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Flashcards in Older People And Nursing Care Deck (20):
1

What are the influencing factors for elderly pts?

Genetics, nutrition, exercise, smoking, infection, disease, trauma, adipose tissue

2

What happens to the stress response in an elderly pt?

Increase in free cortisol
Decrease sensitivity to cortisol
Body produces more cortisol in response causing higher constant level of stress state
Less able to limit inflammatory response

3

What can chronic inflammation cause in an older pt?

Atherosclerosis
Cardiovascular disease
Peripheral vascular disease
Diabetes
Parkinson's disease
Sarcopenia
Osteoporosis

4

What happens to the feedback mechanisms in an older pt?

They fail to neutralise changes leading to increased release of pro-inflammatory proteins

5

What do inflammatory diseases lead to in an older pt?

Lead to immune and endocrine changes to chronic inflammatory state

6

What happens to the cardiovascular systems of an older pt?

Pacemaker cells reduce by 50%
Atrial walls stiffen
Valves become thicker
Heart muscle contraction force is maintained
Atrial vessels stiffen

7

What happens to the respiratory systems of an older pt?

Partial obstruction in inspiration
Reduced chemoreceptor sensitivity
Loss of elastic support around bronchioles
Predisposition to airway closure at normal tidal volumes
Ineffective cough

8

What happens to the autonomic NS in an older pt?

Loss of vagal tone and reduced sympathetic response
Reduced exercise tolerance
Pulse rate variability decreased

9

What happens to the Central NS in older pts?

Decrease in brain weight due to loss of neurones
Adrenergic system leading to autonomic dysfunction

10

What happens to the renal system of an older pt?

Rate of homeostasis reduced by 50%
Antidiuretic hormone resistance increases
Limits ability to conserve or eliminate diluted and water
Accumulation of drugs

11

What happens to the hepatic system of an older pt?

Liver size decreases 45%
Variability in drug clearance
Reduced production of albumin, clotting factors and glucose metabolism

12

What happens to the locomotor systems of an older pt?

Loss of skeletal muscle fibres
Sarcopenia
Postural reflex fail
Osteoporosis

13

What happens to the cognitive systems of an older pt?

Mental function decreases
Cognitive decline
Depression

14

What is frailty?

Non specific state of vulnerability
Reflects multi system physiological change
Associated with specific chronic disease or infection but presents without pre-existing disease

15

What are the characteristics of frailty?

Physical and functional decline
Reserve capacity is decreased and adaptation mechanisms to stress can't be maintained/mobilised

16

What are the mechanisms of frailty?

Inflammation
Neuroendocrine
Immunological
Metabolic alteration

17

What are the consequences of frailty?

Falls
Disability
Dependence
Death

18

What are the causes of frailty?

Ageing
Disease
Neurodegeneration
Cancer
Chronic infections
CVD
Diabetes
Obesity

19

Why is nursing care complex for frail pts?

Recognising the complexity of the pt
Pts past experience of care
Care needs which exist in the home
Difference between care being provided and what is expected

20

What are the issues with immunity in older pts?

Shrinkage in T cell diversity
Decreased T and B cell differentiation
Slower response and less efficient
Increase in natural killer cells