ch 14 potter older adults Flashcards
myths and stereotypes about older adults persist.
gerontology
serve as the primary source of income for most older adults
Social Security benefits
too old/ worthless= no value to us
ageism
provides care that addresses mutually established goals for an older adult, his or her family, and health care team members
Gerontological nursing
(1) the interrelation between physical and psychosocial aspects of aging,
(2) the effects of disease and disability on functional status,
(3) tailoring (use treatments) the nursing assessment to an older person
Nursing assessment takes into account three key points to ensure an age-specific approach
, move to a quiet area to reduce background noise, face the patient, and speak directly in clear, low-pitched tones
When a person has a hearing impairment
SPICES framework (Box 14.3)
can be used to guide assessment of an older adult
SPICES framework
S: Sleep disorders P: Problems with eating or feeding I: Incontinence C: Confusion E: Evidence of falls S: Skin breakdown
Residents with less muscle mass =higher risk for toxicity from protein-binding drugs such as
phenytoin (Dilantin) and warfarin (Coumadin)
Loss of skin elasticity with fat loss in extremities; pigmentation changes; glandular atrophy (oil, moisture, sweat glands); thinning hair, with hair turning gray-white (facial hair: decreased in men, increased in women); slower nail growth; atrophy of epidermal arterioles
Integumentary (
Common Physiological Changes with Aging At a Glance)
Thickening of blood vessel walls, narrowing of vessel lumen, loss of vessel elasticity, lower cardiac output, decreased number of heart muscle fibers, decreased elasticity and calcification of heart valves, decreased baroreceptor sensitivity, decreased efficiency of venous valves, increased pulmonary vascular tension, increased systolic blood pressure, decreased peripheral circulation
Cardiovascular(
Common Physiological Changes with Aging At a Glance)
Periodontal disease; decrease in saliva, gastric secretions, and pancreatic enzymes; smooth-muscle changes with decreased peristalsis and small intestinal motility; gastric atrophy; decreased production of intrinsic factor; increased stomach pH; loss of smooth muscle in the stomach; hemorrhoids; rectal prolapse; and impaired rectal sensation.
Gastrointestinal(
Common Physiological Changes with Aging At a Glance)
Decreased muscle mass and strength, decalcification of bones, degenerative joint changes, dehydration of intervertebral disks, fat tissue increases
Musculoskeletal(
Common Physiological Changes with Aging At a Glance)
Degeneration of nerve cells, decrease in neurotransmitters, decrease in rate of conduction of impulses
Neurological(
Common Physiological Changes with Aging At a Glance)
Decreased accommodation to near/far vision (presbyopia), difficulty adjusting to changes from light to dark, yellowing of the lens, altered color perception, increased sensitivity to glare, smaller pupils
Eyes(
Common Physiological Changes with Aging At a Glance)
Loss of acuity for high-frequency tones (presbycusis), thickening of tympanic membrane, sclerosis of inner ear, buildup of earwax (cerumen)
Ears(
Common Physiological Changes with Aging At a Glance)
Often diminished; often fewer taste buds
Taste(
Common Physiological Changes with Aging At a Glance)
Often diminished
Smell(
Common Physiological Changes with Aging At a Glance)
Decreased skin receptors
Touch(
Common Physiological Changes with Aging At a Glance)
Decreased awareness of body positioning in space
Proprioception(
Common Physiological Changes with Aging At a Glance)
Fewer nephrons, 50% decrease in renal blood flow by age 80, decreased bladder capacity
Male—enlargement of prostate
Female—reduced sphincter tone
Genitourinary(
Common Physiological Changes with Aging At a Glance)
Male—sperm count diminished, smaller testes, erections less firm and slow to develop
Female—decreased estrogen production; degeneration of ovaries; atrophy of vagina, uterus, and breasts; dryness of vaginal mucosa
Reproductive
Common Physiological Changes with Aging At a Glance
General—alterations in hormone production with decreased ability to respond to stress
Thyroid—diminished secretions
Cortisol, glucocorticoids—increased anti-inflammatory hormone
Pancreas—increased fibrosis, decreased secretion of enzymes and hormones, decreased sensitivity to insulin
Endocrine
Common Physiological Changes with Aging At a Glance
Thymus decreases in size and volume
T-cell function decreases
Core temperature elevation is lowered
Immune
Common Physiological Changes with Aging At a Glance
melanoma, basal cell carcinoma, and squamous cell carcinoma
3 malignancies related to sun exposure when examining skin lesions:
, a progressive decline in the ability of the eyes to accommodate from near to far vision, is common
Presbyopia
has to adjust to grandchildren
middle-aged adult
Adjusting to retirement is one of the developmental tasks for an
older person
has to adjust to career
and/or divorce
young or middle-aged adult
Life transitions (older adult)
include retirement and the associated financial changes, changes in roles and relationships, alterations in health
and functional ability, changes in one’s social network, and relocation
universal loss for older adults usually revolves around the (older adult)
loss of relationships through death
sedatives and tranquilizers prescribed for acutely confused older adults sometimes
cause or exacerbate confusion
