Geriatric Aging and Interventions

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Geriatric Aging and Interventions by Mind Map: Geriatric Aging and Interventions

1. Gastrointestinal

1.1. Secretions

1.1.1. Salivary secretions decrease Food is harder to swallow

1.1.2. Gastric secretions decrease Effects the acidity of the stomach

1.1.3. Decrease in pancreatic enzymes Decrease in the breaking down of proteins Decrease in the breaking down of carbohydrates Decrease in the breaking down of fat

1.1.4. Decrease production of intrinsic factor Decrease absorption of vitamin B12 Increased risk of pernicious anemia

1.2. Mouth

1.2.1. Increase risk of periodontal disease

1.2.2. Interventions Good oral care Floss daily Brush teeth at least twice day

1.2.3. Tongue atrophy Decreased taste

1.3. Stomach

1.3.1. Gastric atrophy Causes a decrease in appetite Elders cannot eat as much food

1.3.2. Increased stomach ph Certain vitamins and minerals will not be absorbed well Magnesium Zinc Calcium Iron Vitamin B12

1.3.3. Smooth muscle decreases Decrease in peristalsis

1.3.4. Interventions Eating pattern Small frequent meals Vitamin supplements Make sure to ask doctor before taking vitamin supplements

1.4. Intestines

1.4.1. Decrease in small intestines motility

1.5. Esophagus

1.5.1. Esophageal peristalsis decreases

1.6. Fallacy

1.6.1. “All elders wear diapers” False Incontinence of bowel is caused by a pathological disease not aging

1.7. Dysphagia

1.7.1. Incidence increases with age

1.7.2. Causes GERD Stroke Structural disorders

1.7.3. Goals Prevent aspiration Promotion of adequate nutrition intake

1.8. Peptic ulcer disease

1.8.1. Predisposing factors Alcohol abuse Tobacco use Stress

1.8.2. Cause Helicobacter pylori

1.8.3. Symptoms Heartburn Indigestion Nausea Vomiting Upper abdominal pain Most common symptom

2. Musculoskeletal

2.1. Muscles

2.1.1. Decrease muscle mass Increased risk for help with activities of daily living

2.1.2. Decrease in strength Increase risk for fragility Increase need for assistive devices

2.2. Joints

2.2.1. Degenerative joint changes Increase risk for osteoarthritis Increase risk rheumatoid arthritis Check for RA factor

2.3. Intervertebral discs

2.3.1. Dehydration of intervertebral discs

2.4. Bones

2.4.1. Decalcification of bones Increase risk for fractures Increase risk for osteoporosis

2.4.2. Interventions Consume more calcium Calcium supplements Eat more foods with calcium in them Exercise Muscle strengthening exercises

2.5. Osteoarthritis

2.5.1. Deterioration of joint cartilage with the formation of new bone at the joint cartilage Progressive

2.5.2. Symptoms Pain in joints Can be affected by the weather Joint stiffness Joint crackles Joint swelling Joint tenderness

2.5.3. Treatments Physical therapy Medication NSAIDS Narcotics Surgery Arthroscopy Joint replacements

2.6. Osteoporosis

2.6.1. Most common metabolic disease of the bone

2.6.2. Can cause fractures Affects safety

2.6.3. Risk factors Small frame White women Asian women Sedentary lifestyle Gender Women Post-menopause

2.6.4. Treatments Medication Vitamins Hormone replacement Exercise Healthy diet

3. Integumentary

3.1. Skin

3.1.1. Loss of skin elasticity Cause skin to sag Can result in wrinkles

3.1.2. Subcutaneous fat loss Cause more prominent bony prominences

3.1.3. Pigmentation changes Cause skin spots

3.1.4. Interventions: Stay hydrated 3 liters for men 2.2 liters for women Wear sunscreen Use broad spectrum sunscreen Try to avoid the sun from 10am to 2pm Eat healthy Eat food rich in omega-3 fatty acids Eat food rich in Vitamin E, B, C, and A Eat foods rich in antioxidants Get an adequate amount of sleep Skin repairs itself while one sleeps Receive 6-9 hours of sleep

3.2. Glands

3.2.1. Decrease in oil Cause less supple

3.2.2. Decrease in moisture Cause dry skin

3.2.3. Atrophy of sweat glands Not as easy to cool off when hot

3.2.4. Interventions: MOISTURIZER!!

3.3. Hair

3.3.1. Thinning Some men and women develop forms of alopecia as they age

3.3.2. Turns gray-white

3.3.3. Facial hair decreases in men

3.3.4. Facial hair increases with women Androgens overpower estrogens Because after menopause, estrogen decreases

3.3.5. Interventions: Women can take estrogen supplements to combat the effects of menopause Debatable type of treatment

3.4. Nails

3.4.1. Slower nail growth

3.4.2. Interventions Avoid using glue on nails and toxic polishes Consume biotin Can be taken as a supplement or consumed through food Sardines, nuts, cauliflower, bananas Supposed to help strengthen and grow hair nails

3.5. Seborrheic keratosis

3.5.1. Increase in size with age

3.5.2. Increase in number with age

3.5.3. Need medical evaluation to differentiate from precancerous lesions

3.5.4. Symptoms Itching Small bump on skin

3.5.5. Waxy elevated lesions

3.5.6. Treatments Electrosurgery Freezing Laser therapy Tissue scraping

3.6. Basal cell carcinoma

3.6.1. Most common

3.6.2. Grows slowly

3.6.3. Rarely metastasize

4. Respiratory

4.1. Decreased cough reflex

4.1.1. Increased likelihood of choking

4.1.2. Increased likelihood of aspiration

4.2. Decreased cilia

4.2.1. Increased likelihood of the respiratory tract to become damaged by dust and foreign material

4.3. Increased anterior-posterior chest diameter

4.3.1. Provides less movement during respirations Can cause shortness of breath

4.3.2. Can cause/be caused by air trapping

4.4. Increased airway resistance

4.4.1. Makes it more difficult to breath Can cause shortness of breath

4.5. Interventions

4.5.1. STOP SMOKING Will enhance all the effects aging has on the respiratory system Will cause different pathologies

4.5.2. Allow oneself to take breaks while doing tasks s Helps one not get short of breath Helps decrease fatigue Try to break up errands throughout the day vs. doing them all at once

4.5.3. Chew food thoroughly Listen for a hoarse voice May be indicator of aspiration

4.5.4. Watch for signs of cyanosis Blue lips Blue gums Blue fingertips

4.6. Asthma

4.6.1. Can develop in older years

4.6.2. Increase risks of different illnesses Bronchiectasis Cardiac problems

4.6.3. High mortality rates

4.6.4. Interventions Evaluate nebulizer use

4.6.5. Precaution Avoid adverse side effects with medications

4.7. Chronic bronchitis

4.7.1. Symptoms Wheezing Cough Persistent Productive Shortness of breath

4.7.2. Increase risk for respiratory infections

4.7.3. Management Remove bronchiole secretions Prevent obstruction of airways Maintain adequate food intake

4.7.4. Inflammation of the lining of the bronchiole tubes

5. Cardiovascular

5.1. Blood vessels

5.1.1. Thickening of blood vessel walls

5.1.2. Blood vessel lumen narrows

5.1.3. Loss of some of the elasticity in the blood vessels

5.1.4. Efficiency of venous valves decrease

5.1.5. Interventions Diet Low fat diet Exercise Aerobic exercise

5.2. Circulation

5.2.1. Lower cardiac output Makes it harder to supply nutrients and oxygen all over the body

5.2.2. Decreased in the sensitivity of the baroreceptors

5.2.3. Increase in pulmonary vascular tension

5.2.4. Increased systolic blood pressure

5.2.5. Decreased peripheral circulation Makes it harder for oxygen and nutrients to get to body cells

5.2.6. Interventions Compression stockings Help improve venous return Help prevent blood clots

5.3. Heart muscle

5.3.1. Heart muscle fibers decrease

5.4. Heart valves

5.4.1. Decreased elasticity of heart valves

5.4.2. Calcification of heart valves

5.5. Congestive heart failure

5.5.1. Incidence increases with age

5.5.2. Leading cause of hospitalization

5.5.3. Causes Atherosclerosis Coronary artery disease

5.5.4. Symptoms Shortness of breath Dyspnea on exertion Confusion Insomnia Wandering during the night Agitation Depression Orthopnea Wheezing Weight gain Edema

5.6. Peripheral vascular disease

5.6.1. Atherosclerosis Very common among older adults

5.6.2. Affects smaller vessels that are furthest from the heart

5.6.3. Diagnosis Arteriography Radiography Oscillometric testing

5.6.4. Treatment Warmth Exercise Vasodilators

6. Neurological

6.1. Nerves

6.1.1. Degeneration of nerve cells

6.1.2. Decrease in the rate nerves conduct impulses

6.2. Neurotransmitters

6.2.1. Neurotransmitters decreases

6.3. Fallacy

6.3.1. Age causes memory loss FALSE Memory loss is not a part of aging but a part a pathological disease like Dementia or Alzheimer’s

6.4. Dementia

6.4.1. Irreversible

6.4.2. Progressive

6.4.3. Impairment in cognition Memory affected Orientation affected Reasoning affected Attention affected Language affected Problem solving affected

6.4.4. Cause Damage to brain

6.4.5. Incidence 4.5 million older adults affected

6.4.6. Types of Dementia Alzheimer’s disease Vascular Dementia Lewy body Dementia Frontotemporal dementia Wernicke encephalopathy

7. Sensory

7.1. Eyes

7.1.1. Decreased accommodation Near vision Far vision

7.1.2. Harder to adjust eyes to light to dark

7.1.3. Lenses yellow

7.1.4. Color perception starts to become altered

7.1.5. Eyes become more sensitive to glare

7.1.6. Pupils become smaller

7.1.7. Interventions Wear sunglasses Helps eyes not need to adjust to sunlight as much Helps eye avoid glares Use night light Help elderly see during the dark Help avoid falls

7.2. Ears

7.2.1. Harder to hear high-frequency sounds

7.2.2. Tympanic membrane thickens

7.2.3. Sclerosis of inner

7.2.4. Interventions Avoid loud sounds Boom boxes Loud earphones Consider hearing aids Help with hearing Fallacy

7.3. Taste

7.3.1. Taste is diminished

7.3.2. Fewer taste buds

7.3.3. Interventions Try to promote eating Rationale: helps elderly receive adequate nutrition Season food well Give elderly food they enjoy

7.4. Smell

7.4.1. Diminished smell

7.5. Touch

7.5.1. Skin receptors decrease

7.5.2. Interventions Promote safety Make sure space heaters automatically turn off Make sure home environment is safe, including hot surfaces

7.6. Proprioception

7.6.1. Body position awareness decreases

7.7. Glaucoma

7.7.1. Damage to the ocular nerve caused by an above normal intraocular pressure

7.7.2. Second leading cause of blindness

7.7.3. Symptoms Blurred vision Distorted vision Vision loss

7.7.4. Treatments Laser surgery Beta blockers Trabeculoplasty

7.7.5. Acute Closed or narrow angle Treat early or blindness will occur

7.7.6. Chronic Open angle

7.7.7. Avoid situations that increase IOP Stress Overuse of eyes

7.8. Detached retina

7.8.1. Forward displacement of retina

7.8.2. Need for prompt treatment Avoid further damage Avoid blindness

7.8.3. Symptoms Can be gradual or sudden Redness Blurred vision Seeing flashes of light

8. Genitourinary

8.1. Both genders

8.1.1. Decrease in the amount of nephrons Blood is not filtered as well Increase risk of medication toxicity Medication takes longer to get out of the system of the elderly Half life gets lengthened Interventions Give small doses of medication first and then work your way up Pain medication

8.1.2. Decrease in renal blood flow

8.1.3. Decrease in bladder capacity Can cause urgency Can cause frequency

8.2. Male

8.2.1. Prostate enlarges Can cause feelings of urgency Can cause feelings of frequency Can increase risk of urinary retention Interventions Rule out a urinary tract infection Do a bladder scan to catch urinary retention early

8.3. Female

8.3.1. Tone in urinary sphincter decreases

8.4. Fallacy

8.4.1. “All older adults urinate on themselves.” False Incontinence is not a normal change of aging, it is a symptom of a pathological disease

8.5. Bladder cancer

8.5.1. Risk factors Smoking Chemicals Textile chemicals Rubber chemicals Dye chemicals

8.5.2. Symptoms The number one symptom is blood in urine

8.5.3. Treatments Chemotherapy Surgery Radiation Urinary diversion Ureterostomy

8.6. Glomerulonephritis

8.6.1. Inflammation of the glomeruli

8.6.2. Can be acute or chronic

8.6.3. Diet Low salt Low potassium Low protein

8.6.4. Symptoms Pink urine Foamy urine High blood pressure Edema

8.6.5. Causes Infection Bacterial endocarditis Post-streptococcal glomerulonephritis Immune diseases Lupus Goodpasture’s syndrome

9. Reproductive

9.1. Male

9.1.1. Diminished sperm count

9.1.2. Testes atrophy

9.1.3. Erections develop slower STILL CAN ACHIEVE AN ERECTION Just takes a longer time and the erection is less firm

9.1.4. Interventions If patient cannot receive an election the physician should be notified This is not a normal change of aging Give oneself a testicular exam every day

9.2. Female

9.2.1. Decreased estrogen May need to use estrogen replacement Debatable form of treatment

9.2.2. Atrophy of ovaries

9.2.3. Atrophy of vagina

9.2.4. Atrophy of uterus

9.2.5. Breast become saggier Interventions Monitor for low self-esteem about body image

9.2.6. Decreased amount of secretions Could increase risk of painful sexual untercourse

9.2.7. Interventions Get a mammogram yearly For women age 40 and over Give oneself a thorough breast exam every day

9.3. Fallacy

9.3.1. “Older adults cannot have sex” False Older can and do have sex Older adults can and do enjoy sex

9.4. Tumors of the vulva

9.4.1. Forth most common gynecological malignancy of later life

9.4.2. Diagnosis Biopsy Early treatment improve prognosis

9.4.3. Most often in the labia majora

9.5. Cancer of the endometrium

9.5.1. Not uncommon in older women

9.5.2. Signs and symptoms Postmenopausal bleeding

9.5.3. Diagnosis Biopsy

10. Endocrine

10.1. Ability to respond to stress decreases

10.2. Thyroid

10.2.1. Decreased release of hormones Decreased metabolism Increased likelihood of fatigue

10.3. Cortisol

10.3.1. Increased release of cortisol Increased inflammation

10.4. Glucocorticoids

10.4.1. Increase release of glucocorticoids Increased inflammation

10.5. Pancreas

10.5.1. Decreased release of hormones Increased insulin resistance Interventions

10.5.2. Decreased release of enzymes

10.6. Diabetes mellitus

10.6.1. 7th leading cause of death in older adults

10.6.2. Glucose intolerance

10.6.3. Screenings Fasting blood sugar tested every three years for adults 45 and older More than one test should be taken to avoid false-positive

10.6.4. Diagnosis Random blood glucose test over 200 mg/dL Fasting blood glucose over 126 mg/dL Oral glucose over 200 mg/dL

10.6.5. Management Weight loss If necessary Nutrition Exercise

10.6.6. Patient monitoring Able to handle a syringe and a vial of insulin Demonstrate competency of finger-prick technique Able to recognize signs and symptoms of hypoglycemia and hyperglycemia

10.6.7. Medications Insulin Oral antidiabetic drugs

11. Immune system

11.1. Thymus involution

11.1.1. Effects the development of T cells

11.2. T-cell function decreases

11.2.1. Decreased immunity

11.3. Interventions

11.3.1. Monitor for signs of infection Keep in mind delirium can be a sign of infection in older adults Older adults are more susceptible to infection

11.3.2. Food is medicine Antioxidants Help with inflammation Blueberries Strawberries Pecans Apples High protein Chicken Tofu Nuts Beans Magnesium Spinach Avocado Bananas