10. Thermoregulation & Sexual

Question 1

Age-related changes

Answer 1

• reduced subcutaneous tissue
• reduced ability to acclimatize to heat
• reduced shivering
• reduced sweating
• reduced peripheral circulation
• inefficient vasoconstriction

Question 2

Risk factors

Answer 2

• 75+
• adverse environmental conditions ex temperature
• ETOH (ethyl alcohol use) and medications (which suppresses shivering)
• chronic diseases (endocrine, CV, neuro)

Question 3

Age-related changes+ risk factors=

Negative functional consequences

Answer 3

• reduced ability to respond to adverse temperatures
• increased susceptibility to hypothermia or hyperthermia
• reduced febrile response to illness (fever)

Question 4

Age-related changes+ risk factors=

Negative functional consequences

Answer 4

• reduced ability to respond to adverse temperatures
• increased susceptibility to hypothermia or hyperthermia
• reduced febrile response to illness (fever)

Question 5

2 Pathologic conditions

affection thermoregulation

Answer 5

1. Hyperthermia
   -when body temp rises above normal range
   -is a medical emergency
   -occurs most often in the home where there is no AC
   Risk Factors:
   -CV disease
   -diabetes
   -peripheral vascular disease
   -medications (ex. anticholinergic, antihistamines, antidepressants, antiparkinsonian, diuretics, beta-blockers)

-to lower temp, use a cooling blanket

2. Hypothermia
   -core temp below 35 degrees
   -the person rarely recognizes the problem or seeks assistance
   Risk Factors:
   -homelessness,
   -cognitively impaired,
   -CV, adrenal, or thyroid dysfunction,
   -has been injured in falls,
   -excessive alcohol use
   -poor nutrition
   -inadequate housing
   -use of sedative, anxiolytic, antidepressants

Question 6

Assessment

Answer 6

Assessment: Hyper
Mild:
- weakness, 
-lethargy, 
-nausea, 
-headache, 
-loss of appetite

Moderate-Severe:
-dyspnea,
-dizziness,
-diarrhea, 
muscle cramps,
-vomiting, 
-tachycardia,
-chest pain,
-mental impairment,
-wide pulse range

Assessment: Hypo

-baseline temperature measurement compared against current temp

Mild:

• 32-34.9
• tachycardia
• tachypnea
• dysarthria (Dysarthria is a speech disorder caused by disturbance of muscular control)

Moderate:

• 28-31.9
• slurred speech
• mental changes
• impaired gait
• puffy face
• slowed or irregular pulse
• low BP
• slowed tendon reflexes
• slow, shallow respirations

Severe:

• less than 28
• muscular rigidity
• reduced urine output
• coma
• asystole
• apnea
• a severely hypothermic older adult may not shiver if temp is below 32.2
• when admitted to hospital for hypothermia, give warm IV by warming it in a warm blanket

Question 7

Interventions

to promote healthy thermoregulation

Answer 7

• maintain environmental conditions of around 23.9. degrees (the most important intervention to prevent hypothermia or heat-related illness)
• teach about measures to protect from hypothermia and heat-related illness
• promote caregiver wellness by daily communication with socially isolated older adults during heat heaves or cold spells

Question 8

Common misconceptions

Answer 8

aging= disinterest and disability regarding sexual activity

Question 9

Facts about sex: older adult edition

Answer 9

• hormone levels decline in both genders with age, yet they are still able to participate
• medications can cause hormone changes = decreased libido, erectile dysfunction, vaginal dryness
• the med side effects above may result in reduced med adherence
• older adults are able to respond to sexual stimulation, the response is just slower and less intense
• age 75 testosterone decreases therefore sed can be normal up till age 75

Question 10

Risk factors

that affect sexual function

Answer 10

societal influence on attitude, stereotypes, and prejudices

• social circumstances
• availability of partner
• adverse affects of alcohol and nicotine (Alcohol depresses central nervous system; nicotine interferes with circulation to sexual organs)
• medication side effects that affect

Question 11

Risk factors

that affect sexual function

Answer 11

societal influence on attitude, stereotypes, and prejudices

• social circumstances
• availability of partner
• adverse effects of alcohol and nicotine (Alcohol depresses central nervous system; nicotine interferes with circulation to sexual organs)
• medication side effects that affect libido, erectile. dysfunction, and vaginal dryness
• chronic conditions:
• COPD (SOB), arthritis, urinary incontinence, sensory impairments, pain, cancer, diabetes, CV, obstructive sleep apnea OSA
• gender-specific conditions:
• prostatic hyperplasia, urethritis, vaginitis
• dependency on caregivers
• cognitive impairments
• loss of desire, hypersexuality, sexually inappropriate behaviour

Question 12

Assessment

Answer 12

• assessment of personal attitudes about sexuality ad aging is most important before assessing an older adult’s sexuality concerns \
• assess feelings about sexuality
• assess attitude toward intimacy
• assess medical conditions or medications that are associated with poor sexual health
• screen for HIV infections, STI’s

Question 13

Interventions

to promote sexual function

Answer 13

• address sexual function as a QOL concern
• teaching safe sexual practices
• PLIDDIT model:
• permission
• limited information (providing info to the person. Encourage them to read other resources)
• specific suggestion
• intensive therapy (refer to more appropriate health care. worker)

Question 14

from video

Answer 14

affection, intimacy, and friendship are most important in sexuality