Atypical Disease Presentations/ Physiology and Aging

Question 1

Major Changes with Aging Responsible for Atypical Disease Presentations

1. _______________
2. Fluid Volume Regulation
3. Cardiac (Refer to Age-Associated Physiologic Changes)
4. Immune Alterations (Refer to Age-Associated Physiologic Changes)
5. Nervous System Changes (Refer to Age-Associated Physiologic Changes)

Answer 1

Thermoregulation

Question 2

Thermoregulation:

1. Older adults have ___ ____ body temperatures than other adults.

Answer 2

lower basal

Question 3

Thermoregulation:

2. Possible causes:
   a. ________ heat production per kg of body weight

Answer 3

Decreased

Question 4

Thermoregulation:
2. Possible causes:
b. Reduced _____ activity resulting in the production
of heat

Answer 4

muscle

Question 5

Thermoregulation:

2. Possible causes:
   c. Decreased diet-induced _______-

Answer 5

thermogenesis

Question 6

Thermoregulation:

3. Aged normal temperatures:
   a. Oral = ____ to ____ degrees C (96.4 to 98.2 degrees F)

Answer 6

35.8 to 36.8

Question 7

Thermoregulation:

3. Aged normal temperatures:
   b. Rectal = ____ to ____degrees C (98.2 to 98.9 degrees F)

Answer 7

36.8 to 37.2

Question 8

Thermoregulation:
4. General Rule: The body temperature of older adults averages about ___ to ___ degrees Fahrenheit below that of younger adults. “Elders are ‘cooler’ than younger adults!”

Answer 8

one to two

Question 9

Fluid Volume Regulation

1. Older adults have decreased:
   a. Percentage of body ______

Answer 9

water

Question 10

Fluid Volume Regulation

1. Older adults have decreased:
   b. _____ drive

Answer 10

Thirst

Question 11

Fluid Volume Regulation

1. Older adults have decreased:
   c. _____ response to dehydration

Answer 11

ADH

Question 12

Fluid Volume Regulation

2. Older adults’ renal dysfunction:
   a. Decreased maximum urine _______

Answer 12

osmolality

Question 13

Fluid Volume Regulation
2. Older adults’ renal dysfunction:
b. Impaired ____-_____-______
responsiveness

Answer 13

renin-angiotensin-aldosterone

Question 14

Fluid Volume Regulation

3. Results: Less water taken in, less on ____, less able to retain, thus predisposed to earlier and faster dehydration

Answer 14

reserve

Question 15

General Comments

1. Approxhnately ____% of all deaths in those over the age of 65 are attributable to infection.

Answer 15

40

Question 16

General Comments

2. With sepsis infections, the mortality rate increases ____ times as compared to other adults

Answer 16

9

Question 17

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
a. Immune system decline from lack of cell proliferation,
especially _____ and T cells, leading to decreased
lymphocyte stimulation and production

Answer 17

IL-2

Question 18

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
b. Drying/thinning of the _____ and mucous membranes

Answer 18

skin

Question 19

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
c. Decreased ability to produce _____

Answer 19

antibodies

Question 20

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
d. Comorbid _______

Answer 20

conditions

Question 21

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
e. Inefficient ________ clearance

Answer 21

mucociliary

Question 22

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
f. Malnutrition
• i) Of adults over the age of 65 years, _______%
have both protein and calorie malnutrition.

Answer 22

30-60

Question 23

Often Atypical Findings in the Elderly:
General Comments
3. Possible causes:
f. Malnutrition
ii) Results may include inefficient responses to
________, impaired wound healing, and
increased risk of infection
g. Diabetic foot lacerations may lead to osteomyelitis

Answer 23

vaccines

Question 24

Fever

1. Up to ___% of older adults with infection present without fever.

Answer 24

50

Question 25

Fever | 2. Possible causes: Altered thermoregulation in general, coupled with _______ heat production by adipose tissue

Answer 25

decreased

Question 26

Fever 3. American Medical Directors Association's Clinical Practice Guideline for Infections in Long Term Care Criteria for Fever: a. Increase in temperature of equal to or greater than __°F (1. 1°C) from baseline

Answer 26

2

Question 27

Fever 3. American Medical Directors Association's Clinical Practice Guideline for Infections in Long Term Care Criteria for Fever: b. Two or more measurements of oral temperature equal to or greater than ____°F (37.2°C) or rectal temperature equal to or greater than 99.5°F (37.5° C).

Answer 27

99

Question 28

Fever 3. American Medical Directors Association's Clinical Practice Guideline for Infections in Long Term Care Criteria for Fever: c. Single measurement of temperature equal to or greater than ___°F (37.8°C) •

Answer 28

I00

Question 29

``` Fever 4. Additional atypical findings in the infected/septic older adult: a. _______/low oral intake b. Fatigue and/or withdrawal from typical activities of interest c. Agitation d. Confusion/delirium e. Falls ```

Answer 29

Diminished