Management of the Older Adult Patient Flashcards
What are the leading causes of death in older adults?
heart disease
unintentional injuries
chronic lower pulmonary diseases
stroke
Alzheimer’s disease
What is preventive health care?
encouragement
community-based support services
promoting lifelong health behaviors
What are Cardiovascular changes in older adults?
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
The respiratory system in older adults
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
The integumentary system in older adults
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
The Reproductive System in Older Adults
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
The Genitourinary System in Older Adults
-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)
The Gastrointestinal System in Older Adults
-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
Nutritional Health in Older Adults
-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
What factors affect older adults sleep quality?
- respiratory problems
- restless leg syndrome
-nocturia
-pain
-dementia
What are consequences of poor sleep in older adults?
- cognitive decline
-increase risk for falls
-daytime fatigue
-reduced physical and mental health
-reduced quality of life
The Musculoskeletal System in Older Adults
- alterations in bone remodeling
-loss of bone density
-loss of muscle strenth and size - deterioration of muscle fibers and cell membranes
-degenerated joint cartilage
The Nervous System in Older Adults
-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)
Sensory Changes in older adults
- 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
What are Psychosocial aspects in older adults?
-ageism
-fear of aging
-negative images in society
Stress and Coping in older adults (common stressors)
- 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
Coping in Older Adults
- 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
What is nursing management in older adult patients?
- 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
What are Pharmacologic Aspects in Older Adult Patients?
- 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
Nursing Implications within older adults
- 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
What are Mental Health Problems in the older adult?
-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)
Dementia in Older Adults
-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
Alzheimer’s Disease in older adults
-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
What are nursing management skills in alzheimers
- 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
Geriatric Syndromes in older adult patients
- 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
