SLM Physiologic Changes in the Adult Population

Question 1

Error/cross-linkage theory of aging

Answer 1

Theory that errors in DNA/RNA synthesis accumulate over time, resulting in decreased biological function and ultimately cell death

Question 2

Free Radical theory

Answer 2

Where products of metabolism, ie free radicals form ionic bonds with normal molecules in the body and destroy them. Damage accumulates with each free radical causing aging and death.

Question 3

Wear and Tear Theory

Answer 3

Where physical, emotional, diet, and environmental factors place stress on cells, causing damage and the need for cells to adapt. Overuse and abuse of the cell’s metabolism due to stress causes aging and death

Question 4

Programmed theory- biological clock

Answer 4

Theory that an individual is born with a pre-determined amount of replications of each cell. Thus, when replications reach fixed amount, the person dies.

Question 5

immunological theory

Answer 5

Theory that decreased functioning of the immune system over time, mainly the T cells decreased ability to distinguish antigens, ultimately leads to more infections, immune disorders and cancer. These conditions then lead to death.

Question 6

Neuroendocrine theory

Answer 6

Theory that changes in the neuroendocrine and immune systems change hormone levels and ability to fight infections, eventually causing aging and death.

Question 7

Presbycardia

Answer 7

normal changes in the healthy heart that occur as the adult grows older. These normal changes are related to lifestyle, disease processes, smoking, diet, exercise, stress throughout life, and alcohol consumption.

Question 8

Describe factors that can increase stress on the aging heart

Answer 8

illness or injury, extreme exercise or lack of “, emotional or environmental changes and certain meds

Question 9

Atherosclerosis

Answer 9

build up of plaque on arterial walls that progressively occludes the lumen of the artery and obstructs blood flow. This also causes arteries to lose their elasticity, so they become stiff and can not dilate anymore.

Question 10

Left ventricular hypertrophy

Answer 10

Thickening of the left ventricle myocardium in response to residual blood secondary to atherosclerosis (stiff arteries) and impaired blood flow. LV myocardium enlarges to accommodate for the volume of residual blood in the LV and for the increased pumping effort of heart.

Question 11

According to jarvis, systolic blood pressures will rise 20mmhg within this age range, and then rise another 20mmhg in this second age range. What are the ages?

Answer 11

first rise is from 20-60 years

second rise is 60-80 years

Question 12

Respiratory changes include aotf except:

a) decreased lung tissue elasticity
b) decreased vital capacity
c) decreased residual volume
d) increased A/P diamter of chest wall

Answer 12

c) decreased residual volume, the residual volume is increased with aging b/c of decreased elasticity, so the person is unable to maximally exhale air. This also causes the increased A/P chest diameter to increase.

Question 13

EKG changes in the heart result in what?

Answer 13

changes to the sino-atrial node (pacemaker of the heart) causes a change in heart rate which can decrease CO and venous return, where some p’s will have S&S of inadequate blood volume.

Question 14

What ability does elasticity of lung tissue refer to? What does elasticity decrease with age?

Answer 14

Elasticity refers to the ability of lung tissue to recoil during expiration and return to its resting state. Elasticity decreases due to a decrease in the amount of collagen and elastin in the lung tissue.

Question 15

What is vital capacity and its normal total value?

When does VC decrease and what happens with this decrease?

Answer 15

the maximum volume of air that can be exhaled from the lungs following a maximum inspiration. The normal total for VC is 4800ml. This begins to decrease at age 50 and the individual will have increased residual volume. They also can’t effectively cough and deep breath.

Question 16

What is the normal A/P diameter to transverse diameter ratio for the chest? Why does the A/P diameter increase with aging?

Answer 16

normal ratio is 1:2, A/P increases with aging due to decreased elasticity with decreased VC and increased amount of residual volume. The residual volume eventually causes hyperinflation of the upper lobes of the lungs and under inflation of the lower lobes.

Question 17

What conditions can cause rigidity of the chest wall?

Answer 17

kyphosis, scoliosis, arthritis

Question 18

T or F: The number of alveoli in the lungs begins to decrease around age 20, but this does not normally cause labored breathing in the adult.

Answer 18

true, healthy adults should be able to breath without effort despite the decreased number of alveoli.

Question 19

Prolonged illness, prolonged bedrest, post-op states, pain, and immobility place the patient at risk for what? (respiratory)

Answer 19

The patient will have shallow respirations which can collapse the alveoli and increases the risk for pneumonia.

Question 20

T or F: With aging, a person does not normally experience changes in intellectual ability or cognitive function. Also, depression does not normally occur

Answer 20

True, if there is a change it is important to evaluate the person for infection, dehydration and injury

Question 21

As a person ages, blood flow to the brain _____, the number of neurons ______, and the velocity of nerve conduction ____ which can affect reaction time and relfexes.

Answer 21

all decrease

Question 22

Peripheral nervous system changes

Answer 22

loss of nerve endings in skin with aging, so pain and temperature sensation decreases. Also, proprioception decreases, thus, the person is not always aware of their body’s position in the environment which increases the risk for falls.

Question 23

GI changes with aging include aotf except:

a) decreased saliva
b) decreased gastric juices
c) increased lower esophageal sphincter pressure
d) constipation

Answer 23

c) increased lower esophageal sphincter pressure. Pressure actually decreases with aging which can ultimately prevent constriction of the esophageal sphincter and cause gastro-esophageal reflux disease.

Question 24

What can result from lower amounts of gastric juices (ie HCL and pepsin) being secreted into the stomach of an older adult?

Answer 24

Diminished secretion of pepsin and HCL into the stomach prevents digestion of proteins and absorption of essential vitamins. This can result in Vitamin B12 deficiency, iron deficiency anemia, malabsorption of calcium, malnutrition.

Question 25

Renal blood flow- normal range/minute

Answer 25

the volume of blood that is delivered to the kidney per minute. normal range= 600-1300ml/minute

Question 26

Glomerular filtration rate

Answer 26

amount of blood that is filtered by the kidney per day. normal= 125ml/minute or 180L/day

Question 27

What is creatinine and what is the significance of its value in the blood and urine?

Answer 27

Creatinine is a by-product of muscle breakdown that is excreted in the urine. Lab results for a creatinine test are used to determine kidney function. If creatinine isn’t excreted in the urine, it will accumulate in blood, thus, yielding a high lab result.

Question 28

T or F: Bladder capacity and tone decreases as the person grows older which causes hesitancy, dribbling, and increased frequency with voiding.

Answer 28

True

Question 29

Along with decreased subcutaneous tissue, and decreased elasticity of skin, what other changes occur with aging?

Answer 29

diminished oil production, atrophy of sweat glands, decreased vascularity, and decreased pigmentation of the skin.

Question 30

Atrophy of sweat glands places the older person at risk for what?

Answer 30

the older person has difficulty staying cool and is at risk for hyperthermia. Hyperthermia can also lead to heat stroke, especially during the summer.

Question 31

Senile Lentigo

Answer 31

also called liver spots or age spots. these are black-brown spots on areas of skin that are usually exposed to sunlight.

Question 32

Seborrheic Keratosis

Answer 32

non-cancerous hyperpigmented areas of sun-exposed skin. Usually present on the face, hands, and trunk, and appear crusted or scale-like.

Question 33

Presbycusis

Answer 33

gradual hearing loss with age due to degeneration of nerves in the inner ear. Person will not be able to hear high pitched sounds.

Question 34

Otosclerosis

Answer 34

hereditary and age-related hearing loss due to hardening of the stapes beginning b/w ages 20-40. The stapes is a small bone in the middle ear responsible for transmitting sound vibrations.

Question 35

What effect does atrophying of the cerumen glands have on an older adult?

Answer 35

Cerumen glands produce ear wax. When these glands atrophy ear wax becomes hard and thick and may occlude the external auditory canal causing loss of hearing.

Question 36

Presbyopia

Answer 36

normal aging of the eye that results in hardening of the lens and loss of near-sighted vision.

Question 37

Senile ptosis

Answer 37

loss of elasticity of the eyelid and atrophy of orbital fat resulting in drooping eyelids which may impair vision.

Question 38

Aracus senilis

Answer 38

non pathological condition of the eye in which calcium and cholesterol deposits lead to the presence of a gray-white ring on the outer edge of the iris.

Question 39

cataract

Answer 39

loss of transparency of the lens of the eye, where the lens appears cloudy and may have a yellow-brown discoloration. This may result in vision loss.

Question 40

Macular degeneration

Answer 40

degeneration of cells in the macula of the retina that causes the loss of central vision, with peripheral vision being unaffected. This is the MOST common cause of age related blindness

Question 41

Glaucoma

Answer 41

condition in which increased ocular pressure causes damage to the optic nerve which results in a gradual loss of peripheral vision. Central vision is unaffected

Question 42

ADLS

Answer 42

basic tasks for daily living including bathing, dressing, toileting, eating, transferring, and being continent

Question 43

IADLS

Answer 43

advanced tasks that require physical mobility and mental processing like using the telephone, traveling, shopping, cooking, cleaning, working, and taking medications