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Older Adult by Mind Map: Older Adult

1. Cardiac

1.1. valves become thick and rigid

1.2. blood vessels reduce elasticity

1.3. oxygen used less efficiently

1.4. aorta becomes dilated

1.4.1. slight ventricular hypertrophy

1.4.2. thickening of left ventricular wall

1.5. myocardial muscle less effective

1.5.1. decreased contractile strength

1.5.2. decreased cardiac output when demands increase

1.6. calcification, reduced elasticity of vessels

1.7. less sensitive to baroreceptor regulation of blood pressure

1.8. conditions altering tissue perfusion

1.8.1. hypotension

1.8.2. blood dyscrasias

1.8.3. cardiovascular disease

1.9. Ex: Congestive Heart Failure

1.9.1. incidence increases with age

1.9.2. leading cause of hospitalization

1.9.3. complication of arteriosclerotic heart disease

1.9.4. coronary artery disease is responsible for most cases

1.9.5. symptoms: SOB, dyspnea, confusion, insomnia, orthopnea, wheezing, weight gain, edema

2. Integumentary

2.1. increased benign and malignant skin neoplasms

2.2. reduced sweat gland activity

3. Immune

3.1. depressed immune response

3.1.1. t-cell activity declines

3.1.2. cell-mediated immunity declines

3.2. reduced antibody response

3.3. decreased number of Langerhans cells in the skin

3.4. reduced thickness of the skin

3.5. decreased circulation of the skin

4. Gastrointestinal

4.1. less acute taste sensations

4.2. decreased esophageal motility

4.3. atrophy of small and large intestines

4.3.1. fewer cells on walls impact absorption of dextrose, xylose, and vitamins B and D

4.4. increased risk for aspiration, indigestion and constipation

4.5. presbyesophagus

4.5.1. weaker esophageal contractions and weakness sphincter

4.6. decreased elasticity of stomach

4.6.1. reduces amount of food accommodation at one time

4.7. stomach has higher pH

4.7.1. decline in hydrochloric acid increase in incidence of gastric irritation interferes with absorption of calcium, iron, folic acid, and vitamin B12

4.7.2. deline in pepsin interferes with absorption of protein

4.8. decreased peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet

4.8.1. increased in risk of constipation

4.9. bile salt synthesis decreases

4.9.1. increased risk of gallstones development

4.10. pancreases changes

4.10.1. affects digestion of fats

4.11. Ex: Xerostomia

4.11.1. results from decreased saliva, some medications, mouth breathing and altered cognition

4.11.2. consequences of decreased saliva in the older population

4.11.3. interventions: saliva substitutes, sipping water, sugarless candy or gum

4.12. Dysphasia

4.12.1. swallowing difficulties that increase with age

4.12.2. causes: GERD, stroke, structural disorders

4.13. bowel incontinence

4.13.1. involuntary defecation

4.13.2. most often associated with fecal impaction

5. Urinary

5.1. decline of renal blood flow and glomerular filtration

5.1.1. decrease by 50% by age 90

5.2. hypertrophy and thickening of the bladder muscle

5.2.1. decreases bladder's ability to expand reduced bladder capacity frequency, urgency and nocturne

5.3. changes in cortical control of micturition

5.3.1. nocturne

5.4. kidney filtration ability decreases

5.4.1. affects the ability to eliminate drugs potential for adverse drug reactions

5.5. reduced renal function

5.5.1. high blood urea nitrogen levels

5.6. decreased tubular function

5.6.1. concentration of urine changes in response to water and/or sodium excess/depletion

5.7. increase in renal threshold for glucose

5.7.1. false-negative results for glucose in the urine without symptoms

6. Safety

6.1. lighting

6.1.1. diffuse lighting better than bright light

6.1.2. night lights: soft red light in bedroom

6.2. temperature

6.2.1. older adults have lower than normal body temperatures

6.2.2. decreased natural insulation

6.3. floor coverings

6.3.1. carpeting: sound absorber but can cause problems static electricity and cling difficulty in wheelchair cleaning odors pests

6.3.2. scattered rugs or area rugs can cause falls

6.4. furniture

6.4.1. chairs correct height with arm rests

6.4.2. tables and book cases should be sturdy

6.5. Fall precautions

7. Nervous

7.1. reduction in neurons, nerve fibers and cerebral blood flow

7.2. slower response to change in balance

7.3. hypothalamus less effective in temperature regulation

7.3.1. normal body temperature lowered range 96.9-98.3 degrees F

7.3.2. response to heat is altered

7.3.3. ability to respond to cold temperatures is reduced

7.4. changes in sleep patterns with frequent awakening

7.5. loss of nerve cell mass

7.5.1. atrophy of the brain and spinal cord

7.5.2. brain weight decreases

7.6. number of dendrites declines

7.7. demyelinization

7.7.1. slower nerve conduction

7.7.2. response and reaction times are slower

7.7.3. reflexes become weaker

7.8. plaques, tangles, atrophy of the brain

7.9. free radicals accumulate

7.10. decrease in cerebral blood flow

7.11. fatty deposits accumulate in blood vessels

7.12. ability to compensate declines with age

7.13. intellectual performance maintained until at least 80 years old

7.14. slowing in central processing

7.15. Ex: Parkinsons

7.15.1. affects ability of the CNS to control body movement

7.15.2. dopamine

7.15.3. treatment: anticholinergic medications

7.15.4. temors, shuffling gait, mask face expression

8. Sensory

8.1. presbycusis

8.1.1. distortion of high pitched sounds

8.1.2. cerumen increases

8.1.3. alteration in equilibrium

8.2. presbyopia

8.2.1. narrowing of visual field

8.2.2. pupil size reduction & less reactive

8.2.3. depth perception distorted

8.2.4. decline in visual acuity

8.3. decreases in all senses

8.3.1. taste & smell taste acuity is dependent on smell decreased saliva, poor oral hygiene and medications atrophy of tongue

8.3.2. touch reduction of tactile sensation reduced ability to sense pressure, discomfort, change in temperature

8.3.3. can affect well-being, ADLs, and health

9. Cellular

9.1. functional cell number decreases

9.2. lean body mass decrease

9.3. today body fat increases

10. Physical Appearance

10.1. hair loss, greying, wrinkles

10.2. loss of tissue elasticity

10.2.1. elongated ears

10.2.2. baggy eyelids

10.2.3. double chin

10.3. loss of subcutaneous fat

11. Respiratory

11.1. Reduction of cough and laryngeal reflexes

11.2. increased residual capacity and reduced vital capacity

11.3. high risk for respiratory infection

11.4. lungs reduce in size and weight

11.5. decreased elastic recoil

11.6. alveoli less elastic

11.7. Ex: Asthma

11.7.1. can develop in older years

11.7.2. high risk of complications of bronchiectasis, cardiac problems

11.7.3. high rates of mortality

11.7.4. assess for causative factors and educate patient

11.7.5. evaluate aerosol nebulizer's use

12. musculoskeletal

12.1. thinning disks and shortened vertebrae

12.2. reduced muscle mass, strength and movement

12.3. decreased bone mineral and mass

12.4. diminished calcium absorption

12.5. increased risk of fractures

13. Endocrine

13.1. thyroid gland activity decreases

13.2. ACTH secretion decreases

13.3. Pituitary gland decreases

13.4. insulin release by beta cells is delayed and insufficient

13.5. ability to metabolize glucose is reduced

13.6. higher blood glucose in non diabetic patients

14. Cancer

14.1. #1 predictor of developing cancer is age

15. Sleep

15.1. more time in stages I and II, less time in III and IV

15.2. less sound sleep, delay in onset of sleep

15.3. common disorders

15.3.1. insomnia difficulty falling asleep or staying asleep short term (transient) change in environment, illness, anxiety, stress Chronic (3 weeks or more) physical or mental illness environmental factors substance abuse medications

15.3.2. leg movements

15.3.3. sleep apnea five episodes of cessation of breathing, lasting 10 seconds evaluation of sleep disorder clinic for best treatment supine position for sleep should be avoided

15.3.4. medical conditions

15.3.5. medications

15.4. chronic disorders affecting sleep

15.4.1. diabetes

15.4.2. musculoskeletal conditions

15.4.3. dementia

15.4.4. depression or other emotional problems

15.5. can be affected by

15.5.1. environmental factors snoring spouse loud street noises bright hallway lights

15.5.2. caffeine and alcohol

15.5.3. pain

16. Reproductive

16.1. female

16.1.1. hormonal changes vulva atrophy flattening of the labia loss of subcutaneous fat and fat

16.1.2. vaginal epithelium thins

16.1.3. cervix, uterus, and Fallopian tubes atrophy

16.1.4. vaginal canal changes less lubrication may lead to discomfort with intercourse reduction in collagen and adipose tissue

16.1.5. more alkaline vaginal pH as a result of lower estrogen changes

16.1.6. uterus and ovaries decrease in size

16.1.7. endometrium continues to response to hormonal stimuli

16.1.8. breasts sag and become less firm

16.1.9. Ex: atrophic vaginitis occurs in postmenopausal women increased vaginal fragility increases the risk of irritation leading to vaginitis

16.2. male

16.2.1. seminal vesicles develop thinner epithelium

16.2.2. muscle tissue replaced with connective tissue

16.2.3. decreased capacity to retain fluids

16.2.4. seminiferous tubules changes

16.2.5. atrophy of the testes and reduction in testicular mass

16.2.6. ejaculation fluid contains less live sperm

16.2.7. testosterone stays the same or decreases slightly

16.2.8. more time requires to achieve an erection

16.2.9. enlargement of the prostate gland

16.2.10. Ex: Benign Prostatic Hyperplasia most older men have some degree of BPH men reluctant or embarrassed to seek medical treatment may result in kidney damage