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. Integumentary System
3.1. Age-Related Changes
3.1.1. Less skin elasticity
3.1.2. Dry and fragile skin
3.1.3. Decreased subcutaneous fat
3.1.4. Increased incidence of benign and malignant skin neoplasms
3.1.5. Thinning and graying hair
3.1.6. Decreased sweat gland activity
3.1.7. Melanocyte reduction
3.2. Abnormal Processes
3.2.1. Pruritus
3.2.2. Keratosis
3.2.3. Seborrheic keratosis
3.2.4. Skin cancer
3.2.4.1. Basal cell carcinoma
3.2.4.2. Squamous cell carcinoma
3.2.4.3. Melanoma
3.2.5. Vascular lesions
3.2.6. Stasis Dermatitis
3.2.7. Decubitus ulcers
4. Cardiovascular System
4.1. Age-Related Changes
4.1.1. Lose efficiency and contractile strength
4.1.2. Decrease cardiac output with stress
4.1.3. Oxygen is used less efficiently
4.1.4. Decreased blood vessel elasticity
4.1.5. Valves thicken and become rigid
4.1.6. Increased stroke volume
4.1.7. Left ventricle atrophy
4.1.8. Aorta dilates
4.2. Abnormal Processes
4.2.1. Hypertension
4.2.2. Hypotension
4.2.3. Congestive Heart Failure
4.2.4. Pulmonary embolism
4.2.5. Coronary Artery Disease
4.2.6. Hyperlipidemia
4.2.7. Cardiac arrhythmia
4.2.8. Peripheral vascular disease
4.2.9. Aneurysm
4.2.10. Varicose veins
4.2.11. Venus thromboembolism
5. Urinary System
5.1. Age-Related Changes
5.1.1. Decreased bladder capacity
5.1.1.1. Increased frequency of urination
5.1.1.2. Increased urgency to urinate
5.1.1.3. Nocturia
5.1.1.4. Incontinence is NOT normal
5.1.2. Decreased GFR ( glomerular filtration rate)
5.1.3. Decreased blood flow to kidneys
5.1.4. Reduced renal function
5.2. Abnormal Processes
5.2.1. Urinary incontinence
5.2.2. Bladder cancer
5.2.3. Renal calculi
5.2.4. Glomerulonephritis
6. Neurological System
6.1. Age-Related Changes
6.1.1. Changes in sleep patterns
6.1.1.1. Less time in stage III and IV
6.1.1.2. Less sound sleep
6.1.1.3. Delay in onset of sleep
6.1.1.4. More time in stages I and II
6.1.1.5. Phase advance
6.1.1.5.1. Bedtime earlier in evening and wake earlier in morning
6.1.2. Slower response to change in balance
6.1.3. Decrease blood flow to the brain
6.1.3.1. Does not affect thinking and behavior
6.1.4. Personality
6.1.4.1. Remains consistent with earlier years
6.1.4.1.1. No personality types apply to EVERY older adult
6.1.5. Change may occur because of disease, retirement, death of significant other, loss of independence, decreased income and disability
6.1.6. Memory
6.1.6.1. Age related forgetfulness
6.1.7. Intelligence
6.1.7.1. Basic intelligence is upheld
6.1.7.2. Crystallized intelligence maintained
6.1.7.3. Possible decline in fluid intelligence
6.1.8. Learning
6.1.8.1. Learning ability is typically unchanged
6.1.8.1.1. Learning is best when integrating new information with previous learned information
6.2. Abnormal Processes
6.2.1. Sleep disturbances
6.2.1.1. Insomnia
6.2.1.1.1. inability to fall sleep, difficulty staying asleep, or premature waking
6.2.1.2. Nocturnal myoclonus
6.2.1.2.1. Greater than or equal to 5 leg movements or jerks per hour of sleep
6.2.1.3. Restless leg syndrome
6.2.1.3.1. Uncontrollable urge to move legs when lying down
6.2.1.4. Sleep apnea
6.2.1.4.1. At least five episodes of cessation of breathing
6.2.1.4.2. Last at least 10 seconds
6.2.1.4.3. Occurs per hour of sleep
6.2.1.4.4. Can be accompanied with daytime sleepiness
6.2.1.5. Sleep latency
6.2.1.5.1. Delay in ability to fall asleep
6.2.2. Pain
6.2.2.1. Nociceptive
6.2.2.1.1. Mechanical
6.2.2.1.2. Thermal
6.2.2.1.3. Chemical
6.2.2.1.4. Somatic
6.2.2.1.5. Visceral
6.2.2.2. Neuropathic
6.2.2.2.1. Abnormal processing of stimulus from central or peripheral nervous system
6.2.2.2.2. Sharp
6.2.2.2.3. Stabbing
6.2.2.2.4. Tingling
6.2.2.2.5. Burning
6.2.2.2.6. High intensity onset
6.2.2.3. Unresolved pain
6.2.2.3.1. Complications
6.2.3. Dementia
6.2.4. Parkinson’s Disease
6.2.5. Transient Ischemic Attacks
6.2.6. Cerebrovascular accident
6.2.7. Alzheimer’s
7. Reproductive System
7.1. Age-Related Changes
7.1.1. Men
7.1.1.1. Andropause
7.1.1.2. Thinner epithelium on seminal vesicles
7.1.1.3. Muscle tissue replaced with connective
7.1.1.4. Decreased capacity to retain fluid
7.1.1.5. Seminiferous tubule changes
7.1.1.6. Atrophy of testes
7.1.1.7. Reduction in testicular mass
7.1.1.8. Less live sperm in ejaculation
7.1.1.9. More time required to achieve erection
7.1.1.10. Enlargement of prostate gland
7.1.2. Women
7.1.2.1. Menopause
7.1.2.2. Vulva atrophies
7.1.2.3. Flattening of labia
7.1.2.4. Loss of subcutaneous fat and hair
7.1.2.5. Vaginal epithelium thins
7.1.2.6. Cervix atrophies
7.1.2.7. Uterus atrophies
7.1.2.8. Fallopian tubes atrophy
7.1.2.8.1. Become shorter and straighter
7.1.2.9. Vaginal canal
7.1.2.9.1. Reduction in collagen and adipose tissue
7.1.2.9.2. Shortening and narrowing of canal
7.1.2.9.3. Less lubrication
7.1.2.9.4. More alkaline vaginal pH
7.1.2.10. Endometrium responds to hormonal stimulation
7.1.2.11. Breasts lose firmness and sag
7.1.2.12. Retraction of nipples
7.2. Abnormal Processes
7.2.1. Erectile dysfunction
7.2.2. Senile vulvitis
7.2.3. Tumors of vulva
7.2.4. Atrophic vaginitis
7.2.5. Cancer of vagina
7.2.6. Cancer of cervix
7.2.7. Cancer of endometrium
7.2.8. Cancer of ovaries
7.2.9. Perineal herniation
7.2.10. Dyspareunia
7.2.11. Breast cancer
7.2.12. Benign prostatic hyperplasia
7.2.13. Prostate Cancer
7.2.14. Penis, scrotum and testes tumors
8. Respiratory System
8.1. Age-Related changes
8.1.1. Calcification of costal cartilage
8.1.2. Increased risk for respiratory infection
8.1.3. Decrease of cough and laryngeal reflexes
8.1.4. Increased residual volume
8.1.5. Decreased vital capacity
8.1.6. Decreased elastic recoil
8.1.7. Alveoli less elastic
8.2. Abnormal Processes
8.2.1. COPD
8.2.2. Asthma
8.2.3. Chronic bronchitis
8.2.4. Emphysema
8.2.5. Lung cancer
8.2.6. Lung abscess
8.2.7. pneumonia
9. Gastrointestinal System
9.1. Age-Related Changes
9.1.1. Atrophy of small and large intestine
9.1.2. Decreased esophageal motility
9.1.3. Sense of taste decreases
9.1.3.1. Atrophy of tongue affects taste buds
9.1.4. Decreased saliva production
9.1.5. Decrease in size of liver
9.1.6. Decreased HCL production
9.1.7. Slower peristalsis
9.1.8. Slower fat absorption
9.1.9. Xerostomia
9.2. Abnormal Processes
9.2.1. Constipation
9.2.2. Dysphagia
9.2.3. Hiatal hernia
9.2.4. Esophageal cancer
9.2.5. Peptic ulcer disease
9.2.6. Stomach cancer
9.2.7. Diverticulitis
9.2.8. Diverticulitis
9.2.9. Colorectal cancer
9.2.10. Flatulence
9.2.11. Intestinal obstruction
9.2.12. Fecal impaction
9.2.13. Incontinence
9.2.14. Acute appendicitis
9.2.15. Pancreatic cancer
9.2.16. Biliary tract disease
10. Musculoskeletal System
10.1. Age-Related Changes
10.1.1. Decreased bone mass and mineral
10.1.2. Decreased calcium absorption
10.1.3. Decreased muscle mass
10.1.3.1. Decreased movement
10.1.3.1.1. Impaired extension and flexion
10.1.3.2. Decreased strength
10.1.4. Thinning intervertebral disks
10.1.5. Shortened vertebrae
10.1.5.1. Slight kyphosis
10.1.6. Reduce flexibility on joints and muscles
10.1.7. Sarcopenia
10.2. Abnormal Processes
10.2.1. Osteoporosis
10.2.2. Fractures
10.2.3. Osteoarthritis
10.2.4. Rheumatoid arthritis
10.2.5. Gout
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