Geriatrics Flashcards by Random Carrott

Physiology of aging in getratrics

Greater risk of nearly all types of injuries and illnesses

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4 multifactorial risks

Genetics

Lifestyle

Health status

Access to healthcare

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As aging increases?

Predisposition to different pathologies can accelerate aging process

Specifically those that cannot regenerate

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4 multifactorial risk

Genetics

Lifestyle

Health Status

Access to healthcare

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What happens to cell mitosis over time?

Decreases in part due to decreased metabolic rates that create energy for the cells

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4 things that impact cellular aging

Toxins

Environmental conditions

Bacteria

Viruses

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What happens to your body system as you age?

Everything decreases

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Hormone changes with age

Receptors to the hormones decrease in number/cease being active/cease being active/decrease receptability
—IDDM

Systems may not be able to react as fast as it used to due to breakdown of elastic fibers and replacement with collagen/adipose fibers

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Hormonal changes in men

Slight drop of androgynous hormones
—levels still high enough to maintain functional sperm into old age

Testosterone decline - muscle degeneration does occur without adequate exercise

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Menopause

Menopause considered end of woman’s reproductive/fertile capabilities

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Ovaries produce?

Estrogen and progesterone during Graffian Follicle release

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What does estrogen and progesterone control?

Controls/inhibit Gonadotropic releasing hormone (GnRH)

Without this control, spikes in GnRH occur more and randomly causing hot and cold flashes

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Estrogen decline causes?

Causes acceleration of bone demineralization from osteoclast

Also allows for atrophy of primary and secondary sexual characteristics

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Endocrine, GI, metabolic systems

Decrease amount of total body water and fat

Decrease in total body cells

Degeneration of salivary glands

Decrease in muscle tone between esophagus and stomach

Decrease in smooth muscle contractions in GI system

Degeneration in lining of intestines

Decrease in size, weight, and function of liver

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Integumentary system

Loss of elasticity

Dry mucous membranes

Delayed wound healing

More prone to injury and infection

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Cardiovascular system

Cardiac output drops

Decreased heart rate

Increase calcium deposits around heart

Increase fibrous tissue throughout heart muscle and peripheral vascular system

Walls of heart thicken without the increase of size in the atrium or ventricle Chambers

Conduction system degenerates (arrhythmias, heart blocks)

basically the heart gets weaker even though it must pump through a greater resistance

Central nervous system

Decrease of cells in brain

Decreased in size and weight of brain

Increase in amount of CSF paragraph decrease blood flow with an increase in cerebral blood flow resistance (decrease oxygen consumption of the brain)

slowed reflexes

Decreased pain perception

Decreased sense of equilibrium

Decrease perception of temperature

Special senses

Decrease in sight
—weakening ocular muscles and degenerative diseases

Decrease in hearing
—inability to hear high pitch noises, or even normal volume

Decrease in taste

Decrease in touch
—degenerative processes, disease, decreased reaction times

Respiratory system

Decrease size / strength (atrophy) of muscles used for respiration

Calcium collects and builds up on tendon and fibrous tissue decreasing mobility

Degeneration of alveolar membrane

Body becomes less sensitive to hypoxia or increased levels of carbon dioxide in blood and tissues

What happens to your body’s natural defense with age?

Body’s natural defense is compromised, coughing / gagging

What would make lungs more susceptible to pneumonia and other infectious lung problems?

COPD

Asthma

Bronchitis

Emphysema

Kidney function

Decrease in kidney function

Worn-out

Hypoxia causes shunting away from kidneys = ischemia - injury - infarct

Renal blood flow

Decrease in renal blood flow

Atherosclerosis occurs here to

Kidneys need to respond to body needs, do so via increased and decreased blood flow

Renal system

Fluid and electrolyte imbalances

Decrease fluid means increase concentration = fluid shift away from cells

Electrolytes excreted naturally at too high of rate and also via drug use
—lasix, digoxin

Increased drug toxicity due to drugs staying in system longer - not being excreted

Musculoskeletal system

Loss of minerals in bone ---osteoporosis Decrease in height ---chemical, physical, surgical Loss of flexibility ---calcification of joints Decrease in skeletal muscle mass

Delirium

Consists primarily of organic brain dysfunction, and presents with patients experiencing: Not progressive Confusion Abnormal behavior Hallucinations

Sudden onset of delirium can often be reversed. Causes?

Drug-induced Cancerous tumours Trauma-induced (brain injury, strokes) Infections / fluid and balances

Dementia

Progressive loss of intellectual function Generally progressive and irreversible

Dementia signs and symptoms

Memory (Alzheimer's) Reasoning - --logical processes no longer work (leaps in logic) - --appear to be childlike in reasoning Orientation (time, location, and even self) Decrease the ability to take care of oneself

Alzheimer's

Form of dementia with progressive loss of memory and cognitive function

How does Alzheimer's work

Neuro-fibers become entangled and can block or confuse messages incoming and outgoing Groups of nerves degenerate (demilenation) eventually not allowing messages past General onset after age 65

Parkinson's disease

Slowly progressing degenerative disorder of the nervous system

Parkinson's disease signs and symptoms

Extrapyramidal symptoms Akathisia (restlessness) Parkinsonism (fine motor movement shakes) Acute dystonia (tension of head / neck muscles) Tardive dyskinesia (rapid eye / arm / tongue movement - late) On set after 40 years old

What can mimic symptoms of Parkinson's disease

People on antipsychotic medications

Clues for geriatric abuse

Frequent EMS calls for falls or injuries multiple orthopedic injuries from trivial falls Multiple areas of bruising in various stages of healing Evidence of burns are other scars in various stages of healing Evidence of burns are other scars in various stages of healing Lack of provision of necessary water, fluid, and food Lock of providing necessary medication Lack of proper hygiene, especially bathing the patient after episodes of incontinence Failure to properly assist a patient with elimination

Signs of depression

Lonely, cut off, no defining factor like work or children feelings of helplessness / being a burden Chemical and balances, drugs / alcohol Lack of activity slash unable to do what they used to Surrounded by death Scared / confused by outside world

During assessment

Elderly patients often fail to report importance symptoms Try to find out the underlying problem and treat Elderlies often suffer from more than one element therefore it is important to differentiate between the acute and chronic symptoms

During history taking

Usually requires more time than with a younger patient Usually a longer medical history Always ask for med list

Management for geriatric patients

Fatigue easier May be wearing multiple layers of clothing patients May minimize or deny symptoms to fear of being bedridden or institutionalized Distinguish between acute and chronic symptoms Evaluate surrounding for general hygiene, availability of Life necessities Confusion and fear can be your biggest problems Treat the underlying problem