Geriatrics Flashcards
Exam 2
Body composition changes
- loss of lean body mass
- increased body fat
3.decreased total body water
Thermoregulation changes
- decreased hypothalmus function, so impaired
- longer lasting hypothermia
The only CV change that does not occur is
No change in systolic function
Respiratory changes: _____ chest wall compliance
DECREASED chest wall compliance
Respiratory chagnes: Elastic recoil =
Loss of elastic recoil = reduced FUNCTIONAL alveolar surface area available for gas exchange
Respiratory change: comliance
INCREASE in lung compliance (impairs v/q)
Resp. changes: lung tissue elacticity
decreases
Resp changes: net pulmonary compliance
virtually unchanged
Resp changes: alveolar septae
breakdown =
1. increase anatomic and alveolar daed space
2. increase ventilation
=v/q mismatch
Resp changes: shunt and physiologic dead speace
increase
Res changes: vital capcity
decrease
(d/t increasing residual lung volumes and decrease in inspiratory and expiratory reserve volumes)
OVerall resp changes: Min ventilation, lung compliance, lung elasicity, chest wall compliance
Resp changes: FEV1 and FVC
decrease
Resp changes: VC ERV IRV
decrease
Resp changes: FRC RV
increase
Resp changes: TLC
no change
Elderly: CNS nerve tissue sensitivity to local anesthetics? Why?
Increased
-decreased # and diambeter of myelinated nerve fibers
-decrease in nerve conduction velocity
Regional anesthetic sensitivty (intrathecals, epidurals)
Increased sensitivity to intrathecal anesthetics
increased sensitivty to epidural anesthetics
Difficulty of neuraxial/spinals
increased difficulty
Response to EPI test dose
decreased response to EPI test dose = greater risk of false negative responses (d/t reduced myocardial sensitivity to catecholamines)
Drug DOA
prolonged
Pharmacokinetics of prolonged drug DOA
- decreased blood volume
- Steady state volume varies
- renal decline
- hepatic delcine
Elderly and vasopressors
Decreased sensitivity to vasopressors, may need longer to work
Elderly pharm lipophillic drugs Vd
increased Vd
elderly pharm hydrophillic drugs Vd
decrease in Vd
Elderly lungs
inflate well and trap air
Elderly closing volume
increases (small airways shut down due to increased residual volume overtime = early airway closure
Elderly air closure
early airway closure
Functional residual capacity
increases
closing capacity
increases
total lung capacity
no change
Vital capacity
decreases
inspiratory reserve volume
decreases
residual volume
increases
Expiratory reserve volume
decreases
