Lesson 2

Question 1

Changes in integumentary system

Answer 1

 In skin
Collagen stiffening
Reduced blood supply and capacity for repair

 For hair
melanin and follicles
Reduced blood supply to fingernails

Question 2

Implications of integumentary system

Answer 2

1. Cool, pale, dry skin
2. fragility, wrinkling, tenting, sagging (breast and abdomen with risk of yeast infections)
   3.elasticity, turgor, wound healing and perspiration with reduced ability to maintain temperature
3. Graying, dry, thinner hair with facial hair alterations in men and women
4. Thick, brittle, easily split nails with slow growth and risk of fungal infections

Question 3

Assessment for integ

Answer 3

1. Monitor skin temperature, turgor (anterior chest wall, not forearm), hydration status
2. Inspect for changes in skin color, pigmentation, lesions, bruising
3. Assess intertriginous areas
4. Assess hygiene

Question 4

Care strategies in integ system

Answer 4

1. Prevention of pressure ulcers
2. Dermatology referral for neoplasm or lesions
3. Education on care of dry, fragile skin
4. Environmental temperature control to prevent hypothermia/
   hyperthermia
5. Provide adequate fluid intake

Question 5

changes in skin are based to exposure of

Answer 5

sun and weather

Question 6

Fewer capillaries are present and cell proliferation is decreased, resulting in

Answer 6

slower wound health and atrophy of gland

Question 7

obvious lesions in skin

Answer 7

skin tag, keratosis, liver spots/lentiges

Question 8

small projections in the skin, axilla, neck

Answer 8

skin tags

Question 9

rough raised masses often in dark color

Answer 9

keratosis

Question 10

dark flat macules on hand and face

Answer 10

liver spots/lentiges

Question 11

what occurs as as melanocytes are reduced in number

Answer 11

gray hair

Question 12

what occurs as the number of hair follicles decreases

Answer 12

thinning of hair

Question 13

Aging changes in musculoskeletal system

Answer 13

-narrowed intervertebral discs
-lean body mass replaced by fat
-in mass and regeneration of muscle fibers
-hip/knee flexion tendon and ligament stiffening
- in joints, articular cartilage erosion

Question 14

implication in musculoskeletal system

Answer 14

-kyphosis, height loss 1-4”
-gait and balance instability
-risk of osteoporosis and fracture arthritis
-risk of F&E imbalances
-joint stiffness with decreased mobility

Question 15

Assessment in musculoskeletal system

Answer 15

-assess functionality, mobility, fine and motor skills ADLs
-Ensure joint stabilization and slow movements in ROM exam to prevent injury

Question 16

Care in musculoskeletal system

Answer 16

-education on nutrition, exercise
-info on strategies to maximize function
-referral to physical therapy

Question 16

important change in bone in aging

Answer 16

loss of calcium and bone mass

Question 17

loss of calcium leads to

Answer 17

osteoporosis

Question 18

recommendations to reduce risk and progression of osteoporosis with aging

Answer 18

 Increase calcium and Vitamin D intake for all age groups
 Walking and other weight-bearing exercise, physiotherapy or rehabilitation program
 Drugs such as Biphosphonates, an inhibitor of bone resorption

Question 19

Degeneration of the cartilage in the joints is a common problem that result into

Answer 19

osteoarthritis

Question 20

articular cartilage becomes thin and erosion occur impairing joint
movement and causing pain, particularly in the large weight-bearing joints such as knees and hip

Answer 20

osteoarthritis

Question 20

changes in respiratory system

Answer 20

-Rigid thorax and vertebrae
-Diminished ciliary and
macrophage activity
-Airway reactivity
-Dry mucus membrane
-response to hypoxia and hypercapnia

Question 21

Management in musculoskeletal includes:

Answer 21

Regular moderate, low impact exercise such as swimming helps maintain mobility and flexibility

Good nutrition (CHON, mineral, Vitamins)

Question 21

implication in respiratory system

Answer 21

-Kyphosis; barrel-shaped, rigid chest
-Respiratory rate: 12-24
-Diminished breath sounds particularly at lung bases
-Risk of infection and asthma
-Unchanged total lung capacity

Question 22

assessment in respiratory system

Answer 22

-Respirations – patterns, breath sounds throughout lung fields -Note thorax appearance, chest expansion -Assess cough, deep breathing, exercise capacity -Assess for infections, asthma

Question 23

care in respiratory system

Answer 23

-Maintain patent airway through repositioning, suctioning - Prevention of respiratory infections by hygiene -Incentive spirometry as indicated, particularly if unable to ambulate -Education on cough enhancement

Question 23

ventilation, both inspiration and expiration is limited for several reasons:

Answer 23

o Elasticity in the lung tissue is reduced o The coastal cartilage between the ribs and the sternum calcifies, reducing rib movement o Skeletal muscles atrophies and weakens o Any skeletal change (e.g. rib shape) may reduce thoracic movement

Question 24

Expiration is reduced and residual volume is increased. The more restricted lung movements lead to decreased expansion for deep breathing and coughing.

Answer 24

o Weaker skeletal muscles also reduce cough effectiveness o When the capability for initiating an effective cough is impaired, secretions tend to accumulate, and the risk for pneumonia increases

Question 24

Vascular degeneration in the lungs lead to

Answer 24

decreased perfusion and reduce gas exchange in the alveoli

Question 24

implications in the cardiovascular system

Answer 24

-decreased cardiac reserve and output -Heart rate 40-100 bpm, slow recovery from tachycardia -Fatigue, SOB -Extra heart sound common: S4 not S3 which is always abnormal

Question 25

There tends to be a reduced oxygen level rather than increased carbon dioxide level

Answer 25

t

Question 26

changes in the cardiovascular system

Answer 26

-increased heart weight -Left ventricle hypertrophy -decreased in pacemaker cells - decreased beta adrenergic response -decreased O2 uptake by tissues

Question 27

assessment in the cardiovascular system

Answer 27

-assess BP (lying, sitting, standing) and pulse pressure -Note altered landmarks, -Assess carotid arteries, -Monitor ECG -Assess exercise tolerance

Question 28

e size and number of cardiac muscle cells declines, reducing what

Answer 28

the strength of cardiac contractions.

Question 28

care in the cardiovascular system

Answer 28

-Referral for irregularities in heart function, blood flow -Safety precautions for orthostatic hypotension. Rise slowly from lying or sitting position. Wait 1-2 minutes after position change to stand or transfer -Monitor for overt signs of hypotension: change in sensorium or mental status, dizziness -Institute fall prevention strategies

Question 29

Loss of elasticity and accumulation of collagen in the arterial walls results in the thickening of the arterial walls, thus limiting expansion of the large arteries and obstructing the lumina of smaller arteries, which would lead to

Answer 29

arteriosclerosis and elevated blood pressure

Question 30

Degenerative changes also promote the accumulation of cholesterol and lipid in the wall of the arteries , the condition known as

Answer 30

atherosclerosis