1. Respiratory
1.1. common age related changes
1.1.1. calcification of costal cartilage
1.1.2. trachea and rib cage more rigid
1.1.2.1. not as much room for lungs to expand, not as deep of breaths, not able to open some alveoli back up, lead to pooling of secretions and possibly cause pneumonia
1.1.3. reduction of cough and laryngeal reflexes
1.1.3.1. aspiration pneumonia and pooling of secretions causing pneumonia
1.1.3.1.1. cannot bring up mucous with reduction of cough reflex
1.1.3.1.2. when swallowing, epiglottis does not close all the way causing food to enter the trachea ant then to the lungs rather than food moving through the esophagus to the stomach
1.1.4. increased residual capacity and reduced vital capacity
1.1.4.1. emphysema
1.1.4.1.1. not as many alveoli, so limited surface area for gas exchange causing low oxygen saturation
1.1.5. high risk for respiratory infection
1.1.5.1. pneumonia
1.1.5.1.1. signs and symptoms could include: fever, low oxygen saturation, confused, activity intolerance, mucous cough, generalized weakness
1.2. smokers
1.2.1. COPD: chronic bronchitis and emphysema
1.2.2. lung cancer
2. Nervous
2.1. common age related changes:
2.1.1. decline in weight and blood flow to brain
2.1.2. reduction in neurons, nerve fibers, and cerebral blood flow
2.1.3. slower response to change in balance
2.1.3.1. Fall Risk
2.1.3.1.1. make sure ensure patient safety
2.1.3.1.2. use of assistive devices
2.1.3.1.3. bed alarms and need of assistance when getting up
2.1.4. hypothalamus less effective in temperature regulation
2.1.4.1. more at risk for hyper and hypothermia
2.1.4.1.1. many older adults need to keep thermostat at 70-75 degrees to prevent hypothermia
2.1.5. changes in sleep patterns with frequent awakening
2.1.5.1. spend longer time in
2.2. dementia: irreversible, progressive impairment in cognitive function that affects memory, orientation, language, reasoning,
2.2.1. Alzheimer's Disease
2.2.1.1. most common form of dementia. Stage this disease using the global deterioration scale and functional assessment staging (GDS/FAST)
2.2.1.1.1. make sure ensure patient safety
2.2.1.1.2. use the mini cog assessment tool for dementia and Alzheimers
2.2.1.2. neuritic plaques containing beta-amyloid protein
2.2.1.3. neurofibrillary tangles in the cortex
2.2.1.4. loss or degeneration of neurons and synapses
2.2.1.5. changes in neurotransmitter system
2.3. delirium
2.3.1. rapid, altered level of consciousness that requires prompt treatment to reverse the condition and prevent permanent damage
2.3.1.1. common causes of delirium is UTI, pneumonia, hypoxia
3. Musculoskeletal
3.1. common age related changes
3.1.1. decreased bone mineral and mass
3.1.2. reduced muscle mass, strength, movement
3.1.2.1. need to encourage adequate exercise to prevent deconditioning
3.1.3. diminished calcium absorption
3.1.3.1. bone density decreases leading to osteoporosis
3.1.4. thinning disks and shortened vertebra
3.1.4.1. leading cause to chronic lower back pain in older adults
3.1.5. increased risk of fractures
3.1.5.1. brittle bones from osteoporosis fracture more easily and heal at a slower rate which could cause for potential immobility
3.1.6. decline in size, number of muscle fibers and reduction in muscle mass
3.1.6.1. leads to decrease body strength and endurance declines
3.1.7. connective tissue changes causing reduced flexibility of joints and muscles
3.2. osteoarthritis
3.2.1. progressive deterioration of joint cartilage with the formation of new bone at the joint surface
3.2.1.1. leading cause to lack of mobility and pain with activity
3.2.2. wear and tear!
3.3. rheumatoid arthritis
3.3.1. A chronic inflammatory disorder affecting many joints, including those in the hands and feet
3.3.1.1. deformities and disability begin at an early age and peak during middle age
3.4. osteoporosis
3.4.1. most prevalent metabolic disease of the bone
3.4.2. decrease density of the bone that leads to fracture from activities that should not cause fractures
3.4.2.1. need to have adequate aerobic activity: 150min/week of moderate intensity
4. Gastrointestinal
4.1. common age related changes:
4.1.1. less acute taste sensations r/t atrophy of the tongue affects taste buds and decreases taste sensation
4.1.1.1. lead to anorexia and not wanting to eat food because it has no taste
4.1.2. atrophy of small and large intestines
4.1.3. increased risk of aspiration, indigestion, and constipation
4.1.3.1. esophageal and stomach motility decreases
4.1.3.1.1. risk for aspiration and indigestion because of pooling of food in the esophagus
4.1.3.2. decreased elasticity of the stomach
4.1.3.2.1. reduces the amount of food accumulation at one time
4.1.3.3. dysphagia
4.1.3.3.1. goal is to prevent aspiration and pneumonia
4.1.3.3.2. at risk for nutritional deficiency because of decreased food intake, prolonged time to eat
4.1.4. decreased saliva production causing swallowing to be difficult
4.1.5. stomach has higher pH as a result of decline in hydrochloric acid and pepsin
4.1.5.1. more alkaline stomach can cause so drugs to not be absorbed as well
4.1.5.1.1. decline in hydrochloric acid causes interference of absorption of calcium, iron, folic acid, vit b12
4.1.5.1.2. decline in pepsin causes interference with absorption of protein
4.2. Peptic ulcer disease
4.2.1. r/t use of harsh drugs, stress from chronic diseases, lack of blood flow to digestive area because of stress on the body
4.3. chronic constipation
4.3.1. may need interventions to promote bowel function such as use of safe laxative, use of an elimination chart, promote activity,
4.3.2. make sure aware of s/s of bowel obstruction
4.3.2.1. fever, abdominal pain, inability to have a BM, impacted , lump in abdomen
4.4. incontinence
4.4.1. not a normal age related change
4.4.2. could be caused by neuro impairment or no control over anal sphincter
4.4.3. monitor skin integrity
5. Reproductive
5.1. cancer or tumor
5.1.1. prostate, penile, testicular, scrotum
5.2. common age related changes:
5.2.1. Male
5.2.1.1. fluid retaining capacity of seminal vesicles reduces
5.2.1.2. possible reduction of sperm count
5.2.1.3. venous and arterial sclerosis of penis
5.2.1.3.1. erectile dysfunction
5.2.1.4. decrease testosterone
5.2.1.5. prostate enlarges
5.2.1.5.1. Benign Prostatic Hyperplasia
5.2.2. Female
5.2.2.1. fallopian tubes atrophy and shorten
5.2.2.2. ovaries become thicker and smaller
5.2.2.3. cervix becomes smaller
5.2.2.4. drier and less elastic vaginal canal
5.2.2.4.1. atrophic vaginitis
5.2.2.4.2. dyspareunia (painful/difficult sexual intercourse)
5.2.2.5. endocervical epithelium atrophies
5.2.2.6. uterus becomes smaller in size
5.2.2.7. endometrium atrophies
5.2.2.8. more alkaline vaginal environment
5.2.2.8.1. infections of vulva
5.2.2.9. loss of subQ fat and hair of the vulva
5.3. cancer - vulva, vagina, cervix, endometrium, ovaries, breasts
5.4. perineal herniation
5.4.1. r/t weakening of muscles or build up of fluid as a cystocele
6. Integumentary
6.1. common age related changes:
6.1.1. thinning, graying of hair
6.1.2. decreased subQ fat
6.1.2.1. greater risk for hypo and hyperthermia
6.1.3. increased benign and malignant skin neoplasms
6.1.3.1. increased risk of skin cancer r/t more exposure to the sun
6.1.4. skin is elastic, dry, and fragile
6.1.4.1. more brittle skin and always need to assess skin integrity
6.1.5. reduced sweat gland activity
7. Cardiovascular
7.1. common age related changes:
7.1.1. blood vessels reduce elasticity
7.1.1.1. hyertension
7.1.1.1.1. less sensitive baroreceptor regulation of blood pressure as well as decreased elasticity causing increase in blood pressure
7.1.2. oxygen is used less efficiently
7.1.2.1. this causes the heart to continue to pump blood faster increasing the workload on the heart
7.1.3. reduced cardiac output with physiological stress
7.1.3.1. hypotension
7.1.3.1.1. demands increase and there is a decreased amount of blood ejected from the heart
7.1.3.2. peripheral vascular disease
7.1.3.2.1. decreased amount of oxygenated blood is being sent to the periphery
7.1.4. valves become thick and rigid
7.1.5. heart muscle loses efficiency and contractile strength
7.1.5.1. Congestive Heart Failure
7.1.5.2. dysrhythmias
7.1.5.2.1. irregular beating of the heart cause by increased workload on the heart and loos of ability to contract normally
7.2. atherosclerosis
7.2.1. build up of plaque in the arteries from cholesterol, fat that can cause narrowing of the blood vessel to limit blood flow to specific area of the body
7.2.1.1. Myocardial infarction
7.2.1.1.1. caused by blockage or clot forming in the coronary arteries that occludes the blood flow causing lack of oxygen
7.2.1.1.2. lower your risk of MI or stroke by proper diet, exercise, no cigarette smoking, manage stress
7.2.1.2. ischemic stroke
7.2.1.2.1. caused by a clot lodged in an artery that provides blood to the brain
7.3. arteriosclerosis
7.3.1. hardening of the arteries as the blood vessels lose elasticity
7.3.1.1. advanced arteriosclerosis aids in the development of aneurysms
8. Lymphatic
8.1. common age related changes
8.1.1. decreased immune response by decreased T-cell activity, cell-mediated immunity
8.1.1.1. increased risk for infection
8.1.1.1.1. importance of flu and pneumonia vaccine for older adults to prevent these life threatening infections
8.1.1.2. T-cell function declines which reduces response to foreign antigens
8.1.1.3. decreased cell-mediated and humoral immunity
8.1.1.4. important to take a daily multivitamin, mineral supplement, adequate diet with adequate nutrients
8.1.1.4.1. nutrients with immune boosting effects: protein, magnesium, vitamins A/E/B/C, manganese, folic acid, selenium, pantothenic acid, zinc, iron
8.1.2. inflammatory defenses decline and present atypically
8.1.3. risk for infection becomes significant
8.1.4. decrease strength of the immune response
8.1.5. high prevalence of chronic conditions increases the risk for infection
8.1.5.1. increased risk of exposure to pathogens with hospitalization and institutionalized
9. Endocrine
9.1. common age related changes:
9.1.1. ACTH secretion and pituitary gland decreases
9.1.2. insulin release by beta cells is delayed and insufficient
9.1.2.1. Diabetes Mellitus
9.1.2.1.1. inability to control blood glucose levels
9.1.2.1.2. many complications can occur later in life such as PVD, neuropathy, nephropathy, retinopathy, atherosclerosis, CAD
9.1.3. ability to metabolize glucose is reduced causing higher blood glucose in nondiabetic patients
9.1.4. thyroid gland atrophies, diminished adrenal function, ACTH secretion decreases, volume of pituitary gland decreases
9.1.4.1. hypothyroidism
9.1.4.1.1. decreased amount of thyroid hormone secreted causing fatigue, weight gain, mood swings, lethargic
9.1.4.2. hyperthyroidism
9.1.4.2.1. overactive or too much thyroid hormone causing weight loss, tachycardia, sweating, irritable
9.1.4.2.2. graves disease
9.1.4.3. addison's disease
9.1.4.3.1. adrenal glands don't produce enough cortisol
10. Urinary
10.1. common age related changes:
10.1.1. reduced bladder capacity with urinary frequency, urgency, nocturia
10.1.1.1. caused by hypertrophy and thickening of the bladder muscle
10.1.2. decline of renal blood flow and GFR by about 50% by age 90
10.1.2.1. affects the ability to eliminate drugs and have potential for adverse drug effects r/t drug staying in your body for too long
10.1.2.2. glomerulonephritis
10.1.2.2.1. infection that damages the glomeruli and affects the filtering ability of you kidneys
10.1.2.3. if older adults are given too much fluids, could cause fluid overload because they cannot filter and excrete as well
10.2. urinary incontinence
10.2.1. not normal aging and is commonly embarrassing for older adults
10.2.2. many types: stress, urgency, overflow, neurogenic, functional and mixed
10.2.3. assess neuro status as well as other chronic diseases to find the reason why
10.3. bladder cancer
10.3.1. smokers have an increased risk because all of the toxins go through the bladder in order to be eliminated
10.4. renal calculi (kidney stone)
10.4.1. build up of calcium and not able to void as well
10.5. urinary tract infections
10.5.1. hematuria, confusion, fever