Chapter 12 - Care of the Older Adult Flashcards
(44 cards)
What is the definition of Gerontology?
The scientific study of the aging process
What is the “geriatric cascade”?
When the frail older person will suffer a rapid decline & decompensation as a result of acute illness or worsening of chronic condition.
What are characteristics of the healthy older adult?
healthy eating
exercise
positive outlook
What are age related changes in the Cardiovascular system?
Decreased cardiac output
slower heart recovery rate
decreased pacemaker cells = reduced stroke volume
What is essential to check as a result of changes of aging causing the baroreceptors to be less efficient?
postural blood pressure (detects postural hypotension & teaches pt. to prevent falls by changing positions slowly)
What are the components of maintaining cardiovascular system in the older adult?
cardiovascular assessment at rest & with activity regular exercise weight control low saturated fat & cholesterol diet avoid stress stop smoking
What are age related changes in the body systems in relation to the respiratory system?
Decreased production of protective mucous in large airways
Diminished cough reflex
Changes in alveoli(less elastic tissue)
Decrease gas exchange in the lungs
Skeletal changes that influence chest expansion
Muscular weakness (expansion and contraction)
Reduced recoil incr. residual volumes after expiration; reduced vital capacity
Macrophages in lungs are less effective reducing ability to neutralize viruses
What are the nursing implications for Nursing in the respiratory system of the older adult?
Respiratory assessment positioning deep breathing regular exercise fluid intake (oral and IV) Pneumonia vaccine/Influenza vaccines avoid smoke aspiration risk (pneumonia)
What is the “tripod” position?
When older patients with COPD lean over tables to stretch out their torsos so that more air can enter and exit during respiration.
What is cacaxia?
muscle wasting
What are the changes for the older adult in the Integumentary system?
Decreased subq fat
Capillary fragility
Diminished secretion of natural oils
What are nursing strategies for the older patient skin care?
Limit solar exposure to 10-15 min/day for Vitamin D
Use sunscreen
lubricate skin w/ lotions that contain petroleum or mineral oil
skin check/assessment on a regular basis for pressure ulcers (especially feet and heels)
What is Lentigo?
Age spots
What are changes experienced by older adults in the hair and nails?
Graying and balding
Toenails thicker and more difficult to cut
Nails grow more slowly
Lusterless, hard thick & brittle with yellowish appearance
Physical limitations make nail care difficult
Prone to skin breakdown & infection if nails irritate surround skin
What is the importance of Vitamin D levels in the older adult?
Older adults should ask their primary care provider to check a vitamin D blood level to maintain adequate calcium absorption. If the older person resides in a colder climate, check this level during winter months when sunlight exposure is more likely to be minimal.
What are the changes in the Endocrine System of the older adult?
Less efficient function
Decreased responsiveness of target tissues
Diabetes Mellitus and Thyroid Disease
Decreased sensitivity to insulin resulting in variation fo blood glucose levels
Decreased secretion of insulin
Peripheral tissues may become insulin resistant, especially w/ obesity
What changes occur in the immune system of the older adult?
B & T cells are not as active Body defense mechanisms less effective Thymus gland decreases in size Delayed hypersensitivity reaction Increase autoimmune disorders
What are the changes experienced in the Reproductive System of the older adult?
Degenerative changes in reproductive organs
Decrease levels of hormones
Andropause & Menopause
Life-span sexuality
What are the changes within the Musculoskeletal System of the older adult?
Bone resorption exceeds bone formation
Osteopenia: gradual loss of bone mass
Osteoporosis: pathological loss of bone mass
Cartilage in bone joints b/c rough/with reduced H2O
Strength of tendons & ligament decrease
Incr. muscle weakness
What are risk factors for Osteoporosis?
Female Age Caucasian or Asian Race Low body wgt/Petite body build Estrogen deficiency Cigarette smoking Heredity Inadequate Calcium/Vit. D intake Alcoholism Excessive caffeine Inactivity
What are common symptoms of hearing impairment?
Inability to hear t.v./radio at normal volumes
Freq. complaints that others “mumble” or slur speech when talk
Repeated req. to speak louder
Leaning in closer or cupping hand over ear
Difficulty understanding speech on the telephone
More difficulty in hearing voice of children and women
Inappropriate responses or misinterpretations during convo
What are nursing implications for hearing and sight when caring for the older adult?
Position self to foster communication Adequate lighting Speak clearly & slowly Lower pitch of yr voice Do Not Shout Use touch Illness will affect the energy to communicate
What are changes for the older adult within the gastrointestinal system?
- Has fewest chgs but most complaints from pt.*
- Dilation & pressure changes in esophagus
- Gastric emptying & motility slower
- Shrinkage of mucus membranes in stomach
- Decreased tone of intestinal muscle
- Gallbladder may not empty as easily
- Reduced liver blood flow
- Reduced hepatic cells
What are Nursing implications for gastrointestinal when caring for the older adult patient?
Assessment Medications Nutrition Constipation Gastric Distress Stress Ulcers Nausea/Vomiting/Diarrhea