Gerontology Considerations Flashcards
Renal Gerontology Considerations
Physiological Changes
Diminished renal blood flow (up to 10% per decade after the age of 30 to 40)
Can use decreasing size, both the number and size of nephrons diminish, and the number of glomeruli decreases 30–40%
GFR diminishes approximately 10% per decade after the age of 30
Reduced hormonal response to vasopressin and an impaired ability to conserve sodium
Bladder tone, elasticity, incapacity or reduced
Increase residual urinary frequency, and more nocturnal urine production
Prostate enlargement and men
Renal gerontology considerations
Possible findings/results
Decrease drug clearance Increase risk of: Adverse drug reactions Nephrotoxicity Fluid overload Hyponatremia and dehydration Hypernatremia Hyperkalemia Metabolic acidosis Urinary urgency Incontinence Polyuria night Falls
Creatinine Clearance formula
140 - age in years x body weight in Kg (x 0.85 for women)/
72 x serum creatine
Normal creatinine clearance in adults
Males 97–1 37 (1.65–2.33)
Females: 88–1 28 (1.45–2.18)
– creatinine clearance values usually decreases as one ages (decreases by = 6.5 for every 10 years after the age of 20)
Gerontology UTI Epidemiology
Most common clinical illness for adults over 65 years of age
Men 10.9/100
Women: 14/100
Gerontology Causes
Graham negative bacilli
– E. coli
- Pseudomonas
Gram-positive – ennterococcus – coagulase negative staphylococcus – Streptococcus -staph Aureus
Gerontology UTI sign/symptoms
Weakness Frequency Urgency Dysuria Atypical findings (more common in elderly in the absence of UTI) incontinence Lethargic Decreased appetite Dehydration Confusion
Gerontology UTI Lab/Diagnostics
UAE
WBC may not be present in large numbers
Leukocytes esterase and nitrates may be negative
Culture and sensitivity
– high incidence of asymptomatic bacteria; only treated in pregnancy, patients undergoing urology intervention, and perhaps renal transplant patients
– multiple organisms often present
