ch, 14 Flashcards
(39 cards)
Ageism
discrimination against people because if increasing age.
Geronlogical nursing
requires creative approches for managing the potential of older adults
identify common myths and stereotypes in older adults
- ill, disabled and physically unattractive
- forgetful
- confused
- rigid and bored
- unfriendly
Describe common development tasks for older adults
Adjusting to:
- decrease health and physical strength
- retirement and reduced or fixed income
- death of a spouse, children, sibling &friend
- accepting self as an aging person
- maintaining satisfactory living arrangements
- redefining relationships with adult children & siblings
- find ways to maintain quality of life
Common physiological changes with aging at a glance.
next couple cards
- integumentary
- respiratory
- cardiovascular
- GI
- musculoskeletal
- neuro
- sensory
- genitourinary
- reproductive
- endocrine
- immune system
INTEGUMENTARY
- loss of elasticity
- pigmentation changes
- glandular atrophy
- thinning and gray hair( women increase in hair ,men decrease)
- slower nail growth
- atrophy of epidermal arterioles
Respiratory
- decrease in cough reflex & cilia
- increase: anterior-posterior chest diameter, chest wall rigidity.
- fewer alevoli
- increase airway resistance and risk of infection
Cardiovascular
- Thick blood vessels walls, narrow vessel lumen
- loss of vessel elasticity
- low CO, number of of heart muscle fibers
- decreased elasticity & calcification of heart valves, baroreceptor sensitivity
- decreased eff. of venous valves
- increased systolic bp
- decreased peripheral circulation
GI
- periodontal disease;
- decrease saliva, gastric secretions and pancreatic enzymes
- smooth muscle changes due to decrease peristalsis & small intestinal motility
- gastric atrophy
- decreased intrinsic factor
- inc stomach pH
- loss of smooth muscle; hemorrhoids, rectal prolapse, impaired rectal sensation
Musculoskeletal
- decrease muscle mass & strength
- decalcification of bones, degenerative joint changes
- dehydration of intervertabal disks
- increase in fat tissue
Neuro
- degenerative of nerve cells
- decrease in neurotransmitters
- decrease in rate of conduction of impulses.
sensory
Eyes: decreased near/far vision (presbyopia), difficulty adjusting from light to dark, yellow of lens, altered color perception, increased sensitivity to glare, smaller pupils
EARS: loss of high frequency tones(presbycusis), thick tympanic membrane, sclerosis of inner ear, cerumen
TASTE: diminished, fewer taste buds
SMELL: often diminished
TOUCH: decreased skin receptors
PROPRIOCEPTION: decreased awareness of body positioning
Genitourinary
-fewer nephrons, decrease renal blood flow by age 80
- decrease bladder capacity
Male: enlargement of prostate
Female: reduced sphincter tone
Reproductive
Male: sperm count diminished, smaller testes, erections less firm and slow
Female: decreased estrogen production, degeneration of ovaries, atrophy of vagina, uterus and breast
Endocrine
GENERAL: hormone alterations, decrease ability to respond to stress.
Thyroid: diminished secretions
cortisol:increased anti-inflammatory hormone
Pancreas: increased fibrosis, decreased secretion of enzymes and hormones, decreased sensitivity to insulin
Immune System
- thymus decreased in size and volume
- T-cell function decrease
- core temp elevation is lowered.
Delirium
acute confusional state that is potentially reversible cognitive impairment that has physiological cause.
- pneumonia and UTI, SLEEP deprivation
- older adult in acute care setting
onset: hours less than a month
Course: short, worst at night, in darkeness
Progression: abrupt
Consciusness: reduced
Alertness: fluctuate; legarthic
Assesment: distracted from task; munerous errors
Dementia
Deciline in ability to perfrom basc ADL’s and IADL’s
- gradual progressive, irreversible cerebral dysfunction
-ALZHEIMERS
Duration: months to years
Behavior: apraxia
Thinking:difficulty with with abstraction, diminished thoughts, difficult to find words
Depression
- NOT a normal part of aging
- most common in older adults
- associated: stroke, diabetes, DEMENTIA, PARKINSONS DISEASE, Arthritis.
- Treatment: psycho therapy, ECT
Issues with psychological changes
- social isolations
- sexuality
- housing and environment
- death
cont…
- heart disease; hypertension silent killer and cornonary artery disease - Cancer: malignant neoplasms Chronic lung disease: COPD, - stroke: 4th leading cause - smoking; Alcohol abuse: due to depression, loneliness and lack of social support. repeated falls and accidents - nutrition
Patient teaching; adapting instruction for older adults with health literacy limitations
OBJ - patient verbalizes understanding - they will demonstrate psychomotor skill TEACHINF STRATEGIES - schedule sessions in midmorning - no med term - give patient time to process info - speak slowly -minimize distraction Evaluation - validate understanding by teach back technique before proceeding - make sure patient is able to demonstrate and do psychomotor skills independently
Risk factors for falls in older adults
Intrinsic
-history of previous fall
-impaired vision’
postural hypotension or syncope
- Arthritis, lower extremity muscle weakness, foot problems
- bladder incontinence and frequency, nocturia
-confusion
-med reactions; sedatives, hypnotics, opioids
slowed reaction times
- deconditioning
Extrinsic factors
- enviromental hazards outside and within home; lighting, wet floor, items on floor
- inappropriate footwear
- improper use of assistive devices
