Exam 1 Flashcards
(130 cards)
1
Q
fastest growing age group?
A
85 and older
2
Q
elite groups
A
super-centenarian
110 +
born before 1910
3
Q
centenarian
A
100-109
born 1911-1920
97K right now, 601k by 2050
most are female
30% show no evidence of dementia
4
Q
baby boomers
A
born 1946-1964
5
Q
wellness based models
A
maximize strength
minimize limitations
facilitate adaption
encourage growth
6
Q
health
A
absence of disease
7
Q
wellness
A
concept of wellness incorporates all aspects of ones being
8
Q
promote biological wellness
A
physical activity, healthy eating, smoking cessation, control of underlying diseases
9
Q
promote functional wellness
A
ensure safe envoirment
10
Q
promote physiological wellness
A
conversation with patient, ensure patient is informed
11
Q
promote spiritual wellness
A
allow them to practice beliefs
12
Q
promote cultural wellness
A
understand the culture of the patient
13
Q
promote environmental wellness
A
ensure clean space free from clutter assess for elder abuse
14
Q
primary prevention
A
strategies to prevent illness before it occurs, teaching, vaccination, hand hygiene
15
Q
secondary prevention
A
early detection of the disease or health problem that has already developed screening
16
Q
tertiary prevention
A
addresses the needs of persons who have their day to day wellness challenged by slowing disease or limiting complications
Rehab
17
Q
cellular functioning
A
cells replicate-but not exact replication, they become more complex/specific
with increased replication, there is increased accumulation of damage
process is still not well understood
18
Q
programmed aging
A
the biological “clock”
cells may lose the ability to replicate
segments of DNA become depleted w/ advancing age
75% of variation in lifespan can be explained by non-genetic factors neuroendocrine contro
19
Q
neuroendocrine control/ pacemaker theory
A
aging is a programmed decline in the functioning of the nervous, endocrine and immune systems. the cells lose their ability to reproduce
20
Q
immunity theory
A
aging is a programmed accumulation of damage and decline in the function of the immune system resulting from oxidative stress
t-cells are thought to be responsible for increasing age-related auto-immune disorders
21
Q
error theories
A
aging is the result of an accumulation of random errors in the synthesis of cellular DNA & RNA
-non-predictable
22
Q
cross-linkage theory
A
aging is a product of accumulated damage from errors associated with cross-linked proteins
cross-linked proteins (collagen) become stiff and thick - evidenced by stiffened joints and decreased skin elasticity
23
Q
wear and tear theory
A
cellular errors a result of “wearing out” over time from continued use
a progressive decline in cellular function or increased cellular death
24
Q
oxidative stress theory (free radical theory)
A
- cellular errors are result of random damage from free radicals
- free radicals are natural by-product of cellular metabolism of oxygen - they function to destroy bacteria & other foreign substances
- accumulation of free radicals is referred to as “oxidative stress” or “oxidative damage”
- Mitochondrial DNA most affected by these changes
- antioxidants neutralize as needed (in youth) BUT as we age, process does not keep up & damage is faster than repair
25
Mutations
growing evidence suggests that ROS & free radicals are responsible for cellular mutations of DNA that are responsible for replicative errors, which increase with age
26
telomeres
repeated sequences on chromosomes essential for cellular reproduction
shorten with every cell cycle
hypothesized to be contributory to senescence of the cells
enzyme telomerase counteracts this effect
manipulation of telomeres has potential to affect development & treatment of disease & aging itself
27
telomeres and aging
the white caps at the end of chromosomes. they shorten with age and stress. this is related to early death
28
CV changes in aging
increased heart weight; left ventricle hypertrophy
decreased baroreceptor sensitivity
decreased force of contraction, contractile efficiency, stroke volume
valvular sclerosis
decreased in pacemaker cells
decreased beta adrenergic response
arterial stiffening & wall thickening with decreased compliance
dilated aorta, tortuous veins
decreased 02 uptake by tissues
29
CV changes manifestations
decreased cardiac reserve & output
decrease in maximum (peak exercise) heart rate
heart rate 40-100 bpm
slow recovery from tachycardia
fatigue, SOB increased premature or ectopic beats
risk of valvular dysfunction & systolic murmurs
extra heart sound common: S4 (not S3 which is always abnormal)
risk of conduction abnormalities
risk of postural & diuretic-induced hypotension
increased systolic blood pressure, pulse pressure, peripheral resistance
risk of carotid artery buckling, jugular venous distention
strong arterial pulses; diminished peripheral pulses; cool extremities
risk of inflamed varicosities
30
CV changes assessment
assess BP (lying, sitting, standing) & pulse pressures
note altered landmarks, distant heart sounds, difficulty in isolating point
maximum intensity
assess carotid arteries, right, internal jugular vein, varicosities. Monitor ECG.
assess exercise tolerance
31
CV changes interventions
safety: institute fall precautions for orthostatic hypotension
health promotion/disease prevention
medication regimen
weigh daily independence maintenance
avoid fatigue
32
respiratory changes in aging
thorax & vertebrae rigid
decreased muscle strength & macrophage activity
increased airway reactivity
drier mucus membranes
decreased alveolar function, vascularization, elastic recoil
decreased response to hypoxia & hypercapnia
33
respiratory changes implications
kyphosis; barrel-shaped
RR 12-24
decreased respiratory excursion & chest/lung expansion w/ less effective exhalation and increased residual volume
diminished breath sounds particularly at lung bases
decreased cough, deep-breathing, mucus/foreign matter clearance
risk of infection & asthma
altered pulmonary function
lower maximal expiratory flow (FEV,FEV1/FVC1)
reduced vital capacity
dyspnea on exertion, decreased exercise tolerance
PO2, Sp02 decreased
decreased capacity to maintain acid-base balance
34
respiratory changes assessment
respirations - patterns, breath sounds throughout lung fields
note thorax appearance, chest expansion
assess cough, deep breathing, exercise capacity
assess for infections, asthma
monitor arterial blood gases, pulse oximetry
monitor secretions, sedation, positioning which can reduce ventilation/ oxygenation
presbyphonia (article)
larynx stiffening, larynx muscle atrophy, decrease FEV
35
respiratory changes interventions
maintain PT airway through repositioning, suctioning
prevention of respiratory infections
incentive spirometry/pursed-lip breathing
health promotion/ disease prevention
vaccines: flu & pneumonia
education on cough enhancement, avoidance of environmental contaminants, smoking cessation
36
GI changes in aging
atrophy of taste & olfactory receptors
decreased esophageal motility & lower esophageal sphincter pressure
decreased stomach intestine motility, villi, digestive, enzyme secretion
decreased large intestine blood flow, motility, defecation sensation
decreased liver size, blood flow, enzymatic metabolism of drugs; increased biliary lipids
decreased pancreatic reserve, enzymatic & hormonal secretory cells
decreased thirst perception, saliva with dry mucosa, bone loss
37
GI changes implications
impaired digestive ability w/ possible food intolerances
risk of dehydration, electrolyte imbalances, poor nutritional intake
in mouth, risk of gingivitis, tooth loss w/ chewing impairment
impaired perception of taste (also with many drugs) & smell
risk of dysphagia, hiatal hernia, aspiration
delayed emptying of stomach with risk of maldigestion
GERD
decreased absorption of fat, carbohydrate, protein, vitamin B12, iron, folate, calcium, & vitamin D
constipation, flatulence
risk of fecal impaction, adverse drug reactions
Cholecystolithiasis
38
GI changes assessment
assess abdomen (note smaller liver), bowel sounds
monitor weight, dietary intake, elimination patterns
assess dentition, chewing & swallowing abilities, eating habits/ nutrition
assess pulmonary infection from aspiration/dysphagia
presence of NVD
evaluate chemosensory complaints of poor food taste
39
GI changes interventions
health promotion/ disease prevention
educate on nutrition/ diet approaches to flavor enhancement, fluid intake, toileting habits/bowel training
watch hidden Na+ in foods
40
GU changes in aging
Tubule degeneration
• Reduced response to ADH
• Impaired capacity to dilute, concentrate, acidify urine; impaired sodium regulation
• Decreased kidney weight, blood • flow, oxygenation, glomerular
filtration rate (often < 50%, • measured by creatinine clearance)
• Maintenance of baseline homeostasis for fluid/electrolyte balances
• Decreased functional reserve when
water/salt overload/deficit
In post-menopausal females:
estrogen loss; decreased pelvic area elasticity; gland & epithelial atrophy; alkaline vaginal pH
• Weakened urinary sphincter
• Decreased or delayed perception
of voiding signal
• Increased nocturnal urine production
• In males, decreased prostatic antibacterial factor; risk of benign prostatic hyperplasia (BPH)
Reduced bladder elasticity, muscle tone, capacity
Detrusor instability with involuntary bladder contractions
41
GU changes implications
• Risk of renal complications in illness; susceptibility to acute ischemic renal failure & embolism
• Risk of dehydration, volume overload, hyperkalemia (with potassium-sparing diuretics), hyponatremia (with thiazide diuretics), hypernatremia (with NSAIDs).
• Reduced excretion of acid load
• Risk of postural hypotension
• Decreased drug clearance
• Risk of nephrotoxic injury by drugs
• Normal renal function: constant serum creatinine level; absent proteinuria
• Risk of urinary tract infection (UTI) Why? Increased post-void residual urine
• Nocturnal polyuria- risk for falls
• In males, risk of urinary hesitancy dribbling, frequency, incontinence Why? (BPH)
• In females, risk of atrophic vaginitis, urethritis, vaginal stenosis, vaginal/uterine prolapse
42
GU assessment
• Assess renal function, particularly in acute/chronic illness
• Monitor blood pressure (orthostatic) Why?
• Assess for dehydration, volume overload, electrolyte imbalances, proteinuria
• Determine source of fluid/electrolyte imbalance. Monitor laboratory data e.g.,creatinine clearance What else?
• Assess choice/dose/need for nephrotoxic agents (incl. aminoglycoside antibiotics, radiocontrast dyes) and renally excreted medications
• Palpable bladder after voiding due to retention
• Assess for urinary incontinence, UTI
• Assess for abnormal urine stream with
BPH
• Assess fall risk in nocturnal or urgent 14voiding
43
GU interventions
• Preparation for fluid/electrolyte correction as indicated
• Calculation of creatinine clearance/ Cockcroft-Gault equation
• Safety precautions in nocturnal or urgent voiding & postural hypotension
• Monitor for nephrotoxic drugs, suggest change or alteration in dose (P&T)
• Health promotion/Disease prevention
• Bladder training (Void Q2-3h)
• Kegel exercises
• Fluid intake 2-3L/day unless contraindicated
44
Skin changes in aging
• Decreased subcutaneous fat, interstitial fluid, muscle tone, glandular activity, sensory receptors
• Collagen stiffening
• Reduced blood supply & capacity
for repair
• Capillary fragility
• Cumulative androgen effect
• For hair - decreased melanin & follicles
• Reduced blood supply to fingernails
45
Skin changes implications
Cool, pale, dry skin
Increased fragility, wrinkling, tenting, sagging (breasts & abdomen with risk of yeast infections)
Decreased elasticity, turgor, wound healing, and perspiration with reduced ability to maintain temperature
Risk of skin tears, ecchymosis, dermatitis, pressure ulcers, dehydration
Increased senile lentigines, neoplasms
Decreased sensation with risk of injury
Decreased fat, muscle tone of feet affecting ambulation
Graying, dry, thinner hair with facial hair alterations in men & women
Thick, brittle, easily split nails with slow growth & risk of fungal infections
46
skin assessment
• Monitor skin temperature, turgor (anterior chest wall, not forearm), hydration status (How?)
• Inspect for changes in skin color, pigmentation, lesions, bruising
• Assess intertriginous areas Why? (skinfolds: areas skin touches skin, e.g. groin, under breasts)
• Assess hygiene; need for podiatry services
47
skin interventions
• Prevent pressure ulcers
• Educate on care of dry, fragile skin
• Maintain environmental temperature control to prevent hypo/hyperthermia
• Provide adequate fluid intake to prevent dehydration
48
eyes changes in aging
• Decreased aqueous humor secretion with reduced cleansing of lens & cornea
• Ciliary muscle atrophy
• Lens less elastic, denser, yellow
with decreased light passage
• Decreased orbital fat, muscle elasticity, tear production
• Decreased corneal sensitivity, reflex; increased translucency, flattening
• Increased vitreous gel debris
• Loss of pigment in iris, smaller pupil
49
eyes changes implications
Decreased peripheral vision
• Impaired light/dark adaption, color discrimination
• Decreased night vision, altered depth perception
• Need for more light to see
• Difficulty in fundoscopic exam due
to smaller pupil
• Cataracts, Narrow-angle glaucoma
• Eyes dry & receded with limited upward gaze
• Risk of ectropion, entropion, conjunctivitis, infection, senile ptosis, artifactual visual fields deficit, arcus senilis; risk of corneal abrasion
50
eye assessment
Assess visual acuity (under various light conditions), color vision
• Note difficulties in funduscopic exam
• Evaluate impact of vision limitations on driving (day & night), ambulation, safety, social interactions
• Appraise home environment for hazards, lighting
51
eye interventions
• Health promotion/Disease prevention
• Educate on regular eye
exams
• Driving hazards due to visual impairments
• Organize house...fall prevention, safety, adequate lighting
• Appropriate use of colors —What colors are best? (Blue)
52
hearing changes in aging
• Changes in cartilage of pinna
• Decreased ceruminal glands in external ear
• In middle ear, ossicle joint degeneration; tympanic membrane thinning & loss of resiliency
• In inner ear, atrophy of vestibular structures, cochlea, organ of Corti plus loss of hair cells
53
hearing changes implications
• Changes in external ear appearance (larger, longer)
• Drier cerumen with risk of impaction & hearing loss
• Decreased sound conduction
• Risk of hearing loss (initially of high pitches, presbycusis), tinnitus, equilibrium-balance deficits
54
hearing assessment
• Assess hearing, balance & equilibrium,
• Inspect ear for cerumen build-up; remove if impacted
• Monitor psychosocial dysfunction if hearing loss
• Evaluate safety of home environment, driving
55
hearing interventions
• Educate on regular auditory evaluation, safety if hearing loss
• Encourage social interaction if isolated from hearing loss
• Speak in low toned voice
56
smell and taste change
Hyposmia: Decrease in smell acuity
Decrease neurons that send signal to the brain Difficulty distinguishing smells
Decrease in taste secondary to change in smell acuity
57
MS changes in aging
• Narrowed intervertebral disks
• Decreased cortical & trabecular bone mass
• Lean body mass replaced by fat with redistribution of fat
• Decrease in mass + decreased regeneration of muscle fibers = Sarcopenia = weakness
• Increased latency/contraction time of muscle
• Increased hip/knee flexion
• Tendon & ligament stiffening
• In joints, What type of changes occur? Articular cartilage erosion; increased bone overgrowths & calcium deposits -What problems result?
58
MS changes implications
• Great variability in changes among individuals
• Kyphosis, Height loss (1-4")
• Gait & balance instability common
• Risk of osteoporosis & fractures, osteoarthritis
• Reduced extremity fat; truncal obesity
• Decreased total body water & intercellular/interstitial fluid
• Risk of fluid/electrolyte imbalances
• Decreased muscle strength & agility; slowed deep tendon reflexes/ reaction times
• Decreased endurance
• Joint stiffness with decreased
mobility
• Risk of injury, joint subluxation, crepitus & pain on ROM
59
MS assessment
• Ensure joint stabilization and slow movements in ROM exam to prevent injury
• Assess functionality, mobility, fine & gross motor skills, ADLs
60
MS interventions
Health promotion prevention
• Education on nutrition (e.g., calcium), regular exercise, muscle strengthening
• Information on strategies to maximize function
• Fall Prevention
61
Endocrine changes in aging
• Reduced insulin secretion & increased insulin resistance
• Mineral metabolism affected by decreased vitamin D synthesis, altered parathyroid hormone activity, estrogen decline in post- menopausal women with increased bone osteoclast activity
• Fluid/electrolyte balance affected by decreased renin-angiotensin- aldosterone activity, increased atrial natriuretic hormone
• Body composition affected by decreased growth hormone, altered glucocorticoid & testosterone (males) activity
• Decreased adrenal functional reserve & hormonal response
62
Endocrine changes implications
• Decreased glucose tolerance, risk of Diabetes Mellitus type 2
• Bone mineral density loss with risk of osteoporosis, fractures. Risk of fluid/electrolyte imbalances & postural hypotension
• Change in body composition with increased fat, decreased muscle & bone mass; decreased strength & functionality with risk of falls
• Due to adrenal changes, decreased ability to respond to physiological stressors with risk of reduced functionality
63
Endocrine assessment
Assess functionality, fall risk, hydration (fluid intake/ output), BP (orthostatic)
• Monitor laboratory values (e.g., fasting & post- prandial blood sugars; bone mineral density DEXA
64
endocrine interventions
Health promotion/Disease
prevention
• Education on nutrition (especially calcium & carbohydrates), hydration, safety
• Onset of Diabetes & Thyroid alterations
65
immune system changes in aging
• T-cells number unchanged
• T-cells less mature
• Thymus gland greatly shrink
• Where T-cells mature
• B-cells secrete antibodies in response to antigens
• Reduced function w/ age
• Increased autoantibodies
• Immunosenescence
• Lower body temp
66
immune changes implications
• Fewer antibodies made
against bacteria/viruses
• Lower response to immunizations
• Immunocompromised (chronically)
RISK FOR INFECTION
67
immune assessment
• Signs of infection
• May be atypical in older
• Labs
68
immune interventions
• Standard precautions • Immunizations
• Education
• Diet
• Stress
• Sleep
• Exercise
69
nervous system changes in aging
• Decrease in neurons, brain size, neurotransmitters
• Slowed nerve impulse conduction
• Decreased peripheral nerve
function
70
nervous system changes implications
• Slowed thought processing, response to stimuli, reflexes
• Decreased ability to respond to multiple stimuli & manage multiple tasks concurrently
• Decreased proprioception; potential for extrapyramidal Parkinson-like gait
• Increased threshold for light touch & pain sensation
• Ischemic paresthesia in extremities common
• Risk of poor balance, postural hypotension, falls, injury
• Great individual variation in cognitive function with aging: limited memory impairment, stable crystallized intelligence, some cognitive decline
• Risk of mild cognitive impairment, dementia
71
nervous system assessment
Assess functionality, cognition, BP (orthostatic)
• CVA
• Alzheimer's Disease • Parkinson's
• Evaluate hazards in home environment
• Assess care-giver needs
72
nervous system interventions
• Health promotion/Disease prevention
• Educate on safety, avoidance of falls
• Therapeutic Communication
73
reproductive changes in aging
• Perineal muscle weakness
• Decreased testosterone (sperm count decreases but continues) & estrogen (menopause)
• Libido does not change
• Vaginal wall thinning
74
reproductive implications and interventions
Health promotion/Disease prevention
• Educate on STD prevention
• Lubricants for vaginal dryness
75
Labs
• RBC—Production ↓'d
• Speed/Marrow reserve
• H/H—Change with nutrition & Fluid status
• WBC—Change may be absent or delayed with infection; immunity aging theory
• ESR ↑'d
• Vitamins B,C Short-term
Malnutrition
• Vitamins A,E,B12,K Long-term
Malnutrition
• Vitamin D↓'d
76
Electrolytes
• Natt--↓'d LTC
• Low intake, altered ADH,
increased H2O.
• Ktt
• Catt ↓'d
• Increased bone resorption
• VitD
• Glucose
• Low is most dangerous
• Insulin, malnutrition Albumin—↓'d
• Prealbumin-Acute malnutrition
• PSA - limited use (>75 and high risk)
77
Absorption
• Route of administration
• Bioavailability
• Amount of drug that passes through absorbing surfaces in body
78
Routes of admin of medications
Oral
• Sublingual
• Rectal
• Topical
• Transdermal
• Intramuscular • Intravenous
• Subcutaneous
• Intra-arterial
• Intranasal
• Ophthalmic
• Intraperitoneal • Intrathecal
• Inhalation
• Auricular(inear)
79
Aging changes that affect absorption
• Increased
- Gastric pH
Decrease
- Surface for absorption
- Blood flow to SPLEEN
- GI activity
80
Distribution
• Lipophilic drugs - Normal changes decreased total body water
• Hydrophilic drugs - Normal changes higher body fat
• Once absorbed, systemic circulation transports drug to receptor site on target organ
• Some drugs exert therapeutic effect in absorbed form; others must be metabolized
81
Distribution
Hydrophilic (water-soluble) meds
• Lower body water
• Higher concentrations of meds in body
• Dig, ethanol, aminoglycosides • Think about overdose
Protein bound meds
• Some need to bind to protein/albumin to distribute • Some bind to protein and become inactive
• Remaining is free and active
• Older at higher risk of malnutrition and low protein levels
• Some meds will have more and some less effect • Unpredictable results/effects
• Keep clients nourished!
82
Aging changes that affect distribution
• Increased
- Body FAT
• Decreased
- Cardiac Output
- Total body water • LEAN body mass • Serum albumin
- Protein binding
83
Metabolism
• Drug is converted to metabolite - more easily used and excreted
• Liver is primary site of metabolism, although many other organs have metabolizing enzymes - **First Pass Effect
• Genetic differences in drug metabolism can affect serum drug levels and rate of excretion - ENZYMES
• Genes can SPEED UP or SLOW DOWN metabolism
84
Aging changes that affect metabolism
• Increased
- Body FAT
• Decreased
- Hepatic mass
- Hepatic blood flow
- Enzyme activity
- Enzyme induct ability
85
Excretion
• Drugs and their metabolites are excreted in sweat, saliva, and
other secretions but primarily through kidneys
• Renal drug excretion occurs when drug is passed through kidney and involves glomerular filtration, active tubular secretion, and passive tubular reabsorption
• Assessment of creatinine clearance rate an important consideration in older adults to prevent drug toxicity
86
Aging changes affecting excretion
• Decreased
- Renal blood flow
- GFR
- Tubular secretory function
- Kidney Size
THINK TOXICITY
87
Antagonist
blocker - less action
88
Agonist
Promotes - more action
89
Normal aging
- Decreased baroreceptor response
- Decreased myocardial sensitivity to catecholamines (norepi, epi)
- Decreased response of α- adrenergic system
90
increased sensitivity to anticholinergic effects
- unable to see
- unable to urinate
- dry mouth
- constipation
- confusion
- dizziness
91
Polypharmacy
more than 5
92
Drug - food
Calcium
- Reduce absorption
- Synthroid, tetracycline, ciprofloxacin
Grapefruit
- Inhibit CYP3A4 and increase action of some
- Amiodarone, lovastatin, simvastatin, buspirone
Green, leafy vegetables
- Contain vitamin K
- Antidote to Warfarin-
- Keep intake consistent
High potassium diet
- Potassium sparing diuretics
- Risk of hyperkalemia
- Keep intake consistent
93
Drug - Drug
Competition for receptor sites
- Change in bioavailabilty
Antispasmotics slow GI motility
- Alters absorption of other meds
Altered distribution
- Competition for plasma proteins to bind to
Altered metabolism
- Effects on CYP450 system
Changes in pH
- Sodium Bicarbonate > Increases pH> amphetamines reabsorbed
Alterations in renal tubules > prolonging half life of some meds
Similar SEs or MOAs
94
Role Theory
As individuals go through stages of life, so do the roles they play
Successful aging is determined by completion of one role and moving on to the next
95
activity theory
Continued activity and the ability to "stay young" are indicators of successful aging
96
disengagement theory
In natural course of aging the older adult should withdraw from society to allow younger generation to step up
- withdraw is no longer considered successful aging
97
Echinacea
Treatment and prevention of respiratory infections
Adverse reactions: fever, sore throat, diarrhea, n/v, abdominal pain, dry eyes
SHOULD NOT BE USED IN THOSE WITH A HISTORY OF ASTHMA OR ATOPY, SEVERE ALLERGY TO RAGWEED, SEVERE SYSTEMIC ILLNESS, OR WHEN TAKING IMMUNOSUPPRESSANTS
98
Coenzyme Q10
Studied for array of CV conditions including HF, high BP, and primary prevention for heart disease
Adverse reactions: mild GI effects, and elevated liver function tests
99
Garlic
Treatment of hyperlipidemia and hypertension, reduces LDL and TC
Adverse reactions: garlic smell, flatulence, nausea, heartburn
BLEEDING RISK
contraindication use with anticoagulants
100
red rice yeast
Decreases lipid concentration
May cause headache, heartburn, increases LFT, myalgia
101
Ginkgo
May benefit cognition in dementia or cognitive decline
Side effects: increased BP, intestinal upset, headache, palpitations, dizziness
RISK FOR BLEEDING
Contraindicationed use with anticoagulants, antihypertensives, and antidepressants
Get approval from provider before use
102
St. John's wort
Self-treatment for depression, anxiety, pain, pms
Side effects: dermatitis, GI upset, restlessness, anxiety, headache, dry mouth, and possible sexual dysfunction
Inducer of CYP 3A4 enzyme and cannot be taken with medications metabolized by this route- warfarin and digoxin
103
Ginseng
Reduces stress, lowers LDLs, lower glucose, immune stimulant, erectile dysfunction
Side effects: hypertension, edema, diarrhea, mania
RISK FOR BLEEDING
Contraindicated use with anticoagulants, anti diabetics, antihypertensives, immunosuppressants, stimulants and MAOIs
104
Glucosamine Sulfate
Reduces joint pain
Side effects: GI upset, headache, insomnia, rash, hypoglycemia
Contraindicated with shellfish allergies and glaucoma
Use caution with anti diabetics and hypertension
105
Saw Palmetto
mild to modest ideas for BPH
106
treatment of hypertension
hawthorn
107
HIV
Use herbals with caution, some products may lower therapeutic drug levels or alter metabolism of antiretrovirals
108
treatment of GI disorders
psyllium, calcium, cranberry, probiotics
109
treatment of Alzheimer's
Ginkgo
110
treatment of diabetes
cinnamon
111
herbs that affect bleeding & clotting time
garlic, ginger, ginkgo, ginseng
112
may increase sedative effect of anesthesia & should be discontinued at least 5 days before surgery
St. John's wort
113
Wear and tear theory
a view of aging as a process by which the human body wears out because of the passage of time and exposure to environmental stressors
114
activity theory
theory of adjustment to aging that assumes older people are happier if they remain active in some way, such as volunteering or developing a hobby
115
immunity theory
This Theory of aging is based on the premise that the thymus becomes smaller with age. Ability to produce T-cell differentiation decreases and impairs immunologic functions, results in increased infections, neoplasm's & autoimmune disorders.
116
peck theory
Successful aging requires the older adult to redefine self, accept and adjust to physical changes, and see oneself as part of a whole.
117
cross-linkage theory
Aging is the result of damage that occurs when proteins link with cellular glucose. Bonding chains form and the chains become stiff and thick; thought to be a contributor to the development of atherosclerosis and cataracts.
118
age stratification theory
a theory which states that members of society are stratified by age, just as they are stratified by race, class, and gender. Elders defined by a certain age group.
119
cellular functioning theory
Normal functioning is a process of successful cell reproduction, including genetics (RNA/DNA); the purpose of this theory is to find out the causes and patterns of cellular effects with aging
120
oxidative stress/ free radical
Unpaired ions/free radicals cause damage to mitochondria of cells and keep immune system working to repair damaged cells; the overwhelmed immune system cannot keep up with repair and cellular function is altered.
121
erikson's theory
Theory that proposes eight stages of human development. Each stage consists of a unique developmental task that confronts individuals with a crisis that must be resolved. Suggests balance.
122
gerontology nursing roles include
Preserving function, enhancing health and quality of life and dying.
Conduct research, innovations in care and improving policy.
123
chronological age
number of years since birth
124
biological age
age determined by physiology rather than chronology
125
functional age
age in terms of functional performance
126
what does the concept of wellness include?
physical
emotional
intellectual
social
spiritual
cultural
environmental
127
hayflick's theory of Limited cell replication
cells & organisms have a genetically predetermined lifespan
128
senescence
the natural physical decline brought about by aging
129
pacemaker theory
describes aging as a programmed decline in relation to the function of the nervous, endocrine, & immune systems
130
Jung Development
Focus on outward achievement shifts to self acceptance• Psyche and search for personal meaning/spiritual self – continuous search for “true self”
