Care of the Older Client Flashcards
1
Q
Physiological Changes: Integumentary System
A
- loss of pigment of skins and hair
- wrinkling of the skin
- thinning of the epidermis and easy bruising and tearing of the skin
- decreased turgor, elasticity, and subcutaneous fat
- increased nail thickness and decreased nail growth
- dry, itchy, scaly skin
- seborrheic dermatitis and keratosis formation (overgrowth and thickening of certain areas of skin)
2
Q
Physiological Changes: Neurological System
A
- slowed reflexes
- slight tremors and difficulty with fine motor movement
- loss of balance
- increased incidence of awakening after sleep onset
- increased susceptibility to hypothermia or hyperthermia
- short-term memory decline (long-term memory usually maintained)
3
Q
Physiological Changes: Musculoskeletal System
A
- decreased muscle mass and strength (atrophy of muscles)
- decreased mobility, range of motion, flexibility, coordination, and stability
- change of gait, with shortened step and wider base
- kyphosis (posture and stature changes)
- increased brittleness of the bones due to demineralization
- deterioration of joint capsule components
4
Q
Physiological Changes: Cardiovascular System
A
- low tolerance for exercise
- decreased compliance of the heart, cardiac output and efficiency of blood return
- decreased compensatory response, resting HR
- peripheral pulses can be weak due to lower cardiac output
- increased BP but susceptible to postural hypotension
5
Q
Physiological Changes: Respiratory System
A
- decreased stretch and compliance of the chest wall
- decreased strength and function of muscles
- decreased size and number of alveoli
- decreased depth and ability to cough and expectorate
6
Q
Physiological Changes: Hematological System
A
- hemoglobin and hematocrit levels average toward the low end of normal
- prone to increased blood clotting
- decreased protein available for protein-bound medications
7
Q
Physiological Changes: Immune System
A
- tendency for lymphocyte counts to be low with altered immunoglobulin production
- decreased resistance to infection and disease
8
Q
Physiological Changes: Gastrointestinal System
A
- decreased caloric needs, appetite, thirst, and oral intake
- decreased lean body weight
- slowed gastric motility and increased tendency for constipation
- increased susceptibility for dehydration
- tooth loss
- difficulty in chewing and swallowing
9
Q
Physiological Changes: Endocrine System
A
- decreased secretions of hormones, metabolic rate, and glucose tolerance, with resistance to insulin in peripheral tissues
10
Q
Physiological Changes: Renal System
A
- decreased kidney size, function, and ability to concentrate urine
- decreased glomerular filtration rate
- decreased capacity of the bladder
- increased residual urine and increased incidence of infections and possibly incontinence.
- impaired medication excretion
11
Q
Physiological Changes: Reproductive System
A
- decreased testosterone production and decreased size of testes
- changes in the prostate gland, leading to urinary problems
- decreased secretion of hormones with the cessation of menses
- vaginal changes, including decreased muscle to and lubrication
- impotence or sexual dysfunction for both
12
Q
Infection
A
- altered mental status is a common sign of infection
- nonspecific symptoms may indicate infection or illness: anorexia, apathy, delirium, tachypnea, hyperglycemia, dyspnea, falling, fatigue, incontinence, self-neglect, shortness of breath, BP bellow baseline
13
Q
Medications to avoid in the older client
A
Analgesics: - indomethacin, ketorolac, NSAIDs, meperidine Antidepressants: - first generation tricyclic Antihistamines - first generation Antihypertensives - alpha1-blockers, centrally acting alpha2-agonists Urge incontinence meds - oxybutynin, tolterodine Muscle relaxants - carisoprodol, cyclobenzaprine, metaxalone, methocarbamol Sedative-Hypnotics - barbiturates, benzodiazepines
