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SENIORS HEALTH > Age Related Changes > Flashcards

Age Related Changes Flashcards

0
Q

Cognition: fluid intelligence

A

Includes: abstraction, calculation, common sense. Breadth of knowledge Prefrontal cortex - depends on persons inherit abilities

  • allows someone to draw conclusions about complex relationships
  • with age related changes fluid intelligence may decline
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1
Q

Sexual and reproductive changes

A
  1. Decrease sexual activity is more situational 2. Drug side effects 3. Decrease in estrogen and testosterone 4. Sexual dysfunction is NOT normal part of aging 5. Decrease ovarian function
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2
Q

Cognition: crystal intelligence

A

Hippocampus: Congnitive skills, such as vocab, info, verbal comprehension. = wisdom, judgement and life experiences.

Ie. How do I do a dressing change while fluid intelligence is what dressing do I use - cognition skills that are acquired through culture, education, information learning and other life experiences “School smarts”

  • does not disapear with age related changes. only speed is affected by age.
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3
Q

What is the mmse good for?

A

Memory

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4
Q

What is moCa for

A

Abstract thinking, frontal lobe, fluid intelligence

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5
Q

Cognitive Function: Nursing assessment

A
  • risk factors
  • mental status exam
  • self perceptions about cognition
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6
Q

age related changes: cognitive function

A

-↓ number of neurons
-™↓ weight of brain
-™Histological changes in brain; ↑ intracellular pigment,↓ protein synthesis, **senile plaques **
-™↓rate of conduction in peripheral nerves
**™Change in sleep patterns
-**Depletion of dopamine and some of the enzymes in the brain
-™ ↑ accumulation of lipofuscin
-™query diminished brain cholinergic reserve

** slower reaction time

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7
Q

Consequences to age related changes in cognition/neuro function

A

• ↓ Adaptability
• Slower response to stimuli
• ↓ Sensation
• Impaired proprioception
• Gait changes
• ↓ deep tendo n reflexes
• Slower voluntary movement
• Sleep pattern disturbances
• Susceptibility to
environmental temperature
changes
• ↓ short-term memory

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8
Q

Risk factors to age realted changes in cognition

A
  • myths about cognitive aging
  • decreased vision and hearing
  • adverse effects of alcohol and medications
  • diseases (dementia and depression)
  • nutritional deficiencies
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9
Q

Nursing intervtions for change in cognition

A
  1. teaching about cognition changes in aging
  2. memory enhancing techniques
  3. activities to promote brain fitness
  4. develop strong social netwroks
  5. physical exercise
  6. activities where they have a sense of control
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10
Q

what is scaffolding theory of aging?

A

explains the adaptive response of the brain to the declining nerual structures and function.

Scaffolding is a normal process that involves using ulternate routes in the mind to achieve cognitive goal

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11
Q

Brain and white matter changes

A

Loss of white matter

Decreased cerebral flow and corticol volume

loss, especially in the frontal lobes

Decreased brain weight

Decreased blood flow

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12
Q

Nerve cell changes

A

Number of nerve cells (neurons) in the braindecreases

Varies from person to person

Remaining cells do not function as well as they should

Decreased rate of conduction in peripheral nerves

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13
Q

Change in blood flow to the brain

A

Decreased blood flow to the brain as you age can be caused or cause a stroke or other impairments. Leads to decrease in cognitive ability

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14
Q

Change in Conduction Velocity

A

Slower conduction along nerve pathways result in decreased reaction time, slower thought processes, etc

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15
Q

Change in reaction time

A

Decreased rate of conduction in peripheral nerves, along with slower processing time,causes a slower reaction time. Decrease in adaptability

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16
Q

Change in central processing

A

In ability to learn new things, inability to process new information

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17
Q

change in verbal skills

A
  • Loss of ability to communicate what they are thinking and what they are trying to say
  • Visual changes include: yellowing, opacity and rigidity of the lens, decrease pupil size, decreased accommodation, less efficient absorption of intracellular fluid, narrowing of the visual field, decreased lacrimal secretions, decreased number of cones in the retina
  • Hearing changes include: decreased number of nerve cells in 8th, Increased production of cermen, Atrophy of rigidity of ossicles. Decreased elasticity of tympanic membrane cranial nerve
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18
Q

what is presbyopia

A

inability to focus properly

  • Distorted depth perception
  • Decreased color perception
  • Need for stronger light
  • Increased sensitivity to glare
  • Drier cornea
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19
Q

Presbycusis

A
  • High frequency losses occur first
  • Tone discriminating loss
  • Difficulty following conversations
  • Difficulty following conversations
  • Cerumen impaction
  • Social isolation
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20
Q

Cranial nerve change

A

Loss of elasticity can result in a loss of ability to control facial muscles, changes in eyesight, hearing, etc

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21
Q

Change in hypothalamus

A

Changes in ability to control homeostasis in body can result in heat flashes or feeling cold all the time. Susceptibility to environmental temperature changes

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22
Q

Change in sleep patterns

A

Less time spent in deep sleep, shorter REM cycles. Waking during sleep very common

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23
Q

Cause of change in personality and emotions

A

Decrease of dopamine and some of the enzymes in the brain

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24
Q

change in intelligence and intellectual performance

A

Decreased brain weight and blood flow can cause cognition problems, inability to learn new things, shorter attention span, and memory loss

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25
Q

Change in memory

A

Slower processing affect, Motivation, expectation, experience, personality may all decrease, Limited memory effortful memories decrease due to limited task demands learning ability, IQ, cognitive ability, background health history, and overall health.

Both primary (short) and secondary (long) memory decline in older adults, however have long term memory storage and a decrease of short term memory.

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26
Q

5 health promotion strategies for promoting neurological health

A
  1. Influence positive attitudes toward aging and memory skills, so that memory may improve
  2. Engage in activities that promote memory skills and brain functions, such a simple word games

and puzzles

  1. Physical activity can promote brain flow to the brain, and improve thinking and cognition ability
  2. Stretch and relaxation exercise along with more physical ones
  3. Eat a healthy diet with foods that promote brain activity
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27
Q

Explain the importance of sensory function and the impact of sensory deficits on older adults

A
  • Performance of many important daily activities like communication, protecting oneself from danger, enjoying music and visual images, food enjoyment and etc depend on healthy sensory activity.
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28
Q

age related changes: hearing

A

™↓ number of nerve cells in 8th cranial nerve
™↑ production of cerumen
™↑ amount of keratin in cerumen
™Atrophy of rigidity of ossicles
™↓ elasticity of tympanic
membrane

change in shape and size of pinna

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29
Q

age related Changes in sight

A

™ Yellowing, opacity, rigidity of
the lens
™ ↓ pupil size
™ ↓ accommodation
™ Less efficient absorption of
intraocular fluid
™ Narrowing of visual field
™ ↓ lacrimal secretions
™ ↓ number of cones in retina

30
Q

Change in touch senstation

A

-changes in Pacinian and Meissner’s corpuscles (skin receptors that respond to vibration).

31
Q

how does change in taste occur?

A

-decline in receptor cells in the taste buds, which are located on the tongue, palate, and tonsils.

32
Q

what can nurses do for clients with change in senstation

A

-educating older adults with modifiable risk factors, such as smoking and the use of ototoxic medication

on alleviating the risk factors.

  • using assistive listening devices.
  • improving the clarity of words, slowing rate of speech, and eliminating environmental noise and
    distractions.
  • teaching older adults about preserving optimal visual function by reducing or eliminating risk factors.

Example: use of broad-brimmed hats and close-fitting sunglasses with UV-B absorbing lenses.

-educating about preventing eye disease through nutritional interventions like consumption of foods high

in lutein.

  • teaching about over-the-counter artificial tears or ocular lubricants for dry eyes.
  • teaching on use of low-vision aids like magnifiers and reading glasses.
33
Q

Consequences of changes in sight

A

Presbyopia –inability to focus
properly
• Distorted depth perception
• ↓ colour discrimination
• Need for Stronger light
• Increased sensitivity to glare
• Drier cornea

34
Q

Consequences of changes in hearing

A

• Presbycusis (hearing loss
due to age-related
changes in the inner ear)
• High frequency loss occurs
first
• Tone discrimination loss
• Difficult following
conversations
• Cerumen impaction
• Social isolation

35
Q

Gastrointestinal Aging
Changes

A

™Poor dentition
™↓ number of taste buds
™↓ muscle strength for chewing
™↓ saliva production
™↓ ptyalin in saliva
™ Weakened gag reflex
™↓ gastric acid secretion
™↓ emptying of esophagus and
stomach
™↓ intrinsic factor
™Thickened bile
™Thinned gastric mucosa
™↓ ability of small intestine to absorb
sugars and lipids
™↓ hepatic enzyme stroage capacity

36
Q

Consequences of change in GI health

A
  • ↓ taste sensation
  • ↓ appetite
  • ↓ chewing ability
  • ↓ digestion of starch
  • Possible swallowing difficulty
  • Indigestion, flatus
  • Risk of pernicious anemia
  • problems with elimination
  • ↓ tolerance for fats
  • Possible change in drug metabolism
  • Difficulty gaining weight
37
Q

Nursing interventions for change in GI

A

Increase fluid intake-stay hydrated. Drink 8-10 glasses of noncaffeinated liquid everyday, including fruit juices

Increase activity

Promoting oral and dental health- use a toothbrush with soft nylon bristles

Increase intake of whole grains, consume less sodium and saturated fat

Promote wellness through interventions that improve the older adults independence in procuring and preparing satisfying meals.

Encourage older adults to maintain a sitting or upright position during eating and for 1⁄2 hr to 1 hr after

eating to compensate for any effects of slowing swallowing.

38
Q

Changes in Genitourinary system

A

Genitourinary Aging Changes
™↓ number of nephrons
™↓ glomerular filtration rate and tubular
reabsorption
™Change in renal threshold
™↓ blood flow to kidneys
™↓ bladder capacity from 500 ml to 250
ml
™↓ elasticity of bladder
™↓ bladder tone
™↓ muscle tone of urethra
™Benign prostatic hyperplasia common
in males

39
Q

Consequences in changes of geniturinary systme

A

↓ creatinine clearance

• ↓ ability to concentrate urine
• risk of urinary retention
• incidence of incontinence
• urinary frequency; nocturia
• Effects on drug clearance via
kidneys

40
Q

changes in musculoskeletal system

A

Musculoskeletal Aging
Changes
™ Muscle cells atrophy
™ Generalized symmetrical muscle
wasting
™ Demineralization of bones
™ Deterioration of cartilage surface
of joints
™ Thinning of intervertebral discs
™ Loss of cartilage in vertebral
column
™ Loss of elastic fibers in muscle
tissue
™ Kyphosis

41
Q

Consequences of change in MSK

A

Consequences:
• ↓ muscle strength after
age 70
• Two-inch loss of height
between ages 20 and
70
• incidence of
osteoporosis
• ↓ joint range of motion
• ↓ flexibility
• ↓ mobility
• risk of falls
• Gait changes
• Changes in body image

42
Q

what is this?

A

Kyphosis

43
Q

Cardiovascular changes

A
  • ↑ amount of collagen and fat in
  • cardiac muscle
  • Thickening and rigidity of valves
  • ™ ↓ oxygen utilization
  • ™ Myocardial hypertrophy, but over-all heart size is not affected by age
  • ™ Coronary artery blood flow decreased
  • ™ ↑ peripheral resistance
  • ™ myocardial irritability
  • ™ ↓ blood flow to all organs
44
Q

Consequences of cardiovascular changes

A

• ↓ stroke volume, cardiac output
• ↓ ability to increase heart rate in
response to stress
• aortic volume and systolic blood
pressure
• No change in resting heart rate
• risk of extra systoles
• Electrocardiogram changes

45
Q

Integumentery changes

A
  • ™ Thinning and atrophy of epidermis
  • ™ ↓ strength and elasticity of epidermis
  • ™ ↓ blood flow
  • ™ vascular fragility
  • ™ Loss of subcutaneous fat
  • ™ ↓ size and function of sweat glands
  • ™ ↓ sebaceous secretions
  • ™ “Clustering” of melanocytes
  • ™ ↓ number of nerve cells
  • ™ Thinning and graying of scalp, pubic, and axilla hair
  • ™ Thickening of nasal and ear hair
  • ™ facial hair in women
  • ™ ↓ blood supply to nailbed
  • ™ longitudinal striations in nails
  • ™ Accumulation of “debris” under nails
46
Q

nursing interventions for urinary changes

A

Keeping a bladder diary- document about fluid intake, times of urination, and other factors that can affect continence. Obtaining information about patterns of urinary elimination identifies potential causes of and interventions for incontinence.

Assess environment for safety and assistive devices ex. Elevated toilet seat, grab bars near toilet, grab bars on walls leading to toilet.

Assess home environments for barriers that may interfere with quick performance of urinary elimination-
stairways, long hallways, poor lighting, cluttered surroundings; all which can lengthen time needed to get to toilet.

Health education regarding control of continence, environmental modifications, and surgical procedures.

Pelvic floor muscle training. Kegel exercises.

47
Q

interventions for circulatory changes

A
  • Relaxation techniques (yoga, meditation) to reduce stress
  • Smoking cessation
  • Proper nutrition (lipid levels), limited alcohol intake
  • Physical activity (and maintaining ideal body weight)
  • Counseling (or involvement in other activities) for anxiety/depression/isolation
48
Q

interventions for cardiac changes

A
  • Encouraging smoking cessation and prevention of second hand smoke
  • Strategies for secretion clearance, energy conservation, relaxation
  • Flu and pneumococcal vaccinations
  • Pulmonary rehab and exercise training
  • Disease self-management strategies
49
Q

Consequences of integumentary changes

A

Consequences:
• susceptibility to infection,
trauma, malignant lesions,
pressure ulcers
• Skin is dry, scaly, wrinkled
• ↓ skin turgor
• ↓ ability to maintain body
temperature and
homeostasis; baseline
temperature may be lower
than normal
• Slower rate of healing
• Slower absorption of drugs by
subcutaneous route
• “Liver Spots”
• Nails thicken, grow slowly,
become brittle and yellowed
• risk of splitting

50
Q

interventions for integumentary changes

A

Increased risk of skin cancer: apply sunscreen, stay out of sun, wear protective clothing. Always look for abnormal moles/ skin lesions,

Pressure ulcers: encourage patients to change positions often (help if necessary). Use protective barriers for high risk patients. Evaluate skin integrity. Increase nutritional status, avoid hot water and excessive rubbing, do not massage bony prominences.

Avoid scented soaps, and harsh chemicals (such as bleach)

51
Q

Respiratory changes

A

™ ↓ elasticity of lungs
™ ↓ number of alveoli
™ ↑ size of alveoli
™ ↑ diameter of alveolar ducts and
bronchioles
™ ↓ ciliary action
™ ↑ anteroposterior chest
diameter
™ Weakening of
respiratory muscles
™ ↓ coughing reflex
™ Calcification of costal
cartilages

52
Q

Consequences of respiratory changes

A

Consequences
• 50% increased residual
capacity
• ↓ vital capacity
• ↓ mobility of bony thorax
• ↓ arterial blood oxygen
level
• ↓ oxygen uptake during
exercise
• risk of infection
• amount of dead air
space
• ↓ exercise tolerance
Neurological Aging Changes: • ↓ gas exchange

53
Q

List and describe at least 5 Health Promotion Considerations or Health Promotion Activities

A
  • Encouraging smoking cessation and prevention of second hand smoke
  • Strategies for secretion clearance, energy conservation, relaxation
  • Flu and pneumococcal vaccinations
  • Pulmonary rehab and exercise training
  • Disease self-management strategies
54
Q

Risk of pnuemonia

A
  • dysphagia
  • tube feeding
  • malnutrition and dehydration
  • poor oral hygiene
  • decreased cough reflex
  • diminished salivary flow
  • diminished level of consciousness
  • tobacco use
  • lung disease
  • CHF
  • residence in long term care facility
55
Q

symtoms of pnuemonia

A

fatigue, tachypnea, cough, dyspnea, history of fever, productive sputum, tachycardia, fever (sometimes), and chest pain (sometimes)

56
Q

care considerations for pneumonia

A

pneumonia in older adults is nonspecific, change in mental or functional status may be big clue

57
Q

risks for developing tuberculosis

A

Risks- smoking, diabetes, malnutrition, long term use of corticosteroids

58
Q

Considerations for developing tuberculosis

A

• Care considerations- nonspecific symptoms, nurses must be alert for symptoms especially in those with history of disease

59
Q

risks for COPD

A

COPD (emphysema, chronic bronchitis, asthma)

  • tobacco use genetic predisposition,
  • low socioeconomic status,
  • childhood respiratory disease,
  • secondhand smoke exposure
60
Q

symptoms of COPD

A

cough, dyspnea, wheezing, increased sputum

61
Q

prevention for respiratory condition

A
  • Promoting smoking cessation and second hand smoke avoidance
  • Vaccinations
  • Wash hands and avoid hand to mouth and hand to eye contact
  • Avoid individuals with the flu
  • Adequate nutrition and hydration
  • Oral hygiene
62
Q

Threshold of disability

A
63
Q

what is primary memory?

A

has short duration and a very small capacity, past few seconds.

64
Q

what is Secondary Memory?

A

longer duration and therefore is more important in terms of retrieval as well as storage of info

65
Q

what is recall or recognition memory?

A

Tertiary memory: has to be pulled from remote parts of the mind.

66
Q

Stress Urinary Incontinence

A

involuntary leakage as a result of activty that increase abdominal pressure (ie. lifting something, coughing, sneezing, laughing or exercise)

67
Q

Urge Urinary Incontinence

A

Involuntary Leakage due to the inability to hold urine long enough to reach the toilet after the sensation of urgency

68
Q

Mixed Urinary Incontinence

A

leakage of urine with both the sensation of urgency and an acitivity such as coughing or sneezing

69
Q

overactive bladder

A

sydrome characterized by bothersome urgency, usually accompanied by nocutria and daytime frequency and sometimes urge urinary incontinence.

70
Q

Conductive hearing loss

A

abnormalilites of the external ear and middle ear impair the sound conduction mechansim

71
Q

Sensorineural Hearing Losses

A

abnormalities of the inner ear interfere with the sensory and neural structures

72
Q

mixed hearing loss

A

involves both conductive and sensorineural impairments

SENIORS HEALTH (14 decks)

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