week 4- physical changes with aging Flashcards
1
Q
free radical theory of aging
A
free radicals are more membrane permeable and so they are more likely to bind to DNA, causing changes and oxidative damage (collagen is damaged)
2
Q
changes in CNS (spinal cord)
A
- slight decrease in number of cells in the spinal cord
- decerase in nerve conduction
- impact of degenerative disc disease, compression of nerve roots
3
Q
changes in CNS (cortical area)
A
- selective loss in number and size of neurons
- decrease in dendritic connections
- neurotransmitter imbalances (serotonin decreases with age)
- brain decreases in size and weight
4
Q
changes in memory
A
- may have more difficulty with STM
- need more time to process information
- increased difficulty with words/names and spontaneous retrieval
5
Q
changes in sleep
A
- change in sleep patterns
- decrease in stage IV (deep) sleep
- increase in stage I (light) sleep
- increase in the number of night-time awakenings
- subjective reduction in sleep quality
6
Q
changes in temperature regulation
A
- older adults are more susceptible to hypothermia
- poor circulation as a result of plaque buildup and weakened vessels
- less subcutaneous fat
- vasoconstriction and shivering responses are slower
7
Q
risk factors for hypothermia in older adults
A
- decreased thermogenesis
- decreased vasoconstriction in response to cold
- decrease in intensity of shivering
- reduced insulation with less subcutaneous tissue
- medications
- SES
- co-morbidities and social situation
8
Q
risk factors for hyperthermia in older adults
A
- decreased ability to sweat
- decreased ability to redirect heat
- decreased capacity for peripheral vasodilation
- modest ability to increase cardiac output
9
Q
changes in sight
A
- reduction in pupil size slows adjustment to light changes
- corneal surface flattens, admitting less light into the eye
- reduced lens transparency interferes with reception of colour wavelengths
- reduced blood supply and radiation damage to retinal area (difficulty with glare)
- lens is less elastic, presbyopia, nearsightedness
10
Q
changes in smell
A
decreased number of olfactory receptors, slower signal transduction
11
Q
changes in hearing
A
- eardrum and ossicles thicken and become less flexible
- loss of hair cells in the inner ear affect balance
- loss of cochlear neurons leads to hearing loss (presbycusis)
- cerumen glands atrophy, leading to dryer wax
12
Q
presbycusis
A
loss of hearing at high frequency
13
Q
changes in taste
A
- subjective decline in taste, decrease in number of taste buds
- inability to detect sour, salty and bitter z
14
Q
implications of change in senses for nursing practice
A
- reduce background noise, ensure adequate lighting
- provide glasses or hearing aids if needed
- speak clearly at normal volume, repeat if necessary
- discuss food preferences
15
Q
changes in oropharyngeal (GI)
A
- reduction in submandibular and sublingual gland secretions
- swallowing intact in normal elderly
- collagen and supporting tissues for dentures/plates diminish
- decrease in root and pulp canals
- oral care is important to prevent aspiration pneumonia and maintain nutrition
- need 1500ml/day
16
Q
oral hygiene BPGs
A
- independent as much as possible
- early stage dementia: repeat and remind
- mid-stage dementia: two brushes
- use toothpaste only if they can spit
- brush bottom back last to avoid gag relfex
17
Q
changes in gastric function
A
- modest reduction in stomach volume and fluid emptying
- decline in gastric secretions
- atrophic gastritis more common with more campylobactor pyloris
- prone to increased pH and ulcers
- prone to relaxed esophageal sphincters
18
Q
changes in small intestine
A
- modest decrease in motility
- pancreas shows decrease in overall weight, duct hyperplasia and lobular fibrosis
- villi become broader, shorter and less functional
- decreased nutrient absorption
19
Q
changes in large intestine
A
- changes in motility
- increased transit time
- tendency to constipation
- largely influenced by exercise, diet, drugs and water intake
20
Q
preventing constipation BPGs
A
- obtain bowel history
- conduct physical exam to rule out systemic causes
- hydration
- examine meds
- fibre
- exercise
- positioning during defecation
- laxatives, enemas, fecal impaction removal
21
Q
changes in genitourinary system
A
- decline in renal blood flow from 1200mL/min to 60mL/ min
- oliguria below 20mL/h a concern
22
Q
changes in tubular function
A
- decline in ability to excrete concentrated urine
- delayed/slowed response to sodium changes
- variable response to clearing medications
23
Q
male-specific changes in urogenital system
A
- decreased blood flow may lead to a decrease in erectile function
- sperm count tends to decline and chromosomal abnormalities tend to increase
- the prostate increases in size and prostatic fluid is reduced
24
Q
female-specific changes in urogenital system
A
- reproductive capacity is lost at the time of menopause
- ovary, uterus and vagina tend to atrophy following menopause
- tendency to stress incontinence
25
stress incontinence
defined as an involuntary loss of <50mL of urine during actions that increase intra-abdominal pressure
26
urge incontinence
defined as involuntary urine loss that occurs soon after feeling an urgent need to void, inability to suppress muscle triggered reflex
27
functional incontinence
defined as a situation in which the individual is unable to reach a toilet because of environmental barriers, physical limitations or severe cognitive impairment
28
iatrogenic incontinence
transient incontinence that results from the use of restraints, limited fluid intake, bedrest or IV fluid administration
29
overflow incontinence
frequent small amounts or dribbling caused by distention or obstruction
30
risk factors for urinary incontinence
age, immobility, dementia, medications, smoking, obesity, constipation, pelvic muscle weakness
31
strategies to minimize urinary incontinence
- scheduled voiding
- prompted voiding
- bladder training
- kegel exercises (pelvic floor muscles)
