments, radiation therapy, thyroid therapy, and certain medications. Decreased production of TSH from the pituitary gland is a secondary cause of thyroid disease
Signs & Symptoms
Hoarseness to voice, difficulty swallowing, pain in neck and throat, swollen lymph nodes in your neck, fatigue, slow metabolic rate
Medications
Levothyroxine
Risk Factors
Female sex, exposure to high levels of radiation, and genetic syndromes such as multiple endocrine neoplasia, Cowden's syndrome, and familial adenomatous polyposis
Treatment
Thyroidectomy, thyroid lobectomy, lymph node dissection, thyroid hormone therapy, and radioactive iodine
Admitting Diagnosis: Epistaxis
Patho
Bleeding from the inside of the nose
Signs & Symptoms
Nose bleeds
Medications
Oxymetazoline 2 sprays/nare, BID, intranasal
0800
Risk Factors
Dry air, pressure to the nasal area, frequent use of nasal sprays, trauma to the nose, allergies, bleeding disorders, nasal surgery and use of anticoagulants such as heparin
Treatment
Avoid activities that put pressure on the nose; fall precautions
Atrial Fibrillation
Patho
Rapid, irregular heart rhythm or an arrhythmia that increases a patient's risk for blood clots in the heart. The increase risk for blood clots influences the patient's risk for stroke, myocardial infarction, and heart failure. The irregular rhythm occurs in the atria or the upper chambers of the heart.
Signs & Symptoms
Can be asymptomatic; heart palpitations, cheat pain, fatigue, dizziness, lightheadedness, shortness of breath, weakness, reduced endurance with physical activity
Risk Factors
Age, heart disease, hypertension, thyroid disease, drinking alcohol, obesity, family history, and other chronic health conditions such as diabetes, lung disease, and chronic kidney disease
Medications
Eliquis discontinued due to nose bleeds
Heparin, 5,000 units, TID, subcutaneous,
0800
to prevent blood clot formation
Treatment
Daily lab value of factor