1. Nervous
1.1. Reduction in neurons, nerve fibers, and cerebral blood flow
1.2. Slows signal conduction
1.2.1. Mostly at nerve synapses
1.2.2. Slower response to change in balance
1.3. Lose taste buds, olfactory cells, nerve endings in the skin, and brain cells.
1.4. Hearing loses sensitivity
1.5. Decline in weight and blood flow to the brain
1.6. Conditions
1.6.1. Amyotrophic lateral sclerosis (ALS)
1.6.1.1. Motor neuron disease which weakens the muscles and progressively hampers physical function
1.6.1.2. S/S: muscle weakness, twitching, slurred speech, trouble with physical tasks
1.6.1.3. No cure has been found
1.6.1.3.1. First drug treatment: riluzole (Rilutek) which reduced damage to motor neurons by decreasing release of glutamate
1.6.1.4. Nursing Considerations
1.6.1.4.1. Provide intellectual stimulating activities
1.6.1.4.2. Provide client and family teaching
1.6.1.4.3. Promote measures to enhance body image
1.6.1.4.4. Ensure adequate nutrition
1.6.1.4.5. Prevent respiratory complications
1.6.2. Alzheimer's disease
1.6.2.1. Chronic neurodegenerative disease that usually starts slowly and worsens over time
1.6.2.2. S/S: memory loss, difficult solving problems, completing tasks, determining time and place, finding right words and making decisions
1.6.2.3. No cure but drug and non drug treatments may help with cognitive and behavioral symptoms
1.6.2.4. Nursing considerations
1.6.2.4.1. Assess for characteristics of symptoms
1.6.2.4.2. Determine self care abilities
1.6.2.4.3. Be patient
2. Gastointestinal
2.1. Mouth
2.1.1. Lost teeth and taste buds
2.1.2. Less acute taste sensatations
2.1.3. Could cause constipation and malnourishment
2.2. Esophagus
2.2.1. Dysphagia
2.2.1.1. incidence of swallowing difficulties
2.2.1.2. Caused by GERD, stroke, structural disorders
2.2.1.3. Nursing Considerations
2.2.1.3.1. Before meals, provide adequate rest
2.2.1.3.2. Eliminate environmental stimuli
2.2.1.3.3. Provide oral care before feeding
2.2.2. Decreased motility
2.2.3. Increased risk of aspiration
2.2.4. Cancer
2.2.4.1. Inflammation of the squamous epithelium
2.2.4.2. 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.
2.2.4.3. Treatment: endoscopic treatments
2.3. Stomach
2.3.1. Hypoacidity
2.3.2. Achlorhydria
2.3.3. Cancer
2.3.3.1. Multifactorial, but H pylori plays a role
2.3.3.2. Symptoms include early satiety, obstruction, and bleeding
2.3.3.3. Treatments: surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy
2.4. Pancreas
2.4.1. Increase if Islets of Langerhans are damaged or become overstressed
2.4.2. Cancer
2.4.2.1. Begins in the cells that line the ducts of the pancreas.
2.4.2.2. S/S: changes in bowel and bladder habits, a sore throat, unusual bleeding, indigestion or difficulty bleeding
2.4.2.3. Treatment: pancreaticoduodenectomy
2.5. Intestines
2.5.1. Obstructions of the bowel
2.5.1.1. carcinogenic
2.5.1.2. Diverticular disease
2.5.1.2.1. An inflammation of one or more diverticula
2.5.1.2.2. S/S: diarrhea, constipation, painful cramps, chills or fever
2.5.1.2.3. Treatment: broad septum antibiotics
2.5.1.2.4. Nursing Considerations
2.5.1.3. Hemorrhoids
2.5.1.3.1. Hard stool and increased intraabdominal pressure could cause obstruction of venous return, resulting in engorgement of the hemorrhoidal plexus
2.5.1.3.2. S/S: Constipation, prolonged straining
2.5.1.3.3. Nursing Considerations
2.5.1.4. GI discomfort
2.5.2. Atrophy of small and large intestines
2.6. Nursing Considerations
2.6.1. Cancers
2.6.1.1. Assess patients for stage of grief
2.6.1.2. Provide open and non judgmental environment
2.6.1.3. Encourage verbalization of thoughts or concerns
2.6.1.4. Be aware of mood swings
2.6.1.5. Be aware of debilitating depressions
3. Urinary
3.1. Decline of renal blood flow and glomerular filtration by 50%
3.2. Reduced bladder capacity
3.2.1. Urinary frequency
3.2.1.1. Pain or discomfort during urination, a strong urge to urinate, difficulty urinating, loss of bladder control, unusual urine color
3.2.2. Urgenecy
3.2.2.1. Overactive bladder and involuntary contractions of the bladder muscle
3.2.3. Nocturia
3.2.3.1. 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.
3.2.3.1.1. Nursing Considerations
3.3. Conditions
3.3.1. Urinary Tract Infections
3.3.1.1. Bacterial infection within the urinary tract
3.3.1.1.1. Lower urinary tract infection – cystitis (symptomatic infection of the bladder
3.3.1.1.2. Upper urinary tract infection – acute pyelonephritis
3.3.1.2. S/S: Burning when urinating, frequency of urination, pain or pressure in back or lower abdomen, cloudy, dark or blood urine, feeling tired
3.3.1.3. Treatment: Antibiotics
3.3.1.4. Nursing Considerations
3.3.1.4.1. Wear cotton underwear
3.3.1.4.2. Urinate after sexual intercoure
3.3.1.4.3. Wipe front to back
3.3.2. Chronic Kidney disease
3.3.2.1. Encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure
3.3.2.1.1. 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.
3.3.2.2. No cure
3.3.2.3. Nursing Considerations
3.3.2.3.1. Assess hypertension
3.3.2.3.2. Auscultate heart and lung sounds
3.3.2.3.3. Monitor labs
3.3.3. Benign prostatic hyperplasia
3.3.3.1. An increase in the size of the prostate gland
3.3.3.1.1. Symptoms of BPH are caused by the pressure that a larger prostate can place on the urethra
3.3.3.2. Treatment: medication, surgical therapy
3.3.3.3. Nursing Considerations
3.3.3.3.1. Encourage pt to void every 2-4 hours
3.3.3.3.2. Ask about stress incontience
3.3.3.3.3. Document time and amount of each voiding
4. Reproductive
4.1. Female
4.1.1. Menopause
4.1.1.1. permanent cessation of menses
4.1.1.2. More than a physiological experience
4.1.1.3. Awakening of body, mind, and spirit
4.1.1.4. Physical beauty of youth versus inner beauty of age
4.1.2. Ovaries stop producing estrogen
4.1.3. Atrophy of urethrea
4.1.3.1. Chronic irritation
4.1.3.2. Dryness
4.1.3.3. Vaginal discharge
4.1.4. More likely to develop vaginal infections
4.1.5. Uterus, fallopian tubes and ovaries become smaller
4.1.6. Breasts decrease in size
4.2. Male
4.2.1. Tubes that carry sperm become less elastic
4.2.2. Enlarged prostate gland
4.2.3. Erectile Dysfunction
4.2.3.1. may be caused by medications or illness
4.2.4. Prostatitis
4.2.4.1. Swelling of the prostate caused by UTI
4.2.4.2. S/S: chills, fever, flushing of skin, lower stomach tenderness, body aches
4.2.4.3. Treatment: antibiotics
4.2.4.4. Nursing Considerations
4.2.4.4.1. Urinate often and completely
4.2.4.4.2. Take warm baths to relieve pain
4.2.4.4.3. Avoid alcohol, caffeine, citrus juices, and spicy or hot foods
4.2.5. Decrease in sensitivity
5. Respiratory
5.1. Calcifications of costal cartilage and trachea and rib cage more rigid
5.2. Reduction of cough and laryngeal reflexes
5.3. Increased residual capacity and reduced vital capacity
5.4. High risk for respiratory infection
5.5. Common Respiratory Conditions
5.5.1. Asthma
5.5.1.1. Asthma is a chronic disease that affects your airways, the tubes that carry air in and out of your lungs.
5.5.1.1.1. S/S: wheezing, coughing, chest tightness, SOB
5.5.1.1.2. Nursing Considerations
5.5.1.1.3. Treatment: quit smoking, bronchodilators, oxygen therapy
5.5.2. Chronic bronchitis
5.5.2.1. Causes persistent, productive cough, wheezing, recurrent respiratory infections, SOB
5.5.2.2. Mgmt: remove bronchial secretions, prevent obstruction of airway, maintain adequate fluid intake
5.5.3. Emphysema
5.5.3.1. Abnormal permanent enlargement of air spaces distal to the terminal bronchioles
5.5.3.2. Mgmt: postural drainage, bronchodilators, avoid stress, breathing exercises
5.5.4. Lung cancer
5.5.4.1. Abnormal permanent enlargement of air spaces distal to the terminal bronchioles
5.5.4.2. S/S: dyspnea, coughing, chest pain, fatigue, anorexia, wheezing, and respiratory infections
6. Thermoregulation
6.1. Normal body temperature are lowered
6.1.1. 96.9 to 98.3
6.2. Ability to respond to cold temperatures is reduced
6.3. Response to heat is altered
7. Skin
7.1. Flattens due to loss of subcutaneous fat, skin cells, sweat glands, melanocytes, and hair follicles.
7.2. Loses effectiveness
7.2.1. Protection from bacteria
7.2.2. Thermal regulator
7.2.3. Sensory receptor
7.3. Slower healing
7.4. Cosmetic changes
7.4.1. Color changes
7.4.1.1. Gray
7.4.2. Drying
7.4.3. Thinning
7.4.4. Hair becomes sparse
7.4.5. Ridged fingernails
7.4.6. Flattens due to loss of subcutaneous fat, skin cells, sweat glands, melanocytes, and hair follicles.
7.5. Skin disorders
7.5.1. Pruritis
7.5.1.1. Superficial nerve endings of slow-conducting unmyelinated C-polymodal
7.5.2. Keratoses
7.5.2.1. Thickening in patches
7.5.3. Skin cancer
7.5.3.1. Uncontrolled growth of cells in the skin
7.5.4. Decubitus ulcers
7.5.4.1. Pressure, shear forces, and friction cause microcirculatory occlusion and consequent ischemia, which leads to inflammation and tissue anoxia
7.5.4.2. Nursing Considerations
7.5.4.2.1. Reposition or turn every 2 hours
7.5.4.2.2. Assess sites every shift
7.5.4.2.3. Apply topical ointment as needed
7.5.4.2.4. Perform peri care after using the restroom
7.5.5. Herpes zoster
7.5.5.1. 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
7.5.5.2. S/S: pain on skin, blisters, ulcers,
7.5.5.3. Treatment: antivirals and nerve pain medications
7.5.5.4. Nursing Considerations
7.5.5.4.1. Wear loose, non restrictive clothing
7.5.5.4.2. Apply cool, moist dressings
7.5.5.4.3. Avoid extreme temperatures
7.5.5.4.4. Avoid rubbing or scratching of skin
8. Skeletal
8.1. Loss of bone matter
8.1.1. Osteoporosis
8.1.1.1. Changing rates of osteoblasts and osteoclasts
8.1.1.2. More common in women than men
8.1.1.3. Risk factors: chronic alcoholism, hyperthyroidism, diabetes, uremia, collagen disease
8.2. Loosened cartilage around the joints
8.3. Hardened or contracted ligaments
8.3.1. More in men than women
8.4. Common muscular changes
8.4.1. Loss of muscle cells
8.4.1.1. Permanent
8.4.1.2. Due to inactivity
8.4.1.3. Weakness
8.4.1.4. Slowness
8.4.2. Thinning disks and shortened vertebrae
8.4.2.1. As adipose tissue accumulates
8.4.3. Reduced muscle mass, strength, and movement
8.4.4. Decreased bone mineral and mass
8.4.5. Diminished calcium absorption
8.4.6. Increased risk of fractures
8.5. Skeletal conditions
8.5.1. Sacropenia
8.5.1.1. 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
8.5.1.2. S/S: weakness, loss of stamina, reduced activity
8.5.1.3. Treatment: exercsie
8.5.1.4. Nursing Considerations
8.5.1.4.1. Engage of non stressful exercise such as swimming
8.5.1.4.2. Ensure proper nutrition
9. Cardiovascular
9.1. Slower circulation
9.2. Heart muscle loses efficiency and contractile strength
9.2.1. reduced cardiac output with physiological stress
9.2.2. Decreased contractile strength
9.3. Valves become thick and rigid
9.4. Blood vessels reduce elasticity
9.4.1. calcification
9.5. Oxygen uses less efficiently
9.6. Aorta becomes dilated
9.6.1. Slight ventricular hypertrophy
9.6.2. Thickening of left ventricular wall
9.7. Conditions altering tissue perfusion
9.7.1. Hypertension
9.7.1.1. Chronic disease characterized by elevation of blood pressure.
9.7.1.2. Dull headache, impaired memory, disorientation, confusion, epistaxis, slow tremor
9.7.1.3. Treatment: take antihypertensive medications
9.7.1.4. Nursing Considerations
9.7.1.4.1. Monitor and record BP in both arms
9.7.1.4.2. Note presence of peripheral pulses
9.7.1.4.3. Auscultate heart sounds
9.7.1.4.4. Observe capillary refill, skin color and moisture
9.7.1.4.5. Provide a calm and restful surrounding
9.7.1.4.6. Instruct relaxation techniques such as guided imagery and other distractions
9.7.2. Hyoptension
9.7.2.1. Reduced blood volume or because of increased blood-vessel capacity.
9.7.2.2. May cause falls, stroke, syncope
9.7.2.3. Nursing Considerations
9.7.2.3.1. Note skin color, temperature, and moisture
9.7.2.3.2. Inspect fluid intake and output
9.7.2.3.3. When getting up, rise slowly
9.7.2.3.4. Implement fall risks, such as side rails up, no slip socks and call light within reach
9.7.3. Congestive Heart Failure
9.7.3.1. Fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues
9.7.3.2. S/S: SOB, dyspnea, confusion, insomnia, agitation, depression, weight gain, edema
9.7.3.3. Nursing Considerations
9.7.3.3.1. Inspect skin
9.7.3.3.2. Monitor BP
9.7.3.3.3. Monitor urine output
9.7.3.3.4. Encourage rest
9.7.3.3.5. Provide quiet environment
9.7.4. Pulmonary Emboli
9.7.4.1. Arise from thrombi that originate in the deep venous system of the lower extremities
9.7.4.2. S/S: confusion, apprehension, SOB, temp elevation
9.7.4.3. Nursing Considerations
9.7.4.3.1. Assess for calf tenderness
9.7.4.3.2. Assess S/S of hypoxia
9.7.5. Coronary Artery Disease
9.7.5.1. Ischemic heart disease
9.7.5.2. S/S: pain in chest, indigestion, SOB, light headed
9.7.5.3. Nursing Considerations
9.7.5.3.1. Administer oxygen as needed
9.7.5.3.2. Provide rest
9.7.5.3.3. Avoid greasy foods
10. Endocrine
10.1. Thyroid gland activity decreases
10.2. ACTH secretion decreases
10.3. Pituitary gland decreases
10.4. Insulin release by beta cells is delayed and insufficient
10.4.1. R/t diabetes
10.4.1.1. Combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells.
10.4.1.2. S/S: Thirst, frequent urination, hunger, fatigue, and blurred vision
10.4.1.3. Treatment: Controlling blood sugar through diet, oral medications, or insulin is the main treatment
10.4.1.4. Nursing Consideations
10.4.1.4.1. Restore fluid/electrolyte and acid-base balance
10.4.1.4.2. Correct/reverse metabolic abnormalities
10.4.1.4.3. Identify/assist with management of underlying cause/disease process
10.5. Ability to metabolize glucose is redcued
10.6. Higher blood glucose
10.7. Conditions of the endocrine system
10.7.1. Hypothyroidism,
10.7.1.1. Cccurs when the thyroid gland does not produce enough thyroid hormone to meet the body's needs.
10.7.1.2. S/S: lethargy, weight loss, brittle nails
10.7.1.3. Nursing Considerations
10.7.1.3.1. Promote rest
10.7.1.3.2. Prevent against cold
10.7.1.3.3. Increase fluid intake
11. Immune
11.1. Depressed response
11.1.1. T cell activity declines
11.1.2. Cell mediated immunity
11.1.3. Risk for infection becomes insignificant
11.1.4. Inflammatory defenses declines, inflammation presents atypically
11.2. Conditions
11.2.1. Asthma
11.3. Nursing Considerations
11.3.1. Get the flu and pneumonia vaccines
11.3.2. Get plenty of exerise
11.3.3. Eat healthy foods
11.3.4. Do not smoke
11.4. Responds slower
11.5. Autoimmune disorders
11.5.1. Common disorders
11.5.1.1. Addisons
11.5.1.1.1. Adrenal cortical hypofunction that is characterized by insufficient steroid hormone production by the adrenal glands.
11.5.1.1.2. S/S: fatigue, weight loss, irritable, N/V, depression
11.5.1.1.3. Treatment: oral corticosteroids, corticosteroids injections
11.5.1.1.4. Nursing Considerations
11.5.1.2. Myasthenia gravis
11.5.1.2.1. A weakness and rapid fatigue of muscles under voluntary control.
11.5.1.2.2. S/S: muscle weakness, drooping of eyelid, difficult swallowing
11.5.1.2.3. Treatment: blood transfusion, thymectomy
11.5.1.2.4. Nursing Considerations
11.5.1.3. Rheumatoid arthritis
11.5.1.3.1. A chronic inflammatory disorder affecting many joints, including those in the hands and feet.
11.5.1.3.2. S/S: stiffness, fatigue, anemia, lumps on skin, flare, dry mouth
11.5.1.3.3. Nursing considerations
11.5.1.4. SLE
11.5.1.4.1. An inflammatory disease caused when the immune system attacks its own tissues.
11.5.1.4.2. S/S: pain in muscles, sharp pain in chest, dryness in mouth
11.5.1.4.3. Nursing considerations
11.5.2. May result in
11.5.2.1. Destruction of body tissue
11.5.2.2. Abnormal growth of an organ
11.5.2.3. Changes in organ function
11.5.3. Occurs when the body's immune system attacks and destroys healthy body tissue by mistake
12. Sensory
12.1. VIsion
12.1.1. Presbyopia
12.1.1.1. inability to focus on close objects clearly
12.1.1.2. Narrowing of visual field
12.1.1.2.1. decreased peripheral vision
12.1.1.3. Pupil size reduction and less reactive to light
12.1.1.4. Depth perception distortion
12.1.1.5. Decline in visual acuity
12.1.1.6. Nursing Consideraations
12.1.1.6.1. Eat nutritious food
12.1.1.6.2. Wear sunglasses
12.1.1.6.3. Avoid staring at a computer scree
12.2. Hearing
12.2.1. Prebycusis
12.2.1.1. Progressive loss of hearing
12.2.1.2. Distortion of high pitched sounds
12.2.1.3. Sermon increases
12.2.1.4. Nursing Considerations
12.2.1.4.1. Use hearing aids
12.2.1.4.2. Speak slowly and loudly
12.2.1.4.3. Speak in front of patient
12.3. Taste and smell
12.3.1. Atrophy of tonuge
12.3.2. Decreased saliva, poor oral hygiene, and medications
12.4. Touch
12.4.1. Reduction of tactile sensation
12.4.2. Reduced ability to sense pressure, discomfort, and change in temperature