older adults (333 E2) Flashcards
when does old age begin
65
affects of ageism
-undermine the self confidence
-limit access to care
-takes away personal traits
what defines quality of life in an older person
perception of well being (take of themselves and can do their own ADLs)
universal aging signs during a general survey
-facial wrinkles
-gray hair
-loss of body mass in extremities
-increased body mass in the trunk
normal aging: neurological system
-degeneration of nerve cells
-decrease in neurotransmitters
-decrease in rate of impulse conduction
-voluntary reflex are slower
-less ability to respond to multiple stimuli
-alterations in the quality and quantity of sleep
normal aging: facial features
loss of SubQ fat and skin elasticity
normal aging: vision
-visual acuity declines
-decrease accommodation to near/far vision (presbyopia)
-difficulty adjusting to light changes (from light to dark)
-yellowing of lens
-altered color perception
-increased sensitivity to glare
normal aging: hearing
age related hearing loss (presbycusis), losing the ability to hear high pitched sounds. more common in men
normal aging: taste
-decreased salivary secretion
-taste buds atrophy and loss sensitivity
-often difficult to recognize between salt/sweet/bitter/sour
-health condition & meds can alter taste
normal aging: smell
-loss of smell
-nutrition is a challenge
normal aging: heart / vascular system
-decreased contractile of myocardium (lower CO)
-slight enlargement of heart
-stiffening of heart wall & valves
-HR changes (lowers & doesn’t increase as much w/ exercise)
-BP is sometimes abnormally high
is HTN a normal or abnormal part of aging
common but not a normal part of aging
normal aging: lungs
-strength and lung expansion decreases (cough is less deep & wont clear)
-more susceptible to pneumonia or other infections
-AP diameter of thorax increases
-decrease in # of alveoli & cilia
normal aging: thorax
-kyphosis r/t osteoporosis (preventable)
-calcification of costal cartilage causes decrease mobility of ribs
-chest wall stiffens so less recoil
normal aging: GI system & abdomen
-increased amount of fatty tissue in trunk & abdomen
-Abd more protuberant
-slows of peristalsis
-decreased production of saliva & digestive enzymes
-less tolerant to foods
normal aging: urinary system
-hypertrophy of prostate gland leading to urinary retention, frequency, incontinence & UTIs
-decrease bladder capacity
-urinary incontinence (mainly women)
risk factors for incontinence
age, menopause, DM, hysterectomy, stroke & obesity
normal aging: integument
-decreased turgor, subQ fat & connective tissue
-loses resilience & moisture
-epithelial layer thins
-elastic collagen fibers shrink & become rigid
-wrinkles
-lesions & spots
-sparse hair
-nails growth slows & thickens
normal aging: MS system
-diminishes in proportion to the decline in muscle mass
-osteoporosis
normal aging: repro system - women
-reduced estrogen and progesterone
-dryness of vaginal mucosa, irritation & pain w/ sex
-decrease libido
normal aging: repro system - men
-erection less firm & less forceful ejaculation
-testosterone lessens leads to decrease libido
-no definite cessation of fertility
normal aging: breasts
-estrogen production diminishes
-breast tissue becomes firmer
-decreased muscle mass, tone and elasticity
-gynecomastia (enlarged breasts in men)
-both men and women are at risk for breast cancer
IADLs
transportation, meal prep, shopping
common misconception about aging & cognitive impairments
-confusion or disorientation
-forgetfulness
-loss of language skills or ability to calculate
-poor judgment
these are not normal and need further assessment
normal aging: cognitive
reduction of brain cells & changes in neurotransmitter levels
normal aging: psychosocial
-retirement
-social isolation
-sexuality
-housing and environment (moving out)
-death
acute care setting is
the hospital
pay special attention to
-basic needs of comfort
-safety
-nutrition/hydration
-skin integrity
intrinsic risks for falls
-hx of falls
-fear of falling
-muscle weakness
-postural hypotension
-problems w/ balance and gait
-adverse med rx
-chronic conditions
extrinsic risks for falling
-poor lighting
-lack of handrails
-poor design of stairwells
-lack of bathroom grab bars & nonslip surfaces
-hazards & obstacles
-slippery or uneven surfaces
-improper use of assistive devices
-inappropriate footwear
what is an important way to manage polypharmacy
one HCP manages all medications (medication reconciliation)
review meds monthly
illness indicators in older adults
-changes in mental status
-occurrence & reason for falls
-dehydration
-decrease in appetite
-loss of function
-dizziness
-incontinence
what is the first sign on a UTI in older adults
confusion then incontinent
confusion is the first sign of what in older adults
-UTI
-pneumonia
-MI (+anxious & dyspnea)
elder mistreatment
intentional act or failure to act that causes or creates a risk for harm to an older adult
-physical, emotional, sexual abuse
-financial exploitation
-neglect or abandonment
nutritional recommendations
-increase intake of vit D, B12, E, folate, fiber & calcium (multi vit)
-increase fluid intake if not contraindicated
-limit Na, fat, refined sugar & alc intake
common complications in acute care
-delirium
-malnutrition & dehydration
-HAIs
-urinary incontinence
-falls
normal aging: immune system
-slower
-reduced production of B&T cells
-decrease in body core temp
-decreased stress response
-decreased response to immunizations
