Geriatric Patient

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Geriatric Patient by Mind Map: Geriatric Patient

1. Cardiovascular

1.1. Thick and rigid heart valves

1.2. Myocardial muscle less efficient

1.2.1. decreased contractile strength

1.2.2. Decreased cardiac output as a result of decreased heart rate and stroke volume

1.3. Reduced elasticity of vessels

1.4. Altered tissue perfusion

1.4.1. Cardiovascular disease

1.4.2. Diabetes, cancer, renal failure

1.4.3. Hypotension

1.5. Hypertension

1.5.1. elevated blood pressure related to underlying conditions

1.6. Coronary Artery Disease

1.6.1. higher incidence with age

1.6.2. Ischemic heart disease

1.6.3. Angina

1.6.4. Myocardial infarction

1.6.5. Inadequate supply of oxygen rich blood to the heart muscle because of narrowing or blocking of coronary artery by fatty plaques

1.7. Hyperlipidemia

1.7.1. leads to clots in blood

1.7.2. high cholesterol and high triglyceride levels

1.8. Peripheral vascular disease

1.8.1. slow and progressive circulation disorder caused by narrowing, blockage, or spasms in a blood vessel

1.9. Aneurysms

1.9.1. thrombosis can occur

1.10. Nursing interventions: encourage frequent rest, monitor BP, strict medication regimen

2. Respiratory

2.1. Lungs reduce in size and weight

2.2. Decreased elastic recoil

2.3. Alveoli is less elastic

2.4. Reduction in vital capacity

2.5. At a higher risk for infection

2.6. Other medical complications can cause patients to be bed-ridden

2.6.1. this is a big factor leading to pneumonia

2.7. Asthma

2.7.1. higher incidence in older age

2.7.2. certain medications could poorly interact with other medications taken by the patient

2.7.3. This can lead to cardiac problems and death

2.7.4. Airway inflammation, intermittent airflow obstruction, and bronchial hyper responsiveness

2.8. Chronic bronchitis

2.8.1. causes persistent cough and shortness of breath, or inability to catch ones own breath

2.8.1.1. Hypertrophy of the mucus-producing glands found in the mucosa of large cartilaginous airways. Progressive airflow limitation occurs, usually in association with emphysema (COPD)

2.8.2. Low fluid intake could exacerbate complications

2.9. Emphysema

2.9.1. chronic bronchitis or irritation

2.9.2. patients with cigarette smoking history have high incidence of this

2.10. Lung cancer

2.10.1. twice as prevalent in smokers than non-smokers

2.10.2. Increasing incidence

2.10.3. Higher incidence in men than women

2.11. Nursing interventions: encourage clients to receive influenza and pneumonia vaccine yearly, remember that hypoxia can manifest itself as confusion, if client is smoker; encourage him/her to stop, encourage deep breathing.

3. Renal and Genitourinary

3.1. Hypertrophy and thickening of bladder muscle

3.1.1. Decrease bladder ability to expand

3.1.2. Reduces storage capacity

3.1.2.1. Daytime urinary frequency

3.1.2.2. Nocturia

3.2. Changes in cortical control of micturition

3.3. Kidney filtration ability decreases

3.4. Reduced renal function

3.4.1. high BUN levels

3.5. Decreased tubular function

3.5.1. concentration of urine changes in response to water or sodium excess or depletion

3.6. Decrease in renal threshold of glucose

3.7. Urinary incontinence

3.7.1. Urethral hyper mobility due to impaired support from pelvic floor

3.8. Bladder cancer

4. Gastrointestinal

4.1. Less acute taste sensations

4.2. Decreased esophageal motility

4.3. Atrophy of small and large intestines

4.4. Increased risk of aspiration, indigestion, and constipation

4.5. Decreased elasticity of stomach

4.5.1. Reduces amount of food accommodation at one time

4.6. Stomach has higher pH

4.6.1. result of decline in hydrochloric acid and pepsin

4.7. Bile salt synthesis decreases

4.7.1. increase for risk of gallstones

4.8. Nursing interventions: encourage good oral hygiene, assess dentures for proper fit, educate clients about hidden sodium, promote adequate bowel functioning, adequate hydration, regular exercise, encourage small, frequent meals

5. Musculoskeletal

5.1. Decline in size and number of muscle fibers

5.2. Reduction of muscle mass

5.2.1. Decreased body strength and declining endurance

5.3. Connective tissue changes

5.3.1. Reduced flexibility in joints and muscles

5.4. Sarcopenia

5.4.1. age related reduction of muscle mass or function resulting from a reduction in protein synthesis and an increase in muscle protein degeneration

5.5. Fractures

5.5.1. Brittle bones fracture more easily and heal at a slower rate

5.6. Osteoarthritis

5.6.1. progressive deterioration of joint cartilage with the formation of new bone at the joint surface

5.7. Rheumatoid Arthritis

5.7.1. systemic inflammatory

5.8. Osteoporosis

5.8.1. systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissue, with consequent increase in bone fragility

5.8.2. begins around age forty, more common in women than men

5.9. Gout

5.9.1. access uric acid accumulates in blood

5.10. Thinning disks and shortened vertebrae

5.11. Diminished calcium absorption

5.12. changes in musculoskeletal function: at risk for falls and fractures

5.13. Nursing interventions: adequate calcium intake, muscle strengthening exercises, prevent accidents with safe environment, adequate lighting, discourage excessive alcohol, change positions slowly

6. Nervous System/Cognition

6.1. Slow response time

6.2. Loss of nerve cells and weight (atrophy)

6.3. Dulling of tactile stimulation

6.4. Decline in function of cranial nerves

6.4.1. affecting taste and smell

6.5. Depression

6.5.1. Most frequent mental disorder among older adults

6.5.1.1. depletion of neurotransmitters serotonin, norepinephrine or dopamine in the central nervous system

6.5.2. Changes in sleep and activity

6.5.3. Affects nutrition of patient

6.6. Paranoia

6.6.1. Common in older adults

6.6.2. Need to explore mechanisms to reduce insecurity

6.7. Hypochondriasis

6.7.1. linked to depression and anxiety

6.8. Delirium

6.8.1. Abrupt altered level of consciousness

6.8.1.1. Neurotransmitter imbalance, disruption of synaptic communication caused by increased cytokines and decreased synthesis and release of neurotransmitters

6.9. Dementia

6.9.1. Irreversible

6.9.2. Memory, orientation, reasoning, attention, language, problem-solving

6.9.3. Progressive

6.9.3.1. Degenerative, loss of neurological function by loss of neurons due to old age, can be accompanied by plaques and Lewy bodies

6.10. Alzheimer's Disease

6.10.1. Most common form of dementia

6.10.1.1. Amyloid plaques and neurofibrillary tangles. Amyloid precursor protein causes the plaque fragment of beta-amyloid

6.11. Parkinson's Disease

6.11.1. affects central nervous system to control body movements

6.11.1.1. Loss of pigmented dopaminergic neurons of the substantia nigra compacta and the presence of Lewy bodies

6.12. Transient Ischemic Attack

6.12.1. Reduction in cerebral perfusion

6.12.1.1. Interruption of blood flow

6.13. Hypothalamus less effective in thermoregulation

6.14. Changes in sleep pattern

7. Endocrine

7.1. Thyroid gland atrophies

7.1.1. Hypothyroidism

7.1.2. Hyperthyroidism

7.2. Diminished adrenal function

7.3. ACTH secretion decreased

7.4. Volume of pituitary gland decreased

7.5. Insufficient release of insulin

7.6. Type 2 Diabetes Mellitus

7.6.1. glucose intolerance

7.6.2. The body either produces inadequate amounts of insulin to meet the demands of the body or insulin resistance has developed

8. Nutrition

8.1. anorexia

8.1.1. loss of appetite

8.2. dysphagia

8.2.1. difficulty swallowing

8.3. reduced need for calories

8.3.1. metabolic rate declines

8.4. constipation

8.4.1. slower peristalsis, inactivity, medication side effects

8.5. Nutrition can affect every body system; adequate nutrition and fluids is of utmost importance for healing and maintenance of health.

9. Sexuality

9.1. menopause

9.1.1. permanent cessation of menses

9.2. andropause

9.2.1. testosterone decreases

9.3. general pattern of sexuality remains consistent throughout life

10. Spirituality

10.1. religion

10.1.1. belief in higher power

10.2. spirituality

10.2.1. connects us to a higher power

10.3. holistic care

10.4. assess spirituality in patient to cater to needs

11. Sleep

11.1. Insomnia

11.1.1. inability to fall asleep

11.1.2. premature waking

11.1.3. difficulty staying asleep

11.2. nocturnal myoclonus

11.2.1. five leg jerks or movements per hour while asleep

11.3. phase advance

11.3.1. sleep earlier, wake up earlier

11.4. affects general health and mental health

11.5. medications affect sleep health

12. Physiologic Changes

12.1. loss in compensatory reserve

12.2. progressive loss in efficiency of the body to repair damaged tissue

12.3. decreased functioning of the immune system processes

13. Reproductive System

13.1. Women's ovarian function decreases, breast tissue involutes

13.1.1. ovaries and the uterus slowly atrophy, and neither may be palpable

13.2. testes atrophy, lose weight, soften

13.2.1. erection changes are seen

13.2.1.1. prostate enlargement due to changes in testosterone levels