Older People And Nursing Care Flashcards
What are the influencing factors for elderly pts?
Genetics, nutrition, exercise, smoking, infection, disease, trauma, adipose tissue
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
What can chronic inflammation cause in an older pt?
Atherosclerosis Cardiovascular disease Peripheral vascular disease Diabetes Parkinson's disease Sarcopenia Osteoporosis
What happens to the feedback mechanisms in an older pt?
They fail to neutralise changes leading to increased release of pro-inflammatory proteins
What do inflammatory diseases lead to in an older pt?
Lead to immune and endocrine changes to chronic inflammatory state
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
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
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
What happens to the Central NS in older pts?
Decrease in brain weight due to loss of neurones
Adrenergic system leading to autonomic dysfunction
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
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
What happens to the locomotor systems of an older pt?
Loss of skeletal muscle fibres
Sarcopenia
Postural reflex fail
Osteoporosis
What happens to the cognitive systems of an older pt?
Mental function decreases
Cognitive decline
Depression
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
What are the characteristics of frailty?
Physical and functional decline
Reserve capacity is decreased and adaptation mechanisms to stress can’t be maintained/mobilised
