Older Adult

Gero Concept Map MH 2019

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Older Adult by Mind Map: Older Adult

1. Sensory System

1.1. Age Related Changes

1.1.1. Touch

1.1.1.1. Decreased tactile sensation

1.1.1.2. Decreased ability to sense pressure, discomfort, or change in temp

1.1.2. Vision

1.1.2.1. Decreased light reactivity

1.1.2.2. Pupil size reduction

1.1.2.3. Presbyopia

1.1.2.4. Declining visual acuity

1.1.2.5. Increased sensitivity to glare

1.1.2.6. Peripheral vision reduced

1.1.3. Taste and smell

1.1.3.1. Taste acuity dependent on smell

1.1.3.2. Tongue atrophy

1.1.3.3. Decreased saliva production

1.1.4. Senses are less proficient

1.1.5. Hearing

1.1.5.1. Presbycusis

1.1.5.1.1. Increased cerumen

1.1.5.1.2. Alteration in equilibrium

1.2. Abnormal Processes

1.2.1. Cataracts

1.2.2. Glaucoma

1.2.3. Detached retina

1.2.4. Macular degeneration

1.2.5. Corneal ulcer

2. Nutritional Needs

2.1. Age-Related Changes

2.1.1. Reduced need for calories

2.1.1.1. Less lean body mass

2.1.1.2. Decline in basal metabolic rate

2.1.1.3. Lowered activity level

2.1.2. Daily Dietary Needs

2.1.2.1. Dietary fat intake

2.1.2.1.1. <30% of daily intake

2.1.2.2. Soluble fiber

2.1.2.2.1. Lowers serum cholesterol

2.1.2.2.2. Improves glucose tolerance

2.1.2.3. Carbohydrates

2.1.2.3.1. Decrease and reduce intake

2.1.2.4. Protein

2.1.2.4.1. 10% - 20% of calories

2.1.2.5. Calcium

2.1.2.5.1. Increase intake

2.1.2.6. Fruits and Vegetables

2.1.2.6.1. At least 5 servings a day

2.1.2.7. Hydration

2.1.2.7.1. ~1500 mL of water

2.2. Abnormal Processes

2.2.1. Anorexia

2.2.2. Nutrition related risks with advancing age

2.2.2.1. Heart disease

2.2.2.2. Cancer

2.2.2.3. Osteoporosis

2.2.2.4. Diabetes

2.2.3. Indigestion

2.2.4. Food intolerances

2.2.5. Constipation

2.2.6. Malnutrition

2.2.7. dysphagia

3. Reproductive System

3.1. Age-Related Changes

3.1.1. Men

3.1.1.1. Andropause

3.1.1.2. Thinner epithelium on seminal vesicles

3.1.1.3. Muscle tissue replaced with connective

3.1.1.4. Decreased capacity to retain fluid

3.1.1.5. Seminiferous tubule changes

3.1.1.6. Atrophy of testes

3.1.1.7. Reduction in testicular mass

3.1.1.8. Less live sperm in ejaculation

3.1.1.9. More time required to achieve erection

3.1.1.10. Enlargement of prostate gland

3.1.2. Women

3.1.2.1. Menopause

3.1.2.2. Vulva atrophies

3.1.2.3. Flattening of labia

3.1.2.4. Loss of subcutaneous fat and hair

3.1.2.5. Vaginal epithelium thins

3.1.2.6. Cervix atrophies

3.1.2.7. Uterus atrophies

3.1.2.8. Fallopian tubes atrophy

3.1.2.8.1. Become shorter and straighter

3.1.2.9. Vaginal canal

3.1.2.9.1. Reduction in collagen and adipose tissue

3.1.2.9.2. Shortening and narrowing of canal

3.1.2.9.3. Less lubrication

3.1.2.9.4. More alkaline vaginal pH

3.1.2.10. Endometrium responds to hormonal stimulation

3.1.2.11. Breasts lose firmness and sag

3.1.2.12. Retraction of nipples

3.2. Abnormal Processes

3.2.1. Erectile dysfunction

3.2.2. Senile vulvitis

3.2.3. Tumors of vulva

3.2.4. Atrophic vaginitis

3.2.5. Cancer of vagina

3.2.6. Cancer of cervix

3.2.7. Cancer of endometrium

3.2.8. Cancer of ovaries

3.2.9. Perineal herniation

3.2.10. Dyspareunia

3.2.11. Breast cancer

3.2.12. Benign prostatic hyperplasia

3.2.13. Prostate Cancer

3.2.14. Penis, scrotum and testes tumors

4. Respiratory System

4.1. Age-Related changes

4.1.1. Calcification of costal cartilage

4.1.2. Increased risk for respiratory infection

4.1.3. Decrease of cough and laryngeal reflexes

4.1.4. Increased residual volume

4.1.5. Decreased vital capacity

4.1.6. Decreased elastic recoil

4.1.7. Alveoli less elastic

4.2. Abnormal Processes

4.2.1. COPD

4.2.2. Asthma

4.2.3. Chronic bronchitis

4.2.4. Emphysema

4.2.5. Lung cancer

4.2.6. Lung abscess

4.2.7. pneumonia

5. Integumentary System

5.1. Age-Related Changes

5.1.1. Less skin elasticity

5.1.2. Dry and fragile skin

5.1.3. Decreased subcutaneous fat

5.1.4. Increased incidence of benign and malignant skin neoplasms

5.1.5. Thinning and graying hair

5.1.6. Decreased sweat gland activity

5.1.7. Melanocyte reduction

5.2. Abnormal Processes

5.2.1. Pruritus

5.2.2. Keratosis

5.2.3. Seborrheic keratosis

5.2.4. Skin cancer

5.2.4.1. Basal cell carcinoma

5.2.4.2. Squamous cell carcinoma

5.2.4.3. Melanoma

5.2.5. Vascular lesions

5.2.6. Stasis Dermatitis

5.2.7. Decubitus ulcers

6. Cardiovascular System

6.1. Age-Related Changes

6.1.1. Lose efficiency and contractile strength

6.1.2. Decrease cardiac output with stress

6.1.3. Oxygen is used less efficiently

6.1.4. Decreased blood vessel elasticity

6.1.5. Valves thicken and become rigid

6.1.6. Increased stroke volume

6.1.7. Left ventricle atrophy

6.1.8. Aorta dilates

6.2. Abnormal Processes

6.2.1. Hypertension

6.2.2. Hypotension

6.2.3. Congestive Heart Failure

6.2.4. Pulmonary embolism

6.2.5. Coronary Artery Disease

6.2.6. Hyperlipidemia

6.2.7. Cardiac arrhythmia

6.2.8. Peripheral vascular disease

6.2.9. Aneurysm

6.2.10. Varicose veins

6.2.11. Venus thromboembolism

7. Gastrointestinal System

7.1. Age-Related Changes

7.1.1. Atrophy of small and large intestine

7.1.2. Decreased esophageal motility

7.1.3. Sense of taste decreases

7.1.3.1. Atrophy of tongue affects taste buds

7.1.4. Decreased saliva production

7.1.5. Decrease in size of liver

7.1.6. Decreased HCL production

7.1.7. Slower peristalsis

7.1.8. Slower fat absorption

7.1.9. Xerostomia

7.2. Abnormal Processes

7.2.1. Constipation

7.2.2. Dysphagia

7.2.3. Hiatal hernia

7.2.4. Esophageal cancer

7.2.5. Peptic ulcer disease

7.2.6. Stomach cancer

7.2.7. Diverticulitis

7.2.8. Diverticulitis

7.2.9. Colorectal cancer

7.2.10. Flatulence

7.2.11. Intestinal obstruction

7.2.12. Fecal impaction

7.2.13. Incontinence

7.2.14. Acute appendicitis

7.2.15. Pancreatic cancer

7.2.16. Biliary tract disease

8. Urinary System

8.1. Age-Related Changes

8.1.1. Decreased bladder capacity

8.1.1.1. Increased frequency of urination

8.1.1.2. Increased urgency to urinate

8.1.1.3. Nocturia

8.1.1.4. Incontinence is NOT normal

8.1.2. Decreased GFR ( glomerular filtration rate)

8.1.3. Decreased blood flow to kidneys

8.1.4. Reduced renal function

8.2. Abnormal Processes

8.2.1. Urinary incontinence

8.2.2. Bladder cancer

8.2.3. Renal calculi

8.2.4. Glomerulonephritis

9. Musculoskeletal System

9.1. Age-Related Changes

9.1.1. Decreased bone mass and mineral

9.1.2. Decreased calcium absorption

9.1.3. Decreased muscle mass

9.1.3.1. Decreased movement

9.1.3.1.1. Impaired extension and flexion

9.1.3.2. Decreased strength

9.1.4. Thinning intervertebral disks

9.1.5. Shortened vertebrae

9.1.5.1. Slight kyphosis

9.1.6. Reduce flexibility on joints and muscles

9.1.7. Sarcopenia

9.2. Abnormal Processes

9.2.1. Osteoporosis

9.2.2. Fractures

9.2.3. Osteoarthritis

9.2.4. Rheumatoid arthritis

9.2.5. Gout

10. Neurological System

10.1. Age-Related Changes

10.1.1. Changes in sleep patterns

10.1.1.1. Less time in stage III and IV

10.1.1.2. Less sound sleep

10.1.1.3. Delay in onset of sleep

10.1.1.4. More time in stages I and II

10.1.1.5. Phase advance

10.1.1.5.1. Bedtime earlier in evening and wake earlier in morning

10.1.2. Slower response to change in balance

10.1.3. Decrease blood flow to the brain

10.1.3.1. Does not affect thinking and behavior

10.1.4. Personality

10.1.4.1. Remains consistent with earlier years

10.1.4.1.1. No personality types apply to EVERY older adult

10.1.5. Change may occur because of disease, retirement, death of significant other, loss of independence, decreased income and disability

10.1.6. Memory

10.1.6.1. Age related forgetfulness

10.1.7. Intelligence

10.1.7.1. Basic intelligence is upheld

10.1.7.2. Crystallized intelligence maintained

10.1.7.3. Possible decline in fluid intelligence

10.1.8. Learning

10.1.8.1. Learning ability is typically unchanged

10.1.8.1.1. Learning is best when integrating new information with previous learned information

10.2. Abnormal Processes

10.2.1. Sleep disturbances

10.2.1.1. Insomnia

10.2.1.1.1. inability to fall sleep, difficulty staying asleep, or premature waking

10.2.1.2. Nocturnal myoclonus

10.2.1.2.1. Greater than or equal to 5 leg movements or jerks per hour of sleep

10.2.1.3. Restless leg syndrome

10.2.1.3.1. Uncontrollable urge to move legs when lying down

10.2.1.4. Sleep apnea

10.2.1.4.1. At least five episodes of cessation of breathing

10.2.1.4.2. Last at least 10 seconds

10.2.1.4.3. Occurs per hour of sleep

10.2.1.4.4. Can be accompanied with daytime sleepiness

10.2.1.5. Sleep latency

10.2.1.5.1. Delay in ability to fall asleep

10.2.2. Pain

10.2.2.1. Nociceptive

10.2.2.1.1. Mechanical

10.2.2.1.2. Thermal

10.2.2.1.3. Chemical

10.2.2.1.4. Somatic

10.2.2.1.5. Visceral

10.2.2.2. Neuropathic

10.2.2.2.1. Abnormal processing of stimulus from central or peripheral nervous system

10.2.2.2.2. Sharp

10.2.2.2.3. Stabbing

10.2.2.2.4. Tingling

10.2.2.2.5. Burning

10.2.2.2.6. High intensity onset

10.2.2.3. Unresolved pain

10.2.2.3.1. Complications

10.2.3. Dementia

10.2.4. Parkinson’s Disease

10.2.5. Transient Ischemic Attacks

10.2.6. Cerebrovascular accident

10.2.7. Alzheimer’s

11. Endocrine System

11.1. Age-Related Changes

11.1.1. Decreased thyroid gland activity

11.1.2. Decreased secretion of ACTH

11.1.3. Insulin release is delayed and insufficient production

11.1.4. Decreased ability to metabolize glucose

11.1.5. Increased blood glucose in non-diabetic patient

11.1.6. Thyroid gland atrophies

11.1.7. Diminished adrenal function

11.2. Abnormal Processes

11.2.1. Diabetes

11.2.1.1. Patho

11.2.1.1.1. Type 2

11.2.1.2. Diagnosis

11.2.1.2.1. Glucose screening

11.2.1.2.2. Criteria

11.2.1.3. Treatment

11.2.1.3.1. Medications

11.2.1.3.2. Monitor

11.2.1.3.3. Exercise

11.2.1.3.4. Diet

11.2.1.4. Patient teaching

11.2.1.4.1. Overview the disease process

11.2.1.4.2. Nutrition

11.2.1.4.3. Encourage activity and exercise

11.2.1.4.4. Discuss medication regiment

11.2.1.4.5. Educate on signs and symptoms of hyperglycemia and hypoglycemia

11.2.1.4.6. Discuss the manifestations of complications

11.2.2. Hypothyroidism

11.2.3. Hyperthyroidism