Homeostasis and disease presentation Flashcards
How does minor illness affect a frail older person’s functional abilities in comparison to a fit older person?
What is homeostasis?
Synchronised adjustments in an internal environment within a body to maintain specific physiological parameters eg. BP, pH, temp, glucose
Which system maintains electrolyte and water balance in the body?
Renin-angiotensin-aldosterone system
What occurs in the ageing kidney?
- Decreased renal mass
- Renal fibrosis
- Decreased renal blood flow (narrowed arteries)
- Lower eGFR
- Impaired recovery
Why might there be decreased fluid intake in the elderly?
- Cognition
- Mobility
- Swallowing
Problems associated with above
Why might there be excess fluid loss in elderly patients?
- Diarrhoea
- Infection
- Meds / diuretics
- Diabetes
What is an Osborn wave?
- J waves
- Positive deflection (wave) at J point
- Junction between QRS and ST segment
- Typical of hypothermia
What other features can be noted on an ECG indicating hypothermia?
- Bradycardia
- QT prolongation
Is there an increased or decreased risk of hypothermia in the elderly?
Increased risk, due to:
- reduced body fat
- sarcopenia
- social isolation
- medications
- impaired cognition
- chronic disease
How do older adults respond to a hot environment?
- Sweating occurs later
- Decreased peripheral blood flow response
- Reduced autonomic heart response
How do older adults respond to a cold environment?
- Delay in response to temp + perception
- Impaired shivering
- Impaired cutaneous vasoconstriction
- Decreased metabolic heat production
What are the geriatric giants?
- Immobility
- Instability
- Incontinence
- Intellectual impairment
- Iatrogenic*
*adverse effect or complication arising from medical advice or treatment
