Exam 2 Flashcards
what happens with blood vessels in the aging adult?
- gradual changes
- elasticity decreases
- vessel wall thickens
- smaller vessel lumen
- decreased BF to the organs
how can we promote a healthy heart?
- maintain BP
- engage in regular exercise
- eat a low-fat, low-cholesterol diet
- maintain control of diabetes
- do not smoke
- avoid environmental pollutants
- stress management
- minimize sodium
- maintain body weight
what is expected with normal activity?
slight dyspnea; this is normal with aging
how does exertion change?
less able to meet demand and to respond for as long as compared to a younger person
what are some respiratory system changes?
- decreased cough reflex
- decreased mucus clearance
- decreased cilia activity
- decreased immune response
- high risk for bronchitis and pneumonia
what happens with the chest wall and lung expansion?
- rigid costal cartilage
- less compliant, more rigid rib cage which leads to limited chest expansion
- not adequately getting O2 and pushing CO2 out
what happens with gas exchange?
- PaO2 declines
- PaCO2 slight increase or no change
- slight decrease or no change in pH
- monitor stressful situations
what can a nurse teach a patient for promoting healthy lungs?
- balance exercise/activity with rest
- immunizations
- no smoking
- wash hand frequently
what occurs with the endocrine system?
- increased insulin resistance
- decreased sensitivity to insulin
- decrease in TSH, T3 and T4
- hypothyroidism increases
immune system changes put older adults at risk for what?
infections
when is peak bone mask reached?
early 20s
what can the nurse teach about bones and muscles?
- regular intake of vitamin and calcium
- regular exercise
- flexibility
- no excessive joint strain
osteoporosis
- low bone density
- significant pain, loss of function, suffering, easy to fracture
- fall-related morbidity and mortality
what are some complications of osteoporosis?
- hip fractures
- vertebral fractures
- wrist
- pelvis
risk factors for osteoporosis
- female gender (5-7 years after menopause)
- caucasian or asian
- family history
- advanced age
how often should a DEXA scan be done?
all women 65+ and any younger women with risk factors every 2 years
what exercise is the best in preventing osteoporosis?
walking
treatments and OTC for osteoporosis
- calcium and vitamin D
- biphosphonates
- forteo (teriparatide)
- prolia sq every 6 months
- evista
sources of calcium in food
- yogurt
- soy beverages
- calcium fortified cereal
- orange juice
- cheese
- milk
- salmon
- tofu
- kales
osteoarthritis
where normal bone and cartilage become soft; bone rubs together
non-prescription therapy for osteoarthritis
- heat and cold
- exercise
- joint support
- weight loss
- support group
pharmacologic treatment for osteoarthritis
- analgesics
- NSAIDs
- joint injections
- dietary supplements: glucosamine and chondroitin sulfate
ABCDE for pain assessment and management
- Ask about pain
- Believe patient
- Choose pain control option that are appropriate
- Deliver interventions in a timely manner
- Empower patients
acute pain
- tells patient that there is a problem
- temporary
- post-op, procedural, injury to cells, and traumatic pain
- serves a purpose
persistent (chronic) pain
- no time frame (lasts at least 3-6 mos.)
- varying levels of intensity
- no physiological purpose
most common disorder associated with pain
osteoarthritis
can a person with dementia communicate pain effectively?
not effectively, but they can communicate it
what is a good way to obtain a subjective assessment?
rating scales
OPQRSTU
Onset
Provoking or Palliating factors
Quality
Region and Radiation
Severity
Time and Treatment
Understanding and impact
what occurs in the epidermis of aging skin?
- melanocytes decrease (pale skin)
- lentigines - age spots/liver spots (benign)
- seborrheic keratosis
- freckles, nevi enlarge (noncancerous pigmented spots)
since the dermis thickness is decreased, what is this a risk for?
skin breakdowns
what occurs in aging hair?
- hair color changes to gray since there is a decrease in melanin
- alopecia occurs
- balding/thinning
xerosis
abnormally dry skin
pruritus
itchy skin, consequence of xerosis
scabies
mite and egg; contagious
cherry angioma
benign vascular skin lesion whose cause is unknown
purpura
easily ruptured blood vessels, from minimal trauma
who is more at risk for purpura
those who take blood thinners
what are some prevention tips for skin tears?
- wear long sleeves and pants
- lubricate skin at least twice a day
- transfer with care
- take care with wheelchair and other devices
- substitute for adhesive tape
actinic keratoses
- precancerous
- related to years of UV light exposure
- face, lips, forearms
- monitor every 6-12 months
the most common type of skin cancer
basal cell carcinoma
how does inactivity change caloric needs?
decreased caloric needs
what is a good intervention to enhance food intake?
offer 5 small meals per day
what do we NOT refer to those that need help feeding as?
“a feeder”
what is important to assess for with dysphagia?
- difficult, labored swallowing
- drooling
- aspiration
- coughing, choking at meals
- pocketing food
- absences of chewing or swallowing
- hoarse voice
dysphagia interventions
- sit at 90 degrees during all PO intake
- maintain upright position for at least 30 minutes after PO intake
- keep suction ready at all times
- supervise all meals
- alternate food and fluid
- swallow twice before next mouthful
- downward stroke under chin to prompt swallowing
what are some interventions to decrease nocturia?
limit fluid before bed, drink fluid during the day, void before bed
stress incontinence
leakage on effort or exertion, or on sneezing or coughing
urge incontinence
leakage accompanied by or immediately preceded by urgency
mixed incontinence
stress and urge
functional incontinence
untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet
overflow incontinence
leakage of small amounts of urine because of an overfilled bladder
transient incontinence
leakage that occurs temporarily because of a condition or situation that will pass
is constipation normal?
NO, but peristalsis slows down
what occurs in orthostatic hypotension?
- decreased baroreceptor sensitivity
- increased fall risk
how can we prevent falls in orthostatic hypotension?
- change position slowly
- stand holding ontoi something
- count to ten
- walk cautiously
how can we prevent falls in orthostatic hypotension?
- change position slowly
- stand holding onto something
- count to ten
- walk cautiously
how can we prevent falls in orthostatic hypotension?
- change position slowly
- stand holding ontoi something
- count to ten
- walk cautiously
how can we prevent falls in orthostatic hypotension?
- change position slowly
- stand holding onto something
- count to ten
- walk cautiously
