Exam 1 - Elderly Flashcards
(21 cards)
Adjustment of dosage for elderly
“start low, go slow”
Changes/decline in cardiovascular function in elderly
Decreased cardiac output Diminished ability to respond to stress Heart rate & stroke volume do not increase with maximum demand Slower heart recovery rate Increased blood pressure
Changes/decline in respiratory function in elderly
o Increase in residual lung volume
o Decrease in muscle strength, endurance, vital capacity
o Decreased gas exchange & diffusing capacity
o Decreased cough efficiency
Changes/decline in integumentary function in elderly
o Decreased subq fat, interstitial fluid, muscle tone, glandular activity
o Decreased sensory receptors – results in decreased protection against trauma, sun exposure, and temperature extremes
o Diminished secretion of natural oils & perspiration
o Capillary fragility
Changes/decline in musculoskeletal function in elderly
o Loss of bone density
o Loss of muscle strength and size
o Degenerated joint cartilage – high risk for joint problems
Changes/decline in male elderly genitourinary function
Benign prostatic hyperplasia (squeezes urethra) sx are dribbling, distention, and inability to cath
Changes/decline in female elderly genitourinary function
Relaxed perineal muscles
detrusor inability - urge incontinence
Urethral dysfunction - stress incontinence
Changes/decline in elderly gastrointestinal function
o Decreased sense of thirst, smell, and taste
o Decreased salivation
o Difficulty swallowing food
o Delayed esophageal and gastric emptying
o Reduced GI motility
Changes/decline in elderly nervous function
o Reduced speed in nerve conduction
o Increased confusion with physical illness and loss of environmental cues
o Reduced cerebral circulation – becomes faint, loses balance
- Most common affective disorder of old age
- Changes in reuptake of neurochemical serotonin in response to chronic illness or emotional stresses r/t physical, social changes associated with aging process
Depression
- Acute confused state that progresses to disorientation
- Acute change in level of consciousness
- If not immediately evaluated and treated, can progress to changes in level of consciousness, irreversible brain damage, sometimes death
Delirium
Management of delirium
Focus on identifying and treating underlying cause
Early monitoring along with daily goals for sedation and analgesia
- Gradual decline in cognitive function
- Aroused and aware state of consciousness
- Broad term for syndrome characterized by general decline in higher brain functioning (reasoning) with pattern of eventual decline in ability to perform even basic ADLs
Dementia
Changes/decline in elderly vision
- Diminished ability to focus on close objects
- Inability to tolerate glare
- Difficulty adjusting to changes of light intensity
- Decreased ability to distinguish colors
Decrease in visual accommodation that occurs with advancing age
Presbyopia
Changes/decline in elderly hearing
- Decreased ability to hear high-frequency sounds
* Tympanic membrane thinning, loss of resiliency
Decreased ability to hear high-pitched tones that naturally begins in midlife as a result of irreversible inner ear changes
Presbycusis
Changes/decline in female elderly reproductive function
Vaginal narrowing, decreased elasticity
decreased vaginal secretions
Changes/decline in male elderly reproductive function
Less firm testes
Decreased sperm production
• Legal documents that specify a person’s wishes before hospitalization and provide valuable information that may assist health care providers in decision making
Advance directives
- Type of advance directive
- Limited to situations in which the patient’s medical condition is deemed terminal in most cases
- Not always honored because it is hard to define “terminal”
- Frequently written when people are in good health so patients retain the option to nullify these documents if they change their mind as the illness progresses
Living will
