Study Guide Week 2 Flashcards
Changes associated with the aging population: immune system
Impaired T-cell response to antigen
Increase in function of autoimmune bodies
Increased susceptibility to infection and neoplasia
Leukocytes unchanged, T lymphocytes reduced
Increased erythrocyte sedimentation (nonspecific)
Changes associated with the aging population: integument system
Graying of hair results from decreased melanin production in hair follicles (by age 50, 50°/o of all persons male and female are at least 50°/o gray; pubic hair is last to turn gray)
General wrinkling of skin Less active sweat glands
Decrease in melanin
Loss of subcutaneous fat
Nail growth slowed
Changes associated with the aging population: musculoskeletal
Decrease in height because of shortening of spinal column (2-inch loss in both men and women from the second to the seventh decades)
Reduction in lean muscle mass and muscle strength; deepening of thoracic cage
Increase in body fat
Elongation of nose and ears
Loss of bone matrix, leading to osteoporosis
Degeneration of joint surfaces may produce osteoarthritis
Risk of hip fracture is 10°/o to 25°/o by age 90
Continual closing of cranial sutures (parietomastoid suture does not attain complete closure until age 80)
Men gain weight until about age 60, then lose; women gain weight until age 70, then lose
Changes associated with the aging population: Genitourinary/Reproductive
Decreased glomerular filtration rate and renal blood flow
Decreased hardness of erection, diminished ejaculatory spurt
Decreased vaginal lubrication
Enlargement of prostate
Incontinence
Changes associated with the aging population: special senses
Thickening of optic lens, reduced peripheral vision
Inability to accommodate (presbyopia)
High-frequency sound hearing loss (presbyacusis)-25°/o show loss by age 60, 65°/o by age 80
Yellowing of optic lens
Reduced acuity of taste, smell, and touch
Decreased light-dark adaption
Changes associated with the aging population: neuropsychiatric
Takes longer to learn new material, but complete learning still occurs
Intelligence quotient (IQ) remains stable until age 80
Verbal ability maintained with age
Psychomotor speed declines
Changes associated with the aging population: memory
Tasks requiring shifting attentions performed with difficulty
Encoding ability diminishes (transfer of short-term to long-term memory and vice versa)
Recognition of right answer on multiple-choice tests remains intact
Simple recall declines
Changes associated with the aging population: cardiovascular
Increase in size and weight of heart (contains lipofuscin pigment derived from lipids)
Decreased elasticity of heart valves
Increased collagen in blood vessels Increased susceptibility to arrhythmias
Altered homeostasis of blood pressure
Cardiac output maintained in absence of coronary heart disease
Changes associated with the aging population: GI
At risk for atrophic gastritis, hiatal hernia, diverticulosis
Decreased blood flow to gut, liver
Diminished saliva flow
Altered absorption from GI tract (at risk for malabsorption syndrome and avitaminosis)
Constipation
Changes associated with the aging population: Respiratory
Decreased vital capacity
Diminished cough reflex
Decreased bronchial epithelium ciliary action
Elder abuse: physical
Physical force: Result in bodily injury, pain, or impairment
Acts of violence: striking, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, burning.
Inappropriate use: drugs, physical restraints, force feeding, and physical punishment of any kind.
Signs: bruises black eyes, welts, lacerations, rope marks, bone fractures, wounds: cut, punctures, various stages of healing, sprains, dislocations, internal injuries. Lab finding of medication overdose or under utilization, being hit slapped, kicked, mistreated.
Sudden change in behavior, care givers refusal to allow visitors to see an elder alone.
Elder abuse: sexual
Non-consensual sexual consent of any kind
Sexual contact w/ any person incapable of giving consent
Ex: unwanted touching, rape, sodomy, coerced, nudity, sexual explicit photographing
Signs: Bruises around breast or genital area, venereal disease or genital infection, vaginal or anal bleeding, torn stained bloody unclothing, report f being sexually assaulted or raped
Elder abuse: Emotional or Psychological
Infliction of anguish, pain, or distress through verbal non verbal acts
Verbal assaults, insults, threats, intimidation, humiliation, harassment
Isolating victims from their family, friends, regular activities.
Treating older person like an infant
Silent tx and enforced social isolation
Emotionally upset or agitated
Extremely withdrawn and non-communicative of non-responsive
Unusual behavior: sucking, biting, rocking
An elders report of being verbally or emotionally mistreated
Elder abuse: Abandonment
Desertion of an elderly person by an individual who has assumed responsibility for providing care for an elder
Desertion of an elder at a hospital, nursing, facility or institution
Desertion of an elder at a shopping center or other public place
Elders report of being abandoned
Elder abuse: Financial or material exploitation
Illegal or improper use of elders funds, property, assets
Ex: cashing checks w/o auth or permission, forgiving a signature, misusing or stealing money
Sudden change in bank account/ banking practice
Unauth w/d of elders bank signature card,
Funds using an ATM card
Abrupt changes in a will
Disappearance of funds
Substandard care provided or bills unpaid despite the availability of financial resources
Discovery of an elders signature being forged
Relatives claiming their rights
Unexplained sudden transfer of assets
Elder abuse: Neglect
Behavior of an elderly person that threatens his/her own health safety
Manifested as refusal or failure to provide himself/herself with adequate food/water/clothing
Excludes: a situation in which a mental competent older person who understands consequences of their decisions and makes conscious decisions to engage in acts that threaten their health or safety as a matter of personal choice.
Dehydration, malnutrition, untreated medial conditions or poor hygiene
Hazardous unsafe living conditions/arrangements
No indoor plumbing/heat/running water
Unsanitary/unclean living quarters
Grossly inadequate housing/homeless
REM sleep
Rapid eye movement
Body paralysis
Mind very active
Vivid dreams
Problem-solving
NREM sleep
Slow eye movements
Lower physiological functions
Peaceful state relative to waking
HR, respiratory, and B/P is lower
Involuntary body movements
Unusual arousal characteristics
Insomnia
Difficulty initiation or maintaining sleep
Transient or persistent
Dissatisfaction with sleep quantity or quality associated with one or more:
Difficulty in initiating sleep
Difficulty in maintaining sleep w/ frequent awakenings
Problems returning to sleep
Early morning awakening w/ inability to return to sleep
Hypersomnolence Disorder
Excessive sleepiness
Life-threating noncommunicable conditions
Sleepiness can be a consequence of
Insufficient sleep
Basic neurologic dysfunction in brain systems regulating sleep
Disruptive sleep
A phase of an individual’s circadian rhythm
Narcolepsy
A condition characterized by excessive sleepiness as well as auxiliary symptoms that represent the intrusion of an aspect of REM sleep into the waking states
Sleep attacks
Irresistible sleepiness, leading to 10-20 minutes of sleep
Can occur at inappropriate times: eating, driving, talking, during sex.
OSA
Repetitive collapse or partial collapse of the upper airway during sleep
As pt falls asleep, airway resistance increases
Decrease arterial oxygen saturation and transient arousal after which respiration resumes normally
Define parasomnias
Abnormal behavior or physiological events occurring in association with sleep specific sleep stages or sleep wake transitions
Sleepwalking
Repeated episodes of rising from bed during sleep and walking about
While sleepwalking the individual has a blank starting face, is relatively unresponsive to the efforts of others to communicate with him/her
Can be awakened only w/ great difficulties
NREM sleep
