Lecture 2 Flashcards
Bronchiectasis
a permanent abnormal widening of the airways due to inflammation.
Physical Deconditioning
decline in cardiovascular function due to physical inactivity
Presbyesophagus
age-related changes to the esophagus causing reduced strength of esophageal contractions and slower transport of food down the esophagus.
Nocturia
voiding at least once during the night. (If the happens once per night)
Presbyopia
Age-related decrease in the eye’s ability to change shape of the lens to focus on near objects (Begins in 40s)
Presbycusis
age-related high-frequency sensorineural hearing
Hyposmia
Decrease in smell acuity
Sarcopenia
The decline walking speed and/or grip strength related to decreased muscle mass/function.
Aging changes
Anatomical and physiological changes that are attributed to aging…All cells are affected by AGING
Risks to Adequate Respiration due to Aging
- Trachea stiffens = reduces ability to cough
- Reduced number of nerve endings lead to = weaker gag reflex
- Lungs become smaller in weight and size= Decreased recoil
- Alveoli are less elastic = reduces gas exchange
- Loss of skeletal muscle strength in the thorax and diaphragm = leads to Kyphosis or a look of having a “barrel chest”.
As people get older they have a different …
baseline temperature
What is on the nurse’s mind with a patient with respiratory problems?
- Hypoxia
- Easily fatigued related to decreased respiratory efficiency
- Risk of asthma
- Increased potential for infection
Leading cause of death in older adults
Pneumonia
Risk to Adequate Circulation Related to Aging
- Heart valves increase in thickness and rigidity R/T sclerosis and fibrosis
- Aorta becomes dilated
- Slight ventricular hypertrophy
- Myocardial muscle loses some of its contractile strength causes a reduction in cardiac output, meaning it is less efficient with increased activity or demands on the heart.
- Diastolic filling and systolic emptying require more time to complete the cycle.
- Calcification and reduced elasticity of vessels. Reduces regulation of blood pressure. Reduced arterial BP leads to decreased tissue profession.
- Changes are usually gradual and become more apparent when the older adult is placed under increased activity. Consider early morning walks to restroom – increased death.
Nursing Considerations for geriatric patients with Cardiovasuclar patients
-Poor peripheral circulation (Fluid in legs and lower extremities? Edema? Fingernails Capillary refill?)
-Easliy fatigued
-Inadequate circulation to heart tissue
-Shortness of breath
-Reduced cardiopulmonary tissue perfusion
o Hypotension
o Tachycardia
o Edema
o Dyspnea
o Delirium (Sign of infection? Lack of oxygen? Will cause mental status change.)
o Restlessness
o Pallor
o Memory disturbance (A recent change of memory
Urinary Elimination Changes related to Aging
o Hypertrophy of the bladder muscle and thickening decreases the ability of the bladder to expand and reduces capacity, leading to urinary frequency and nocturia. Kidney circulation improves when a person is in a recumbent position and increase the need to void. This is not a normal part of aging and is related to other aging issues.
o Retention of urine due to neurological inefficiencies and a weaker bladder that does not empty properly.
o Woman: fecal impaction
o Men: prostatic hypertrophy (they can’t empty their bladder) (If a man has a UTI there is 99% chance there is an underlying problem)
o Reduced filtration efficiency of the kidneys affects the body’s ability to eliminate drugs and causing higher blood urea nitrogen levels.
o Incontinence Also not a normal part of aging, but usually caused by age-related physical or mental disorders.
If a geriatric patient is having GU problems consider potential adverse drug reactions or toxicity because..
the drugs arent clearing in their system, its just sitting there
Skin Changes related to Aging
o Reduced thickness of the dermis o Reduced vascularity of the dermis o Decrease rate of epidermal turnover o Degeneration of elastic fibers o Increased coarseness of collagen o Reduction of melanocytes o Reduced blood supply o Results in increased fragility of the skin
Nursing considerations for geriatric patients
o Risk for skin tears o Risk for wounds o Risk for infection o Risk for pressure injury o Bruising o Decreased Turgor o Slow healing o Decreased fat and muscle in the feet (Leads to an unsteady gait/ Increases fall risk)
Vision Changes related to Aging
o Reduced elasticity and stiffening of the muscle fiber of the eye lens leading to presbyopia. Usually begins In the 40’s and continues with age interfering with the ability to focus.
o Reduced pupil size, opacification of the lens, and a reduction of photoreceptors in the retina reduces visual acuity.
o Light perception decreases leading to difficulty seeing at night
o Sensitivity to glare increase
o Distortion of colors such as blue and green
o Depth perception becomes distorted
o Peripheral vision is reduced
o Decreased tear production distorts light
Nursing Considerations for Eyes
o Blurred vision o Decreased vision o Need for more light to see/read o Impaired light/dark adaption o Decreased night vision o Risk for falls/injury o Risk for social isolation
Hearing Changes related to Aging
o Tympanic membrane thinning with loss of resiliency. (Decreased hearing)
o Ossicle Joint degeneration
o Vestibular structures atrophy. Organ of Corti, cochlea.
o Loss of hair cells
o Changes in cartilage of pinna
Nursing considerations for hearing in geriatric patients
o Decreased sound conduction
o Risk of hearing loss – Presbycusis, tinnitus, equilibrium deficits (balance)
o Changes in appearance of external ear, larger and longer
Changes in Smell and Taste related to Aging
o Decrease neurons that send signal to the brain
o Difficulty distinguishing smells
o Decrease in taste secondary to change in smell acuity
Musculoskeletal Changes related to Aging
o Decline in muscle fibers leads to reduced muscle mass, causing a decrease in strength and endurance.
o Decreased flexibility of joints and muscles related to changes in connective tissue
o Tendon and ligament stiffening
o Redistribution of fat
o Narrowed intervertebral disks
o Decline in walking speed (sarcopenia)
o Increased latency/contraction of muscles
Endocrine Changes related to Aging
o Thyroid gland atrophies leading to a decrease in activity.
o Reduced / Insufficient release of insulin (Diabetes type 2)
o Reduction in sensitivity to insulin (resistance)
o Decreased Adrenocorticotropic hormone secretion leading to reduced estrogen and progesterone secretions
Nursing Considerations from the endocrine for geriatric patients
o Risk of developing DM type 2
o Risk for hypoglycemia
o Decreased ability to respond to physiological changes/stressors
o Risk for medication safety issues
Immune System Changes related to Aging
o T-Cell activity declines
o More immature T-Cell present
o Thymic mass decreases. Leads to immature T-Cells
o Cell-mediated immunity declines. reduces ability to fight infection
o Lower body temperature
o Ability to respond to cold temps decreases. R/T inefficient vasoconstriction, reduced peripheral circulation, decreased cardiac output, reduced muscle mass, and reduced subcutaneous tissue
Nervous System Changes related to Aging (Dementia)
o Atrophy of the brain and spinal cord r/t loss of nerve cell mass
o Decline in nerve cells
o Reduced nerve conduction
o Slowed central processing
o Approximately 20 percent reduction in cerebral blood flow
o Decreased peripheral nerve function
o Decreased cranial nerves
Reproductive Changes related to Aging
o Hormonal Changes
o Women: Estrogen decreases – Menopause
o Men: Testosterone and sperm count decreases
