week 5- physical changes with aging pt 2 Flashcards
changes in skin
- dryer, thinner, wrinkled
- dermis loses about 20% of thickness with aging
- dermal blood vessels are reduced
- collagen synthesis decreases
- loss of connections between dermis and epidermis (leads to tearing)
- decreased immune cells in the integument
- decreased activation of vita min D, increased damage from sun
lentigo
changes in melanin production, leads to a pigmented flat/slightly raised lesion with clearly defined edge
keratosis
aging of keratinocyte epithelial cells
changes in integumentary system
- vulnerable to tearing or bruising
- diminished adipose tissue below dermis
- delayed response to topically-administered toxic agents
- decreased oil and dermal lubricant
- sunlight exposure results in pre-mature age-related changes
- decreased perfusion and circulation, so slow to heal
- nail thickening may indicate decreased perfusion
nursing implications of changes in integument
- use humidifier to keep room humid
- use lukewarm water
- avoid bath oils
- use mild, unscented cleansers
- choose soft clothing
- apply lots of moisturizer
- protect bony prominences from friction
identifying melanoma
A: asymmetry
B: border irregularity
C: colour (not uniform)
D: diameter (bigger than pencil eraser)
E: evolution (in size, shape etc)
candidiasis
- candida is present on the skin of all healthy people but can develop into a fungal infection in people who are obese, malnourished or are receiving antibiotic/steroid therapy
- grows well in moist, warm, dark places
- growth in the mouth is known as thrush
- maculopapular, glazed and dark pink
nursing implications of fungal infections
- no power
- dry well
- manage incontinence (clean ASAP)
- assess for underlying tissue issues
pressure ulcer risk factors
neurological impairments, involuntary weight loss, immobility, bony prominences, inadequate nutrition, advanced age, diminished sensation, incorrect positioning, excessive body heat
stage 1 pressure sore
skin is still intact, prolonged redness
stage 2 pressure ulcer
slight break in skin, penetrates epithelium and part of dermis
stage 3 pressure ulcer
full-thickness break in skin, passes through epidermis and dermis and into fat/muscle
stage 4 pressure ulcer
deep crater that extends all the way to bone
braden scale
- used to predict pressure sore risk
- takes into account sensory perception, moisture, activity, mobility, nutrition and friction/shear
changes in neuromuscular junction
- decreased number of motor neurons
- increased distance between the junctional axon and the motor end-plate (slower signals)
- decreased number of Ach receptors at end-plate
- decreased in the amount and release of Ach in the junctional vesicles
sarcopenia
- occurs between the ages of 30 and 75
- decrease in estrogen and testosterone
- decrease in number and size of muscle fibres
- linked to dietary changes
changes in muscle fibres
- type 1 (slow twitch) are resistant to age-associated atrophy until 60-70
- type 2 (fast twitch) muscle fibres decline with increased age, atrophy is related to denervation
changes in muscle strength
- lower extremities are better able to maintain force output
- lower extremity muscle loss exacerbates knee osteoarthritis
- resistance exercises can improve muscle strength
- immobilization during hospitalization results in 1% muscle strength loss per day
osteoporosis
loss of endocrine protection and reduced endogenous production of vitamin D leads to a severe loss in BMD
guidelines for avoiding osteoporosis
- three servings of milk or alternatives
- 800-2000 IU daily vitamin D
- weight bearing exercise and muscle strengthening
nonmodifiable fall risks
- reduced sensory input
- delayed nerve conduction
- reduction in number of motor neurons
- reduced fast twitch fibres
- reduced muscle mass
- impaired balance
- reduced vision
change in CV system
- no change in CO at rest
- reduced ability to respond to increased demand (ie. exercise)
- results from reduced beta adrenergic response, lifestyle and pathologies
changes in the heart
- reduced elasticity, increased peripheral resistance
- thickened septum
- reduced diastolic filling rate
- prolonged action potential, reduced myocytes, delayed relaxation
consequences of changes in heart
- higher systolic BP
- lower diastolic BP
- reduced ability to increase HR
- increased likelihood of postural hypotension
