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. 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) Motor neuron disease which weakens the muscles and progressively hampers physical function S/S: muscle weakness, twitching, slurred speech, trouble with physical tasks No cure has been found First drug treatment: riluzole (Rilutek) which reduced damage to motor neurons by decreasing release of glutamate Nursing Considerations Provide intellectual stimulating activities Provide client and family teaching Promote measures to enhance body image Ensure adequate nutrition Prevent respiratory complications

1.6.2. Alzheimer's disease Chronic neurodegenerative disease that usually starts slowly and worsens over time S/S: memory loss, difficult solving problems, completing tasks, determining time and place, finding right words and making decisions No cure but drug and non drug treatments may help with cognitive and behavioral symptoms Nursing considerations Assess for characteristics of symptoms Determine self care abilities 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 incidence of swallowing difficulties Caused by GERD, stroke, structural disorders Nursing Considerations Before meals, provide adequate rest Eliminate environmental stimuli Provide oral care before feeding

2.2.2. Decreased motility

2.2.3. Increased risk of aspiration

2.2.4. Cancer Inflammation of the squamous epithelium 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. Treatment: endoscopic treatments

2.3. Stomach

2.3.1. Hypoacidity

2.3.2. Achlorhydria

2.3.3. Cancer Multifactorial, but H pylori plays a role Symptoms include early satiety, obstruction, and bleeding 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 Begins in the cells that line the ducts of the pancreas. S/S: changes in bowel and bladder habits, a sore throat, unusual bleeding, indigestion or difficulty bleeding Treatment: pancreaticoduodenectomy

2.5. Intestines

2.5.1. Obstructions of the bowel carcinogenic Diverticular disease An inflammation of one or more diverticula S/S: diarrhea, constipation, painful cramps, chills or fever Treatment: broad septum antibiotics Nursing Considerations Hemorrhoids Hard stool and increased intraabdominal pressure could cause obstruction of venous return, resulting in engorgement of the hemorrhoidal plexus S/S: Constipation, prolonged straining Nursing Considerations GI discomfort

2.5.2. Atrophy of small and large intestines

2.6. Nursing Considerations

2.6.1. Cancers Assess patients for stage of grief Provide open and non judgmental environment Encourage verbalization of thoughts or concerns Be aware of mood swings 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 Pain or discomfort during urination, a strong urge to urinate, difficulty urinating, loss of bladder control, unusual urine color

3.2.2. Urgenecy Overactive bladder and involuntary contractions of the bladder muscle

3.2.3. Nocturia 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. Nursing Considerations

3.3. Conditions

3.3.1. Urinary Tract Infections Bacterial infection within the urinary tract Lower urinary tract infection – cystitis (symptomatic infection of the bladder Upper urinary tract infection – acute pyelonephritis S/S: Burning when urinating, frequency of urination, pain or pressure in back or lower abdomen, cloudy, dark or blood urine, feeling tired Treatment: Antibiotics Nursing Considerations Wear cotton underwear Urinate after sexual intercoure Wipe front to back

3.3.2. Chronic Kidney disease Encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure 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. No cure Nursing Considerations Assess hypertension Auscultate heart and lung sounds Monitor labs

3.3.3. Benign prostatic hyperplasia An increase in the size of the prostate gland Symptoms of BPH are caused by the pressure that a larger prostate can place on the urethra Treatment: medication, surgical therapy Nursing Considerations Encourage pt to void every 2-4 hours Ask about stress incontience Document time and amount of each voiding

4. Reproductive

4.1. Female

4.1.1. Menopause permanent cessation of menses More than a physiological experience Awakening of body, mind, and spirit Physical beauty of youth versus inner beauty of age

4.1.2. Ovaries stop producing estrogen

4.1.3. Atrophy of urethrea Chronic irritation Dryness 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 may be caused by medications or illness

4.2.4. Prostatitis Swelling of the prostate caused by UTI S/S: chills, fever, flushing of skin, lower stomach tenderness, body aches Treatment: antibiotics Nursing Considerations Urinate often and completely Take warm baths to relieve pain 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 Asthma is a chronic disease that affects your airways, the tubes that carry air in and out of your lungs. S/S: wheezing, coughing, chest tightness, SOB Nursing Considerations Treatment: quit smoking, bronchodilators, oxygen therapy

5.5.2. Chronic bronchitis Causes persistent, productive cough, wheezing, recurrent respiratory infections, SOB Mgmt: remove bronchial secretions, prevent obstruction of airway, maintain adequate fluid intake

5.5.3. Emphysema Abnormal permanent enlargement of air spaces distal to the terminal bronchioles Mgmt: postural drainage, bronchodilators, avoid stress, breathing exercises

5.5.4. Lung cancer Abnormal permanent enlargement of air spaces distal to the terminal bronchioles 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 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 Superficial nerve endings of slow-conducting unmyelinated C-polymodal

7.5.2. Keratoses Thickening in patches

7.5.3. Skin cancer Uncontrolled growth of cells in the skin

7.5.4. Decubitus ulcers Pressure, shear forces, and friction cause microcirculatory occlusion and consequent ischemia, which leads to inflammation and tissue anoxia Nursing Considerations Reposition or turn every 2 hours Assess sites every shift Apply topical ointment as needed Perform peri care after using the restroom

7.5.5. Herpes zoster 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 S/S: pain on skin, blisters, ulcers, Treatment: antivirals and nerve pain medications Nursing Considerations Wear loose, non restrictive clothing Apply cool, moist dressings Avoid extreme temperatures Avoid rubbing or scratching of skin

8. Skeletal

8.1. Loss of bone matter

8.1.1. Osteoporosis Changing rates of osteoblasts and osteoclasts More common in women than men 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 Permanent Due to inactivity Weakness Slowness

8.4.2. Thinning disks and shortened vertebrae 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 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 S/S: weakness, loss of stamina, reduced activity Treatment: exercsie Nursing Considerations Engage of non stressful exercise such as swimming 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 Chronic disease characterized by elevation of blood pressure. Dull headache, impaired memory, disorientation, confusion, epistaxis, slow tremor Treatment: take antihypertensive medications Nursing Considerations Monitor and record BP in both arms Note presence of peripheral pulses Auscultate heart sounds Observe capillary refill, skin color and moisture Provide a calm and restful surrounding Instruct relaxation techniques such as guided imagery and other distractions

9.7.2. Hyoptension Reduced blood volume or because of increased blood-vessel capacity. May cause falls, stroke, syncope Nursing Considerations Note skin color, temperature, and moisture Inspect fluid intake and output When getting up, rise slowly Implement fall risks, such as side rails up, no slip socks and call light within reach

9.7.3. Congestive Heart Failure Fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues S/S: SOB, dyspnea, confusion, insomnia, agitation, depression, weight gain, edema Nursing Considerations Inspect skin Monitor BP Monitor urine output Encourage rest Provide quiet environment

9.7.4. Pulmonary Emboli Arise from thrombi that originate in the deep venous system of the lower extremities S/S: confusion, apprehension, SOB, temp elevation Nursing Considerations Assess for calf tenderness Assess S/S of hypoxia

9.7.5. Coronary Artery Disease Ischemic heart disease S/S: pain in chest, indigestion, SOB, light headed Nursing Considerations Administer oxygen as needed Provide rest 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 Combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells. S/S: Thirst, frequent urination, hunger, fatigue, and blurred vision Treatment: Controlling blood sugar through diet, oral medications, or insulin is the main treatment Nursing Consideations Restore fluid/electrolyte and acid-base balance Correct/reverse metabolic abnormalities 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, Cccurs when the thyroid gland does not produce enough thyroid hormone to meet the body's needs. S/S: lethargy, weight loss, brittle nails Nursing Considerations Promote rest Prevent against cold 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 Addisons Adrenal cortical hypofunction that is characterized by insufficient steroid hormone production by the adrenal glands. S/S: fatigue, weight loss, irritable, N/V, depression Treatment: oral corticosteroids, corticosteroids injections Nursing Considerations Myasthenia gravis A weakness and rapid fatigue of muscles under voluntary control. S/S: muscle weakness, drooping of eyelid, difficult swallowing Treatment: blood transfusion, thymectomy Nursing Considerations Rheumatoid arthritis A chronic inflammatory disorder affecting many joints, including those in the hands and feet. S/S: stiffness, fatigue, anemia, lumps on skin, flare, dry mouth Nursing considerations SLE An inflammatory disease caused when the immune system attacks its own tissues. S/S: pain in muscles, sharp pain in chest, dryness in mouth Nursing considerations

11.5.2. May result in Destruction of body tissue Abnormal growth of an organ 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 inability to focus on close objects clearly Narrowing of visual field decreased peripheral vision Pupil size reduction and less reactive to light Depth perception distortion Decline in visual acuity Nursing Consideraations Eat nutritious food Wear sunglasses Avoid staring at a computer scree

12.2. Hearing

12.2.1. Prebycusis Progressive loss of hearing Distortion of high pitched sounds Sermon increases Nursing Considerations Use hearing aids Speak slowly and loudly 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