Age related changes in older adults

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Age related changes in older adults by Mind Map: Age related changes in older adults

1. Skin

1.1. Flattens due to loss of subcutaneous fat, skin cells, sweat glands, melanocytes, and hair follicles.

1.2. Loses effectiveness

1.2.1. Protection from bacteria

1.2.2. Thermal regulator

1.2.3. Sensory receptor

1.3. Slower healing

1.4. Cosmetic changes

1.4.1. Color changes

1.4.1.1. Gray

1.4.2. Drying

1.4.3. Thinning

1.4.4. Hair becomes sparse

1.4.5. Ridged fingernails

1.4.6. Flattens due to loss of subcutaneous fat, skin cells, sweat glands, melanocytes, and hair follicles.

1.5. Skin disorders

1.5.1. Pruritis

1.5.1.1. Superficial nerve endings of slow-conducting unmyelinated C-polymodal

1.5.2. Keratoses

1.5.2.1. Thickening in patches

1.5.3. Skin cancer

1.5.3.1. Uncontrolled growth of cells in the skin

1.5.4. Decubitus ulcers

1.5.4.1. Pressure, shear forces, and friction cause microcirculatory occlusion and consequent ischemia, which leads to inflammation and tissue anoxia

1.5.4.2. Nursing Considerations

1.5.4.2.1. Reposition or turn every 2 hours

1.5.4.2.2. Assess sites every shift

1.5.4.2.3. Apply topical ointment as needed

1.5.4.2.4. Perform peri care after using the restroom

1.5.5. Herpes zoster

1.5.5.1. Localized disease characterized by unilateral radicular pain and a vesicular rash limited to the area of skin innervated by a single dorsal root or cranial sensory ganglion

1.5.5.2. S/S: pain on skin, blisters, ulcers,

1.5.5.3. Treatment: antivirals and nerve pain medications

1.5.5.4. Nursing Considerations

1.5.5.4.1. Wear loose, non restrictive clothing

1.5.5.4.2. Apply cool, moist dressings

1.5.5.4.3. Avoid extreme temperatures

1.5.5.4.4. Avoid rubbing or scratching of skin

2. Skeletal

2.1. Loss of bone matter

2.1.1. Osteoporosis

2.1.1.1. Changing rates of osteoblasts and osteoclasts

2.1.1.2. More common in women than men

2.1.1.3. Risk factors: chronic alcoholism, hyperthyroidism, diabetes, uremia, collagen disease

2.2. Loosened cartilage around the joints

2.3. Hardened or contracted ligaments

2.3.1. More in men than women

2.4. Common muscular changes

2.4.1. Loss of muscle cells

2.4.1.1. Permanent

2.4.1.2. Due to inactivity

2.4.1.3. Weakness

2.4.1.4. Slowness

2.4.2. Thinning disks and shortened vertebrae

2.4.2.1. As adipose tissue accumulates

2.4.3. Reduced muscle mass, strength, and movement

2.4.4. Decreased bone mineral and mass

2.4.5. Diminished calcium absorption

2.4.6. Increased risk of fractures

2.5. Skeletal conditions

2.5.1. Sacropenia

2.5.1.1. Characterized by loss of muscle mass, strength and function. This debilitating condition is common in the elderly and results in frailty, disability, and high mortality

2.5.1.2. S/S: weakness, loss of stamina, reduced activity

2.5.1.3. Treatment: exercsie

2.5.1.4. Nursing Considerations

2.5.1.4.1. Engage of non stressful exercise such as swimming

2.5.1.4.2. Ensure proper nutrition

3. Nervous

3.1. Reduction in neurons, nerve fibers, and cerebral blood flow

3.2. Slows signal conduction

3.2.1. Mostly at nerve synapses

3.2.2. Slower response to change in balance

3.3. Lose taste buds, olfactory cells, nerve endings in the skin, and brain cells.

3.4. Hearing loses sensitivity

3.5. Decline in weight and blood flow to the brain

3.6. Conditions

3.6.1. Amyotrophic lateral sclerosis (ALS)

3.6.1.1. Motor neuron disease which weakens the muscles and progressively hampers physical function

3.6.1.2. S/S: muscle weakness, twitching, slurred speech, trouble with physical tasks

3.6.1.3. No cure has been found

3.6.1.3.1. First drug treatment: riluzole (Rilutek) which reduced damage to motor neurons by decreasing release of glutamate

3.6.1.4. Nursing Considerations

3.6.1.4.1. Provide intellectual stimulating activities

3.6.1.4.2. Provide client and family teaching

3.6.1.4.3. Promote measures to enhance body image

3.6.1.4.4. Ensure adequate nutrition

3.6.1.4.5. Prevent respiratory complications

3.6.2. Alzheimer's disease

3.6.2.1. Chronic neurodegenerative disease that usually starts slowly and worsens over time

3.6.2.2. S/S: memory loss, difficult solving problems, completing tasks, determining time and place, finding right words and making decisions

3.6.2.3. No cure but drug and non drug treatments may help with cognitive and behavioral symptoms

3.6.2.4. Nursing considerations

3.6.2.4.1. Assess for characteristics of symptoms

3.6.2.4.2. Determine self care abilities

3.6.2.4.3. Be patient

4. Gastointestinal

4.1. Mouth

4.1.1. Lost teeth and taste buds

4.1.2. Less acute taste sensatations

4.1.3. Could cause constipation and malnourishment

4.2. Esophagus

4.2.1. Dysphagia

4.2.1.1. incidence of swallowing difficulties

4.2.1.2. Caused by GERD, stroke, structural disorders

4.2.1.3. Nursing Considerations

4.2.1.3.1. Before meals, provide adequate rest

4.2.1.3.2. Eliminate environmental stimuli

4.2.1.3.3. Provide oral care before feeding

4.2.2. Decreased motility

4.2.3. Increased risk of aspiration

4.2.4. Cancer

4.2.4.1. Inflammation of the squamous epithelium

4.2.4.2. S/S: change in your voice, trouble swallowing (dysphagia), weight loss, sore throat, constant need to clear your throat. persistent cough (may cough up blood), swollen lymph nodes in the neck, wheezing.

4.2.4.3. Treatment: endoscopic treatments

4.3. Stomach

4.3.1. Hypoacidity

4.3.2. Achlorhydria

4.3.3. Cancer

4.3.3.1. Multifactorial, but H pylori plays a role

4.3.3.2. Symptoms include early satiety, obstruction, and bleeding

4.3.3.3. Treatments: surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy

4.4. Pancreas

4.4.1. Increase if Islets of Langerhans are damaged or become overstressed

4.4.2. Cancer

4.4.2.1. Begins in the cells that line the ducts of the pancreas.

4.4.2.2. S/S: changes in bowel and bladder habits, a sore throat, unusual bleeding, indigestion or difficulty bleeding

4.4.2.3. Treatment: pancreaticoduodenectomy

4.5. Intestines

4.5.1. Obstructions of the bowel

4.5.1.1. carcinogenic

4.5.1.2. Diverticular disease

4.5.1.2.1. An inflammation of one or more diverticula

4.5.1.2.2. S/S: diarrhea, constipation, painful cramps, chills or fever

4.5.1.2.3. Treatment: broad septum antibiotics

4.5.1.2.4. Nursing Considerations

4.5.1.3. Hemorrhoids

4.5.1.3.1. Hard stool and increased intraabdominal pressure could cause obstruction of venous return, resulting in engorgement of the hemorrhoidal plexus

4.5.1.3.2. S/S: Constipation, prolonged straining

4.5.1.3.3. Nursing Considerations

4.5.1.4. GI discomfort

4.5.2. Atrophy of small and large intestines

4.6. Nursing Considerations

4.6.1. Cancers

4.6.1.1. Assess patients for stage of grief

4.6.1.2. Provide open and non judgmental environment

4.6.1.3. Encourage verbalization of thoughts or concerns

4.6.1.4. Be aware of mood swings

4.6.1.5. Be aware of debilitating depressions

5. Cardiovascular

5.1. Slower circulation

5.2. Heart muscle loses efficiency and contractile strength

5.2.1. reduced cardiac output with physiological stress

5.2.2. Decreased contractile strength

5.3. Valves become thick and rigid

5.4. Blood vessels reduce elasticity

5.4.1. calcification

5.5. Oxygen uses less efficiently

5.6. Aorta becomes dilated

5.6.1. Slight ventricular hypertrophy

5.6.2. Thickening of left ventricular wall

5.7. Conditions altering tissue perfusion

5.7.1. Hypertension

5.7.1.1. Chronic disease characterized by elevation of blood pressure.

5.7.1.2. Dull headache, impaired memory, disorientation, confusion, epistaxis, slow tremor

5.7.1.3. Treatment: take antihypertensive medications

5.7.1.4. Nursing Considerations

5.7.1.4.1. Monitor and record BP in both arms

5.7.1.4.2. Note presence of peripheral pulses

5.7.1.4.3. Auscultate heart sounds

5.7.1.4.4. Observe capillary refill, skin color and moisture

5.7.1.4.5. Provide a calm and restful surrounding

5.7.1.4.6. Instruct relaxation techniques such as guided imagery and other distractions

5.7.2. Hyoptension

5.7.2.1. Reduced blood volume or because of increased blood-vessel capacity.

5.7.2.2. May cause falls, stroke, syncope

5.7.2.3. Nursing Considerations

5.7.2.3.1. Note skin color, temperature, and moisture

5.7.2.3.2. Inspect fluid intake and output

5.7.2.3.3. When getting up, rise slowly

5.7.2.3.4. Implement fall risks, such as side rails up, no slip socks and call light within reach

5.7.3. Congestive Heart Failure

5.7.3.1. Fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues

5.7.3.2. S/S: SOB, dyspnea, confusion, insomnia, agitation, depression, weight gain, edema

5.7.3.3. Nursing Considerations

5.7.3.3.1. Inspect skin

5.7.3.3.2. Monitor BP

5.7.3.3.3. Monitor urine output

5.7.3.3.4. Encourage rest

5.7.3.3.5. Provide quiet environment

5.7.4. Pulmonary Emboli

5.7.4.1. Arise from thrombi that originate in the deep venous system of the lower extremities

5.7.4.2. S/S: confusion, apprehension, SOB, temp elevation

5.7.4.3. Nursing Considerations

5.7.4.3.1. Assess for calf tenderness

5.7.4.3.2. Assess S/S of hypoxia

5.7.5. Coronary Artery Disease

5.7.5.1. Ischemic heart disease

5.7.5.2. S/S: pain in chest, indigestion, SOB, light headed

5.7.5.3. Nursing Considerations

5.7.5.3.1. Administer oxygen as needed

5.7.5.3.2. Provide rest

5.7.5.3.3. Avoid greasy foods

6. Urinary

6.1. Decline of renal blood flow and glomerular filtration by 50%

6.2. Reduced bladder capacity

6.2.1. Urinary frequency

6.2.1.1. Pain or discomfort during urination, a strong urge to urinate, difficulty urinating, loss of bladder control, unusual urine color

6.2.2. Urgenecy

6.2.2.1. Overactive bladder and involuntary contractions of the bladder muscle

6.2.3. Nocturia

6.2.3.1. Due to infection or enlargement of the prostate, bladder prolapse, overactive bladder, tumors of the bladder, prostate, or pelvic area, diabetes, anxiety, kidney infection, or edema or swelling of the lower legs.

6.2.3.1.1. Nursing Considerations

6.3. Conditions

6.3.1. Urinary Tract Infections

6.3.1.1. Bacterial infection within the urinary tract

6.3.1.1.1. Lower urinary tract infection – cystitis (symptomatic infection of the bladder

6.3.1.1.2. Upper urinary tract infection – acute pyelonephritis

6.3.1.2. S/S: Burning when urinating, frequency of urination, pain or pressure in back or lower abdomen, cloudy, dark or blood urine, feeling tired

6.3.1.3. Treatment: Antibiotics

6.3.1.4. Nursing Considerations

6.3.1.4.1. Wear cotton underwear

6.3.1.4.2. Urinate after sexual intercoure

6.3.1.4.3. Wipe front to back

6.3.2. Chronic Kidney disease

6.3.2.1. Encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure

6.3.2.1.1. S/S:Nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, changes in how much you urinate, decreased mental sharpness, muscle twitches and cramps.

6.3.2.2. No cure

6.3.2.3. Nursing Considerations

6.3.2.3.1. Assess hypertension

6.3.2.3.2. Auscultate heart and lung sounds

6.3.2.3.3. Monitor labs

6.3.3. Benign prostatic hyperplasia

6.3.3.1. An increase in the size of the prostate gland

6.3.3.1.1. Symptoms of BPH are caused by the pressure that a larger prostate can place on the urethra

6.3.3.2. Treatment: medication, surgical therapy

6.3.3.3. Nursing Considerations

6.3.3.3.1. Encourage pt to void every 2-4 hours

6.3.3.3.2. Ask about stress incontience

6.3.3.3.3. Document time and amount of each voiding

7. Endocrine

7.1. Thyroid gland activity decreases

7.2. ACTH secretion decreases

7.3. Pituitary gland decreases

7.4. Insulin release by beta cells is delayed and insufficient

7.4.1. R/t diabetes

7.4.1.1. Combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells.

7.4.1.2. S/S: Thirst, frequent urination, hunger, fatigue, and blurred vision

7.4.1.3. Treatment: Controlling blood sugar through diet, oral medications, or insulin is the main treatment

7.4.1.4. Nursing Consideations

7.4.1.4.1. Restore fluid/electrolyte and acid-base balance

7.4.1.4.2. Correct/reverse metabolic abnormalities

7.4.1.4.3. Identify/assist with management of underlying cause/disease process

7.5. Ability to metabolize glucose is redcued

7.6. Higher blood glucose

7.7. Conditions of the endocrine system

7.7.1. Hypothyroidism,

7.7.1.1. Cccurs when the thyroid gland does not produce enough thyroid hormone to meet the body's needs.

7.7.1.2. S/S: lethargy, weight loss, brittle nails

7.7.1.3. Nursing Considerations

7.7.1.3.1. Promote rest

7.7.1.3.2. Prevent against cold

7.7.1.3.3. Increase fluid intake

8. Reproductive

8.1. Female

8.1.1. Menopause

8.1.1.1. permanent cessation of menses

8.1.1.2. More than a physiological experience

8.1.1.3. Awakening of body, mind, and spirit

8.1.1.4. Physical beauty of youth versus inner beauty of age

8.1.2. Ovaries stop producing estrogen

8.1.3. Atrophy of urethrea

8.1.3.1. Chronic irritation

8.1.3.2. Dryness

8.1.3.3. Vaginal discharge

8.1.4. More likely to develop vaginal infections

8.1.5. Uterus, fallopian tubes and ovaries become smaller

8.1.6. Breasts decrease in size

8.2. Male

8.2.1. Tubes that carry sperm become less elastic

8.2.2. Enlarged prostate gland

8.2.3. Erectile Dysfunction

8.2.3.1. may be caused by medications or illness

8.2.4. Prostatitis

8.2.4.1. Swelling of the prostate caused by UTI

8.2.4.2. S/S: chills, fever, flushing of skin, lower stomach tenderness, body aches

8.2.4.3. Treatment: antibiotics

8.2.4.4. Nursing Considerations

8.2.4.4.1. Urinate often and completely

8.2.4.4.2. Take warm baths to relieve pain

8.2.4.4.3. Avoid alcohol, caffeine, citrus juices, and spicy or hot foods

8.2.5. Decrease in sensitivity

9. Immune

9.1. Depressed response

9.1.1. T cell activity declines

9.1.2. Cell mediated immunity

9.1.3. Risk for infection becomes insignificant

9.1.4. Inflammatory defenses declines, inflammation presents atypically

9.2. Conditions

9.2.1. Asthma

9.3. Nursing Considerations

9.3.1. Get the flu and pneumonia vaccines

9.3.2. Get plenty of exerise

9.3.3. Eat healthy foods

9.3.4. Do not smoke

9.4. Responds slower

9.5. Autoimmune disorders

9.5.1. Common disorders

9.5.1.1. Addisons

9.5.1.1.1. Adrenal cortical hypofunction that is characterized by insufficient steroid hormone production by the adrenal glands.

9.5.1.1.2. S/S: fatigue, weight loss, irritable, N/V, depression

9.5.1.1.3. Treatment: oral corticosteroids, corticosteroids injections

9.5.1.1.4. Nursing Considerations

9.5.1.2. Myasthenia gravis

9.5.1.2.1. A weakness and rapid fatigue of muscles under voluntary control.

9.5.1.2.2. S/S: muscle weakness, drooping of eyelid, difficult swallowing

9.5.1.2.3. Treatment: blood transfusion, thymectomy

9.5.1.2.4. Nursing Considerations

9.5.1.3. Rheumatoid arthritis

9.5.1.3.1. A chronic inflammatory disorder affecting many joints, including those in the hands and feet.

9.5.1.3.2. S/S: stiffness, fatigue, anemia, lumps on skin, flare, dry mouth

9.5.1.3.3. Nursing considerations

9.5.1.4. SLE

9.5.1.4.1. An inflammatory disease caused when the immune system attacks its own tissues.

9.5.1.4.2. S/S: pain in muscles, sharp pain in chest, dryness in mouth

9.5.1.4.3. Nursing considerations

9.5.2. May result in

9.5.2.1. Destruction of body tissue

9.5.2.2. Abnormal growth of an organ

9.5.2.3. Changes in organ function

9.5.3. Occurs when the body's immune system attacks and destroys healthy body tissue by mistake

10. Respiratory

10.1. Calcifications of costal cartilage and trachea and rib cage more rigid

10.2. Reduction of cough and laryngeal reflexes

10.3. Increased residual capacity and reduced vital capacity

10.4. High risk for respiratory infection

10.5. Common Respiratory Conditions

10.5.1. Asthma

10.5.1.1. Asthma is a chronic disease that affects your airways, the tubes that carry air in and out of your lungs.

10.5.1.1.1. S/S: wheezing, coughing, chest tightness, SOB

10.5.1.1.2. Nursing Considerations

10.5.1.1.3. Treatment: quit smoking, bronchodilators, oxygen therapy

10.5.2. Chronic bronchitis

10.5.2.1. Causes persistent, productive cough, wheezing, recurrent respiratory infections, SOB

10.5.2.2. Mgmt: remove bronchial secretions, prevent obstruction of airway, maintain adequate fluid intake

10.5.3. Emphysema

10.5.3.1. Abnormal permanent enlargement of air spaces distal to the terminal bronchioles

10.5.3.2. Mgmt: postural drainage, bronchodilators, avoid stress, breathing exercises

10.5.4. Lung cancer

10.5.4.1. Abnormal permanent enlargement of air spaces distal to the terminal bronchioles

10.5.4.2. S/S: dyspnea, coughing, chest pain, fatigue, anorexia, wheezing, and respiratory infections

11. Sensory

11.1. VIsion

11.1.1. Presbyopia

11.1.1.1. inability to focus on close objects clearly

11.1.1.2. Narrowing of visual field

11.1.1.2.1. decreased peripheral vision

11.1.1.3. Pupil size reduction and less reactive to light

11.1.1.4. Depth perception distortion

11.1.1.5. Decline in visual acuity

11.1.1.6. Nursing Consideraations

11.1.1.6.1. Eat nutritious food

11.1.1.6.2. Wear sunglasses

11.1.1.6.3. Avoid staring at a computer scree

11.2. Hearing

11.2.1. Prebycusis

11.2.1.1. Progressive loss of hearing

11.2.1.2. Distortion of high pitched sounds

11.2.1.3. Sermon increases

11.2.1.4. Nursing Considerations

11.2.1.4.1. Use hearing aids

11.2.1.4.2. Speak slowly and loudly

11.2.1.4.3. Speak in front of patient

11.3. Taste and smell

11.3.1. Atrophy of tonuge

11.3.2. Decreased saliva, poor oral hygiene, and medications

11.4. Touch

11.4.1. Reduction of tactile sensation

11.4.2. Reduced ability to sense pressure, discomfort, and change in temperature

12. Thermoregulation

12.1. Normal body temperature are lowered

12.1.1. 96.9 to 98.3

12.2. Ability to respond to cold temperatures is reduced

12.3. Response to heat is altered