1. Hyperthyroidism
1.1. Thyroid gland excretes excess amounts of thyroid hormone
1.2. S/S
1.2.1. Diaphoresis
1.2.2. Tachycardia
1.2.3. Palpitation
1.2.4. Hypertension
1.2.5. Tremors
1.2.6. Diarrhea
1.3. Treatment
1.3.1. Anti thyroid medication
1.3.2. Surgery
1.4. Nursing interventions
1.4.1. Monitor V
1.4.2. ECG for HR and rhythm
1.4.3. Weigh daily
2. Hypothyroidism
2.1. Subnormal concentrations of thyroid hormone
2.2. S/S
2.2.1. Fatigue
2.2.2. Weakness
2.2.3. Anorexia
2.2.4. Constipation
2.2.5. Weight gain
2.3. Treatment
2.3.1. Replacement of thyroid hormone
2.4. Nursing interventions
2.4.1. Prevent constipation
2.4.2. Advise about dressing in warm clothing
3. Diabetes
3.1. Body does not produce enough insulin or does not use it efficiently
3.2. S/S
3.2.1. Fatigue
3.2.2. Confusion
3.2.3. Blurry vision
3.3. Treatment
3.3.1. Drug therapy
3.3.2. Diet and exercise
3.4. Nursing interventions
3.4.1. Monitor blood glucose before and after meals
3.4.2. Assess for hyper & hypoglycemia
3.4.3. Monitor VS
4. Colorectal cancer
4.1. Patho
4.1.1. Cancer that forms in colon or rectum
4.1.1.1. Cells proliferate out of control
4.2. Risk factors
4.2.1. Inflammatory bowel disease
4.2.2. Family history
4.2.3. Lack of physical activity
4.2.4. Low fiber diet
4.2.5. Diet low in fruits and vegetables
4.2.6. Overweight
4.2.7. Alcohol consumption
4.2.8. Smoking
4.3. S/S
4.3.1. Rectal bleeding-bloody stools
4.3.2. Change in bowel pattern
4.3.3. Anorexia
4.3.4. Nausea
4.3.5. Abdominal discomfort
4.3.6. Weakness
4.3.7. Anemia
4.4. Treatment
4.4.1. Chemotherapy
4.4.2. Colectomy
4.5. Nursing interventions
4.5.1. Counseling for adjustment to bodily changes
4.5.2. Education of colostomy care
4.5.2.1. Warm water and pat dry
5. Peptic ulcer disease
5.1. Patho
5.1.1. Open sore or raw area in lining of stomach or intestines
5.1.1.1. Lining broken down by: irritants, infection
5.2. Risk factors
5.2.1. Smoking
5.2.2. Heavy alcohol
5.2.3. Stress
5.2.4. Caffeine
5.2.5. H.pylori infection
5.3. S/S
5.3.1. Pain
5.3.2. Bleeding
5.3.3. Obstruction
5.3.4. Perforation
5.4. Treatment
5.4.1. Medication to decrease stomach acid production
5.4.1.1. Antacid
5.4.1.2. Proton pump inhibitors
5.4.2. Antibiotics if caused by bacteria
5.4.2.1. Penicillin
5.5. Nursing interventions
5.5.1. Assess pain and location
5.5.2. Instruct pt. To avoid NSAIDS
5.5.3. Encourage smoking cessation
5.5.4. Small frequent meals
6. Esophageal cancer
6.1. Patho
6.1.1. Cancer originated in squamous cell or columnar cells that line the esophageal lumen
6.2. Causes
6.2.1. Alcohol use
6.2.2. Heavy smoking
6.2.3. Poor oral hygiene
6.3. S/S
6.3.1. Dysphasia
6.3.2. Weight loss
6.3.3. Excessive salvation
6.3.4. Thirst hi
6.3.5. Hiccups
6.3.6. Anemia c
6.3.7. Chronic bleeding
6.4. Treatment
6.4.1. Surgical resection
6.4.2. Radiation
6.4.3. Chemotherapy
6.4.4. Laser therapy
6.4.5. Photodynamic therapy
6.5. Nursing intervemtions
6.5.1. Smoking cessation
6.5.2. Assess ability for pt. to swallow
6.5.3. Check for coughing while eating
6.5.4. Instruct pt. to sit up right while eating
7. Pneumonia
7.1. Patho
7.1.1. Breakdown in body’s natural defenses allows germs to invade and multiply within the lungs
7.2. Risk factors
7.2.1. Immobility
7.2.2. Smoking
7.2.3. Lung disease
7.2.4. Asthma
7.2.5. Being hospitalized
7.3. S/S
7.3.1. Chest pain
7.3.2. Cough
7.3.3. Fever
7.3.4. Fatigue
7.3.5. SOB
7.4. Treatment
7.4.1. Antibiotics
7.4.2. Oral rehydration
7.4.3. Oxygen
7.4.4. IV fluids
7.5. Nursing interventions
7.5.1. Assess for cough productivity
7.5.2. Auscultate lung sounds and airflow
7.5.3. Observe sputum color, consistency, odor
7.5.4. Assess patients hydration statue
7.5.5. Elevate head of bed
7.5.6. Change position frequently
7.5.7. Encourage adequate fluids
8. COPD
8.1. Smoking
8.2. Chronic bronchitis
8.2.1. Persistent cough, URI, SOB
8.2.1.1. Remove secretions
8.2.1.2. Prevent airway obstruction
8.2.1.3. Adequate fluid intake
8.3. Emphysema
8.3.1. Postural drainage
8.3.2. Bronchodilators
8.3.3. Avoid stress
8.3.4. Breathing exercises
8.4. Treatment
8.4.1. Steroids
8.4.2. Bronchodilators
8.4.3. Oxygen therapy
8.5. Nursing interventions
8.5.1. Encourage physical exercise
8.5.2. Smoking cessation
8.5.3. Instruct to modify diet
9. Alzheimer’s
9.1. Neurotic plaques of beta-amyloid protein
9.1.1. Changes in neurotransmitter systems
10. Respiratory changes
10.1. Connective tissue cause relaxation at lower edge of septum
10.2. Submucosal glands decrease secretions
10.2.1. Reduced ability to dilute mucous/ difficult to remove
10.3. Calcification of costal cartilage
10.4. Anterior-posterior chest diameter increases
10.5. Inspiratory/exploratory muscles weaken
10.6. Decrease in number of cilia
10.6.1. Hard to remove mucous
10.7. Alveoli decrease
10.7.1. Loss of elasticity
10.7.1.1. Lungs smaller,more rigid,firmer, less recoil
10.8. Reduction in cough and laryngeal reflexes
10.9. Less lung expansion/ decreased ability to expel foreign matter
10.10. Increase residual capacity and reduced vital capacity
10.11. High risk for respiratory infection
11. Sarcopenia
11.1. Reduction in protein synthesis
11.2. Increase in muscle protein degeneration
11.2.1. Can lead to disabilities
11.2.1.1. Promote good nutrition
12. Gastrointestinal changes
12.1. Less acute taste sensations
12.1.1. Lose sweet
12.2. Decreased esophageal motility
12.3. Reduced saliva and digestive enzymes
12.3.1. Reduced piddlin
12.3.1.1. Cannot break down carbohydrates as well
12.4. Liver is smaller
12.5. Reduced intestinal blood flow
12.5.1. Absorption of drugs
12.5.1.1. Slower absorption/metabolism
12.6. Atrophy of gastric muscles
12.7. Decreased stomach motility
12.8. Atrophy of small and large intestine
12.8.1. Fewer cells to absorb nutrients
12.9. Increased risk of aspiration, indigestion, constipation
12.10. Decreased production of acid
12.10.1. Difficulty breaking down iron, B12 and B6
12.11. Decreased pepsin, lipase, pancreatic enzymes
12.12. Slower peristalsis
12.13. Less acute taste sensations
12.13.1. Lose sweet
12.14. Decreased esophageal motility
12.15. Reduced saliva and digestive enzymes
12.15.1. Reduced piddlin
12.15.1.1. Cannot break down carbohydrates as well
12.16. Liver is smaller
12.16.1. Decrease in size and function
12.16.1.1. Affects metabolism of drugs
12.16.1.1.1. Longer metabolism
12.17. Reduced intestinal blood flow
12.18. Atrophy of gastric muscles
12.19. Decreased stomach motility
12.20. Atrophy of small and large intestine
12.20.1. Fewer cells to absorb nutrients
12.21. Increased risk of aspiration, indigestion, constipation
12.22. Decreased production of acid
12.22.1. Difficulty breaking down iron, B12 and B6
12.23. Decreased pepsin, lipase, pancreatic enzymes
12.24. Slower peristalsis
13. Musculoskeletal changes
13.1. Thinning disks and shortened vertebrae
13.2. Reduced muscle mass, strength and movement
13.3. Decreased bone mineral mass
13.4. Diminished calcium absorption
13.5. Increased risk of fractures
13.6. Tendons shrink and harden
13.6.1. Tendon jerk
13.7. Reflexes lessen in arms, lost in abdomen and maintained in knee
13.8. Muscle cramping common
14. Nervous system
14.1. Decline in blood flow to brain
14.1.1. Does not affect thinking and behavior
14.2. Reduction in neurons, nerve fibers and cerebral blood flow
14.2.1. Nerve conduction slower
14.3. Slower response to balance
14.3.1. Fall risk
14.4. Slower recognition and response to stimuli
14.4.1. Decrease in new axon growth and nerve reinnervation of injured peripheral nerves
14.5. Hypothalamus
14.5.1. Less effective temperature regulation
14.6. Changes in sleep patterns with frequent awakening
15. Endocrine
15.1. Thyroid gland activity decrease
15.2. ACTH decrease d/t decrease in pituitary gland
15.3. Insulin release by beta cells is delayed
15.4. Ability to metabolize glucose is reduced
15.5. Higher blood glucose in non diabetic patient
16. Immune system
16.1. Depressed immune system
16.2. T-cell activity declines
16.3. Cell-mediated immunity declines
16.3.1. Risk for infection increases
16.3.2. Inflammatory defenses decline
17. Personality
17.1. Remains constant
18. Safety Risks
18.1. Accidents are 6th leading cause of death
18.2. Falls leading cause of injury-related death
18.3. Factors that contribute to injuries
18.3.1. Parkinson’s
18.3.1.1. Reduction in dopamine
18.3.1.2. Resting tremors- pill rolling
18.3.1.3. Bradykinesia
18.3.1.4. Shuffling gait
18.3.2. Stroke
18.3.3. Seizures
18.3.4. Dimentia
18.3.4.1. Irreversible and progressive
18.3.4.1.1. Impairment in cognitive function
18.3.5. Depression
18.3.6. Orthostatic hypotension
18.3.6.1. Decline in systolic blood pressure of 20 mm Hg after rising in morning or standing for one minute
18.3.6.1.1. Rise slowly in morningc
18.3.6.1.2. Change positions slowly
18.3.7. Arrhythmias
18.3.7.1. Abnormal heart rate and rhythm
18.3.7.2. S/S
18.3.7.2.1. Weakness
18.3.7.2.2. Fatigue
18.3.7.2.3. Confusion
18.3.7.2.4. Dizziness
18.4. Home safety
18.4.1. Diffuse lighting better than bright lights
18.4.2. Nightlights should be soft
18.4.3. Scattered rugs removed
18.4.4. Arm rests on chairs
18.4.5. Use handrails and side rails
19. Pressure ulcers
19.1. Tissue anoxia/ ischemia resulting from pressure
19.2. Risk factors
19.2.1. Poor nutritional intake
19.2.2. Fragile skin
19.2.3. Reduced sensation
19.2.4. Immobility
19.3. Nursing interventions
19.3.1. Educate about high protein diet
19.3.2. Change positions frequently
19.3.3. Frequent skin assessments
20. Skin cancer
20.1. Risk factors
20.1.1. Sun exposure
20.1.2. UV radiation
20.1.3. Radiation therapy
20.2. Treatment
20.2.1. Evaluate and biopsy lesions
20.2.1.1. Removal
20.3. Nursing interventions
20.3.1. Teach about self inspection
20.3.2. Teach about suspicious lesion criteria
21. Pruritis
21.1. Itching caused by the drying of a persons skin
21.2. S/S
21.2.1. Itching
21.2.2. Irritation
21.3. Treatment
21.3.1. Antihistamine
21.3.2. Topical steroids
21.4. Nursing interventions
21.4.1. Educate about excessive bathing
21.4.2. Educate about water temperature
21.4.3. Instruct not to scratch excessively b/c leads to infection
22. Glomerulonephritis
22.1. Patho
22.1.1. Inflammation of glomeruli
22.2. S/S
22.2.1. Fever
22.2.2. Fatigue
22.2.3. Edema
22.2.4. Abdominal pain
22.2.5. Proteinuria
22.2.6. Hematuria
22.3. Treatment
22.3.1. Antibiotics
22.3.2. Restrict sodium and protein
22.3.3. Strict I+Os
22.4. Nursing interventions
22.4.1. Close observation for accumulation of medications
22.4.2. Evaluate patient for renal failure often
22.4.3. Monitor input and output
23. Renal Calculi
23.1. Patho
23.1.1. Stone formation of crystals that adhere to the urothelium
23.2. Causes
23.2.1. Immobilization
23.2.2. Infection
23.2.3. Changes in pH of urine
23.2.4. Chronic diarrhea
23.2.5. Dehydration
23.2.6. Hypercalemia
23.3. S/S
23.3.1. Pain
23.3.2. Hematuria
23.3.3. UTI symptoms
23.3.4. Upset GI system
23.4. Treatment
23.4.1. Small stones
23.4.1.1. Increase water intake
23.4.1.2. Pain relievers
23.4.1.3. Medications-alpha blockers relax ureters
23.4.2. Large stones
23.4.2.1. Sound waves to break up stones
23.4.2.2. Surgery to remove
23.5. Nursing interventions
23.5.1. Prevent urinary stasis
23.5.2. Provide ample fluids
23.5.3. Facilitate prompt UTI treatments
24. Incontinence
24.1. Types
24.1.1. Stress
24.1.1.1. Caused by intra abdominal pressure- cough, sneezing, laughing
24.1.2. Overflow
24.1.2.1. Caused by bladder neck obstructions/ medication
24.1.3. Urgency
24.1.3.1. Caused by UTI, BPH, irritation or spasms of bladder
24.1.4. Neurogenic
24.1.4.1. Arising from cortex lesions, MS, or other disturbances in neural pathway
24.2. Treatment
24.2.1. Medications
24.2.2. Track voids
24.2.3. Bladder training
24.2.4. Fluid management
24.3. Nursing interventions
24.3.1. Toileting schedule
24.3.2. Keel exercises
24.3.3. Biofeedback
24.3.4. Medications
25. Arrhythmias
25.1. Patho
25.1.1. Disturbance of normal heart rhythm conduction
25.2. Causes
25.2.1. Digitalis toxicity
25.2.2. Hypokalemia
25.2.3. Acute infections
25.2.4. Hemorrhage
25.2.5. Coronary insufficiency
25.3. S/S
25.3.1. Weaknessf
25.3.2. Fatigue
25.3.3. Palpitationsc
25.3.4. Confusion
25.3.5. Dizziness
25.3.6. Hypotension
25.3.7. Bradycardias
25.3.8. syncope
25.4. Treatment
25.4.1. Medication
25.4.1.1. Beta blocker
25.4.1.2. Calcium channel blocker
25.4.1.3. Anti arrhythmic
25.4.2. Pacemaker
25.4.3. ICD
25.4.4. Cardioversion
25.5. Nursing interventions
25.5.1. Monitor HR and rhythm
25.5.2. Palpate pulses
25.5.3. Continuous cardiac monitor
26. Pulmonary embolism
26.1. Patho
26.2. Risk factors
26.2.1. Fractures
26.2.2. CHF
26.2.3. Arrhythmias
26.2.4. History of thrombosis
26.2.5. Immobilization
26.3. S/S
26.3.1. Confusion
26.3.2. Apprehension
26.3.3. SOB
26.3.4. Elevated temperature
26.3.5. Elevated ESR
26.4. Treatment
26.4.1. Blood thinners/ anticoagulants
26.4.2. Catheter to remove/ dissolve clot
26.4.3. Compression stockings
26.5. Nursing interventions
26.5.1. Assess skin color/ cap refill
26.5.2. Monitor VS
26.5.3. Assess for s/s of hypoxia
26.5.3.1. Confusionh
26.5.3.2. Headache
26.5.3.3. Restlessness
26.5.3.4. Tachycardia
26.5.3.5. Pale skin
26.5.4. Auscultation of lung sounds
26.5.5. Asses for calf swelling, pain, redness, hardened areas
27. Cancer of prostate
27.1. Patho
27.1.1. Adenocarcinoma that develops in prostate gland
27.2. S/S
27.2.1. Blood in urine
27.2.2. Decrease force of stream
27.2.3. Decreased stream
27.2.4. Dribbling
27.3. Risk factors
27.3.1. Increased age
27.3.2. Obesity
27.3.3. Family history
27.4. Treatment
27.4.1. Diagnosed by digital rectal exam
27.4.1.1. Hormone therapy
27.4.1.2. Chemotherapy
27.4.1.3. Radiation
27.4.1.4. Surgery
27.5. Nursing interventions
27.5.1. Educate about maintaining healthy diet
27.5.2. Exercise education
27.5.3. Counseling about diagnosis
28. Erectile dysfunction
28.1. Patho
28.1.1. Metabolic imbalance between relaxatory and contractile processes within smooth muscle of penis
28.2. S/S
28.2.1. Inability to achieve and sustain erection
28.3. Risk factors
28.3.1. Diabetes
28.3.2. Smoking
28.3.3. Obesity
28.3.4. Hypertension
28.4. Treatment
28.4.1. Silendafil (viagra)
28.4.2. Vardenifil
28.4.3. Taladafil (cialis)
28.5. Nursing interventions
28.5.1. Smoking cessation education
28.5.2. Education about controlling blood pressure
28.5.3. Counseling about self-image
29. Tumor of vulva
29.1. 4th most common malignancy
29.2. S/S
29.2.1. Pain and irritation
29.2.2. Pruritis
29.3. Patho
29.3.1. DNA mutation causes cells to grow and divide rapidly
29.3.1.1. Squamous cell carcinoma
29.3.1.1.1. Cancer of thin, flat cells that line the surface of vulva
29.3.1.2. Vulva melanoma
29.3.1.2.1. Cancer of the pigment-producing cells in skin of vulva
29.4. Treatment
29.4.1. Radical vulvectomy
29.4.2. Radiation
29.5. Nursing interventions
29.5.1. Educate about HPV vaccine
29.5.2. Counseling about self-image
29.5.3. Body practice education
29.5.4. Sexual activity education
29.6. Risk factors
29.6.1. Increased age
29.6.2. Smoking
29.6.3. Exposure to HPV
29.6.4. Weakened immune system
30. BPH
30.1. S/S
30.1.1. Nocturia
30.1.2. Dribbling
30.1.3. Decreased stream
30.1.4. Hesitancy
30.2. Risk factors
30.2.1. Overweight
30.2.2. Increased age
30.2.3. Diabetes
30.2.4. Heart disease
30.2.5. Inactivity
30.3. Treatment
30.3.1. Alpha blockers
30.3.2. TURP
30.3.3. Prostatectomy
30.4. Nursing interventions
30.4.1. Encourage voiding every 2-4 hours
30.4.2. Ask patient about stress incontinence: coughing, sneezing,lifting objects
30.4.3. Have patient document voiding
30.4.4. Encourage fluids
30.4.5. Watch closely for signs of obstruction
30.4.6. Sitz baths for comfort
30.5. Patho
30.5.1. Proliferation of cells in prostate
31. Breast cancer
31.1. Patho
31.1.1. Proliferation of cells, invading other structures
31.1.1.1. Epithelial tumors that develop from cell lining ducts or lobules
31.2. Risk factors
31.2.1. Increased age
31.2.2. Overweight
31.2.3. Smoking
31.2.4. Hormone treatment
31.2.5. Alcohol consumption
31.3. S/S
31.3.1. Lump on breast
31.3.2. Bloody discharge from nipples
31.3.3. Change in shape or texture of nipple or breast
31.4. Treatment
31.4.1. Radiation
31.4.2. Surgery
31.4.2.1. Mastectomy
31.4.2.2. Lumpectomy
31.5. Nursing interventions
31.5.1. Regular breast exams
31.5.1.1. Yearly mamograms
31.5.2. Education about self breast exams
32. Atrophic vaginitis
32.1. Risk factors
32.1.1. Post menopause
32.1.2. Cancer treatments
32.1.3. Immunologic disorders
32.2. S/S
32.2.1. Itching and burning
32.2.1.1. Increase fragility and alkaline
32.3. Patho
32.3.1. Low estrogen production leads to atrophy of vulvar epthelium
32.4. Treatment
32.4.1. Estrogen replacement
32.4.2. OTC moisturizer/ water-based lubricant
32.5. Nursing interventions
32.5.1. Assess pain
32.5.2. Assess sexual desires
32.5.3. Instruct about water-soluble lubricant to decrease pain
33. Preventing complications
33.1. Promote circulation
33.2. Adequate fluid intake
33.3. Avoid smoking
33.4. Frequent position changes
33.5. Proper diet
33.6. Exercise
34. CHF
34.1. S/S
34.1.1. SOB
34.1.2. dyspnea
34.1.3. Confusion
34.1.4. Insomnia
34.2. Patho
34.2.1. Heart muscle does not pump blood efficiently d/t narrowed blood vessels or hypertension
34.3. Risk factors
34.3.1. High blood pressure
34.3.2. Heart attack
34.3.3. Diabetes
34.3.4. Smoking
34.3.5. Obesity
34.4. Treatment
34.4.1. Blood pressure medication
34.4.2. ICD
34.4.3. Surgery
34.4.3.1. Coronary artery bypass
34.5. Nursing interventions
34.5.1. Smoking cessation education
34.5.2. Encourage physical exercise
34.5.3. Auscultation of heart sounds
34.5.4. Palpate peripheral pulses
34.5.5. Monitor BP
34.5.6. Inspect skin for pallor/ cyanosis
34.5.7. Monitor urine output
35. Cellular changes
35.1. Functional cell number decreases
35.2. Lean body mass decreases
35.3. Total body fat increases
35.4. Extracellular fluid constant, intracellular fluid reduces= less total body fluid
36. Cardiovascular changes
36.1. Slight left ventricular hypertrophy, aorta dilated and elongated
36.2. AV valves thick and rigid
36.2.1. Sclerosis and fibrosis
36.2.1.1. Systolic/diastolic murmur
36.3. Heart muscle loses efficiency and contractile strength
36.3.1. Reduced carduac output
36.3.1.1. Compensate with SV
36.3.1.2. Raise plasma drug levels
36.4. Pacemaker cells decrease in number
36.5. Blood vessels reduce elasticity
36.5.1. More prominent vessels in head and neck
36.6. Oxygen used less efficiently
36.7. SV decrease by 1% each year
36.8. Heart pigmented with lipofuscin granules
37. Renal
37.1. Decline in renal blood flow and GFR by 50% by age 90
37.2. Decrease in erythropoietin
37.3. Atrophy of kidney
37.4. Decrease tubular function
37.5. Decrease nephrons
37.6. Reduced bladder capacity
37.6.1. Urinary frequency, urgency, nocturia
38. Reproductive changes
38.1. Male
38.1.1. Seminal vesicles thin and reduce fluid-retaining capacity
38.1.2. Seminiferous tubules=fibrosis
38.1.3. Reduce sperm count
38.1.4. Sclerosis and fibrobelastosis of penis
38.1.5. Prostatic enlargement
38.1.6. Decrease in testosterone levels
38.2. Female
38.2.1. Atrophy of vulva
38.2.2. Vaginal epithelium thin and avascular
38.2.3. Cervix atrophy
38.2.4. Endometrium responds to hormones
38.2.4.1. Postmenopausal bleeding
38.2.5. Uterus ligaments weaken and backwards tilt
38.2.6. Fallopian tubes atrophy and shorten
38.2.7. Ovaries atrophy
38.2.7.1. Thicker and smaller
38.2.8. Estrogen depletion
38.2.8.1. Weakening of pelvic floor muscles
38.2.8.1.1. Involuntary release of urine when increase in intra abdominal pressure
38.2.9. Vagina= alkaline and flora/secretions decrease
39. Sensory changes
39.1. Vision
39.1.1. Presbyopia
39.1.1.1. Inability to focus on close objects clearly
39.1.2. Pupil size reduction and less reactive to light
39.1.3. Narrowing of visual field
39.1.3.1. Decreased peripheral vision
39.1.4. Depth perception distortion
39.1.5. Decline in visual acuity
39.2. Hearing
39.2.1. Presbycusis
39.2.1.1. Progressive loss of hearing
39.2.2. Cerumen increases
39.2.2.1. Affects hearimg
39.2.3. Alteration in equilibrium
39.3. Taste and smell
39.3.1. Sense of small altered with age
39.3.2. Taste acuity dependent on smell
39.3.3. Atrophy of tongue
39.3.4. Decreased saliva
39.3.4.1. Poor oral hygiene
39.3.4.2. Medications
39.4. Touch
39.4.1. Reduced tactile sensation
39.4.2. Reduced ability to sense pressure, discomfort and change in temperature
40. Integumentary
40.1. Skin less elastic, dry and fragile
40.2. Decreased subcutaneous fat
40.3. Increased benign skin neoplasms
40.4. Atrophic changes
40.5. Reduced sweat gland activity
41. Thermoregulation
41.1. Normal body temp lowered
41.1.1. 96.9-98.3