Management of the Older Adult Patient Flashcards

1
Q

What are the leading causes of death in older adults?

A

heart disease
unintentional injuries
chronic lower pulmonary diseases
stroke
Alzheimer’s disease

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2
Q

What is preventive health care?

A

encouragement
community-based support services
promoting lifelong health behaviors

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3
Q

What are Cardiovascular changes in older adults?

A

Heart disease is the leading cause of death
myocardial hypertrophy; decreased cardiac output
increased fibrosis: reduced stroke volume
calcium and fat deposits: hypertension and increased workload
slower heart recovery rate to stress
orthostatic hypertension

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4
Q

The respiratory system in older adults

A

age-related changes may be subtle and gradual
diminished respiratory efficiency
reduced maximal inspiratory and expiratory force
lung mass decreases and residual volume increases
smoking most significant risk factor

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5
Q

The integumentary system in older adults

A

aging can interrupt all functions of the skin and affect appearance
epidural proliferation decreases, dermis becomes thinner
elastic fibers are reduced and collagen becomes stiffer
subcutaneous fat diminishes: less likely to conserve body heart
loss of resiliency with wrinkling and sagging of the skin

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6
Q

The Reproductive System in Older Adults

A

female:
- vaginal narrowing
-decreased elasticity
-decreased vaginal secretions
-decreased tone

Male:
-less firm testes but may continue to produce viable sperm up to 90 years old
-diminished production of testosterone

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7
Q

The Genitourinary System in Older Adults

A

-decreased filtration rate
-diminished tubular function with less efficiency in reabsorbing and concentrating the urine
-Male: benign prostatic hyperplasia
-Female: relaxed perineal muscles, detrusor instability (urge incontinence), urethral dysfunction (stress urinary incontinence)

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8
Q

The Gastrointestinal System in Older Adults

A

-decreased sense of thirst, smell, and taste
-decreased salivation
-difficulty chewing and swallowing food
-delayed esophageal, gastric emptying
- diminished secretion of gastric acid and pepsin
-reduced gastrointestinal motility

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9
Q

Nutritional Health in Older Adults

A

-require a more nutrient-rich healthy diet in response to alterations in body mass and a more sedentary lifestyle
- recommendations include reducing fat intake while consuming sufficient protein, vitamins, minerals, and dietary fiber for health and prevention of disease
- budgetary constraints and physical limitations may interfere with food shopping and meal preperation

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10
Q

What factors affect older adults sleep quality?

A
  • respiratory problems
  • restless leg syndrome
    -nocturia
    -pain
    -dementia
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11
Q

What are consequences of poor sleep in older adults?

A
  • cognitive decline
    -increase risk for falls
    -daytime fatigue
    -reduced physical and mental health
    -reduced quality of life
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12
Q

The Musculoskeletal System in Older Adults

A
  • alterations in bone remodeling
    -loss of bone density
    -loss of muscle strenth and size
  • deterioration of muscle fibers and cell membranes
    -degenerated joint cartilage
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13
Q

The Nervous System in Older Adults

A

-decreased nerve cells—small loss of brain mass
-reduced speed in nerve conduction
-increased confusion with physical illness, loss of environmental cues
-reduced cerebral circulation (becomes faint, loses balance)

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14
Q

Sensory Changes in older adults

A
  • vision: diminished ability to focus on close objects; inability to tolerate glare, difficulty adjusting to changes of light intensity, decreased ability to distinguish colors
  • Macular degeneration: primary cause of loss of vision
  • hearing: decreased ability to hear high-frequency sounds
  • taste and smell: decreased ability to do both
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15
Q

What are Psychosocial aspects in older adults?

A

-ageism
-fear of aging
-negative images in society

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16
Q

Stress and Coping in older adults (common stressors)

A
  • normal aging changes that impair physical function, activities, and appearance
  • disabilities from injury or chronic illness
    -social and environmental losses related to loss of income
  • decreased ability to perform previous roles and activities
  • death of significant other
17
Q

Coping in Older Adults

A
  • abilities to adapt to change, make decisions, and respond predictably are also determined by past experiences
  • often has fewer choices and diminished resources to deal with stressful events
  • many rely strongly on their families and spiritual beliefs for comfort during stressful times
18
Q

What is nursing management in older adult patients?

A
  • supporting cognitive function
  • promoting physical safety
  • promoting independence in self- care activities
  • reducing anxiety and agitation
  • improving communication
  • providing for socialization and intimacy needs
  • promoting adequate nutrition
  • promoting balanced activity and rest
  • supporting home, community-based, and transitional care
19
Q

What are Pharmacologic Aspects in Older Adult Patients?

A
  • polypharmacy: administration of multiple medications at the same time; common in older adults with severe chronic illnesses

Aging Changes alter drug:
- absorption
- metabolism
-distribution
- excretion

20
Q

Nursing Implications within older adults

A
  • need adjustment of dosage due to age; start low, go slow
  • assess knowledge of medications and use
  • review need for medication, coordination of prescriber
    1. factors that affect compliance
    2. keep medication regimen as simple as possible
    3. strategies to improve compliance
21
Q

What are Mental Health Problems in the older adult?

A

-depression: most common affective disorder
- risk for suicide is increased
- substance misuse
- delirium: acute, confused state that begins with disorientation (if not immediately evaluated and treated it can progress to changes in level of consciousness, irreversible brain damage, and sometimes death)

22
Q

Dementia in Older Adults

A

-symptoms subtle in onset
-progress slowly
- Alzheimers disease most common: accounts for 70% of dementia
- non-alzheimers: degenerative, vascular, neoplastic, demyelinating, infectious, inflammatory, toxic, metabolic, and psychiatric disorders

23
Q

Alzheimer’s Disease in older adults

A

-complex brain disorder
-5th leading cause of death for adults over age of 65
- affects half of those 85 and older
- not a normal aging process

24
Q

What are nursing management skills in alzheimers

A
  • supporting cognitive function
  • promoting phsyical safety
  • promoting independence in self-care activities
  • reducing anxiety and agitation
  • improving communication
  • providing for socialization and intimacy needs
  • promoting adequate nutiriton
  • promoting balanced activity and rest
  • supporting home, community and transitional care
25
Q

Geriatric Syndromes in older adult patients

A
  • geriatric triad: cognitive changes, falls, incontinence
  • impaired mobility
  • dizziness
  • falls and falling
  • urinary incontinence
  • increased susceptibility to infection
  • altered pain and febrile responses
  • altered emotional impact
  • altered systemic response