Lecture 2

Question 1

Bronchiectasis

Answer 1

a permanent abnormal widening of the airways due to inflammation.

Question 2

Physical Deconditioning

Answer 2

decline in cardiovascular function due to physical inactivity

Question 3

Presbyesophagus

Answer 3

age-related changes to the esophagus causing reduced strength of esophageal contractions and slower transport of food down the esophagus.

Question 4

Nocturia

Answer 4

voiding at least once during the night. (If the happens once per night)

Question 5

Presbyopia

Answer 5

Age-related decrease in the eye’s ability to change shape of the lens to focus on near objects (Begins in 40s)

Question 6

Presbycusis

Answer 6

age-related high-frequency sensorineural hearing

Question 7

Hyposmia

Answer 7

Decrease in smell acuity

Question 8

Sarcopenia

Answer 8

The decline walking speed and/or grip strength related to decreased muscle mass/function.

Question 9

Aging changes

Answer 9

Anatomical and physiological changes that are attributed to aging…All cells are affected by AGING

Question 10

Risks to Adequate Respiration due to Aging

Answer 10

• 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”.

Question 11

As people get older they have a different …

Answer 11

baseline temperature

Question 12

What is on the nurse’s mind with a patient with respiratory problems?

Answer 12

• Hypoxia
• Easily fatigued related to decreased respiratory efficiency
• Risk of asthma
• Increased potential for infection

Question 13

Leading cause of death in older adults

Answer 13

Pneumonia

Question 14

Risk to Adequate Circulation Related to Aging

Answer 14

• 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.

Question 15

Nursing Considerations for geriatric patients with Cardiovasuclar patients

Answer 15

-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

Question 16

Urinary Elimination Changes related to Aging

Answer 16

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.

Question 17

If a geriatric patient is having GU problems consider potential adverse drug reactions or toxicity because..

Answer 17

the drugs arent clearing in their system, its just sitting there

Question 18

Skin Changes related to Aging

Answer 18

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

Question 19

Nursing considerations for geriatric patients

Answer 19

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)

Question 20

Vision Changes related to Aging

Answer 20

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

Question 21

Nursing Considerations for Eyes

Answer 21

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

Question 22

Hearing Changes related to Aging

Answer 22

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

Question 23

Nursing considerations for hearing in geriatric patients

Answer 23

o Decreased sound conduction
o Risk of hearing loss – Presbycusis, tinnitus, equilibrium deficits (balance)
o Changes in appearance of external ear, larger and longer

Question 24

Changes in Smell and Taste related to Aging

Answer 24

o Decrease neurons that send signal to the brain
o Difficulty distinguishing smells
o Decrease in taste secondary to change in smell acuity

Question 25

Musculoskeletal Changes related to Aging

Answer 25

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

Question 26

Endocrine Changes related to Aging

Answer 26

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

Question 27

Nursing Considerations from the endocrine for geriatric patients

Answer 27

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

Question 28

Immune System Changes related to Aging

Answer 28

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

Question 29

Nervous System Changes related to Aging (Dementia)

Answer 29

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

Question 30

Reproductive Changes related to Aging

Answer 30

o Hormonal Changes
o Women: Estrogen decreases – Menopause
o Men: Testosterone and sperm count decreases