older patient Flashcards
1
Q
what influences changes physiologic reserves
A
- Periods of stress
- fluctuating temperatures
- dehydration
- shock
2
Q
common changes of vital signs
A
- Aorta and large ARTERIES STIFFIN leading to systolic hypertension with WIDENED PULSE PRESSURE
- be aware of orthostatic hypotension
3
Q
common changes of heart rate and rhythem
A
- DECLINE in maximal heart rate, atrial or ventricular ectopy, syncope
4
Q
common changes of temperature
A
- susceptibility to hypothermia
5
Q
common changes of the eyes
A
- lens loses its elasticity
- accommodation and near focus become a problem, presbyopia, cataracts, glaucoma, macular degeneration
6
Q
common changes of the hearing
A
- Presbycusis
7
Q
common changes of the mouth and teeth
A
- decreased salivary secretions ( causes tooth erosion and mouth diseases)
- decreased sense of taste
- medication causes
- decreased olfaction
8
Q
common changes of the thorax and lungs
A
- capacity for exercise decreases
- chest wall becomes STIFFER
- respiratory muscles weaken
- increased risk of ATELECTASIS, pneumonia and kyphosis
9
Q
common changes of the cardiovascular system
A
- neck vessels = systolic bruits
- diastolic dysfuction = loss of atrial kick
- S3 heart sounds = heart failure
- S4 can be normal or indicate impaired ventricular filling
- common to find a systolic aortic murmur, aortic stensosis, mitral regurgitation
10
Q
common changes of the peripheral vascular system
A
- abdominal aortic aneurysm (BRUIT’s)
- temporal arteritis
- Bruit’s in the neck (SIGNIFICANT)
11
Q
common changes of the abdomen
A
- aging may blunt the manifestations of acute abdominal disease
12
Q
common changes of male and female
A
- menopause, BPH
13
Q
common changes of musculoskeletal system
A
- loss of lean body mass and strength
- strength training in older adults can slow or reverse the process
14
Q
common changes of nervous system
A
- mental status
- motor and sensory function
15
Q
what are some history concerns
A
- full history and physical exam may be too much for some patients at one time
- question reliability - screening tests - can use mini-cog, mini mental tests
- what about presbycusis, dementia
- patients may be in denial
- may have a patient that every question you ask is positive or yes
