Changes in the Older Adult Client: Morgan Radcliff

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Changes in the Older Adult Client: Morgan Radcliff by Mind Map: Changes in the Older Adult Client: Morgan Radcliff

1. Respiratory

1.1. Normal Changes

1.1.1. . Pathological Changes Nursing Diagnoses COPD Asthma Emphysema Chronic bronchitis Pnemonia Influenza Lung cancer

1.2. PO2 reduced as much as 15% between 20-80 yrs old

1.3. Loss of elasticity and increased rigidity

1.4. Decreased ciliary action

1.5. Exploratory volume reduced

1.6. Blunting cough and reflexes

1.7. 90 years old= 50% increase in residual capacity

1.8. Fewer and larger alveoli

1.9. Rigid thoracic muscles, reduced basilar inflation

2. Cardiovascular

2.1. Normal Changes

2.1.1. . Pathological Changes Nursing diagnoses: HTN CHF Hypotension Pulmonary embolism CAD MI/ angina Hyperlipedemia Arrhythmia A fib PVD Arteriosclerosis Aneurysm Varicose veins Venous thromboembolism

2.2. Prominent arteries in head, neck, and extremities

2.3. Valves become thicker & more rigid

2.4. SV decreases by 1% q year

2.5. Less efficient O2 utilization

2.6. Aorta becomes dilated & elongated

2.7. CO decreases

2.8. BP increases to compensate for increased peripheral resistance and decreased CO

2.9. Less elasticity of vessels

3. Gastrointestinal

3.1. Normal Changes

3.1.1. . Pathologic Changes Nursing Diagnosis Xerostomia Periodontal disease Dysphagia Hiatal hernia Esophageal cancer PUD Cancer of stomach Diverticulitis Colorectal disease/ cancer Chronic constipation/ flatulence Intestinal obstruction Fecal impaction Fecal incontinence Acute appendicitis Cancer of pancreas Biliary tract disease

3.2. Decrease taste

3.3. Dilated esophagus

3.4. Reduced saliva

3.5. Liver smaller in size

3.6. Reduced intestinal blood flow

3.7. Decreased esophageal motility

3.8. Atrophy of gastric mucosa

3.9. Decreased stomach motility, hunger contractions, and emptying time

3.10. Less production of Hcl acid, pepsin, lipase, & pancreatic enzymes

3.11. Fewer cells on absorbing surface, slower peristalsis

4. Urinary

4.1. Normal Changes

4.1.1. . Pathologic Changes Nursing Diagnosis UTI Urinary incontinence Bladder cancer Renal calculi Gomerulonephritis

4.2. Decrease renal mass

4.3. Decreased tubular function

4.4. Decreased bladder capacity

4.5. Decrease in nephrons

4.6. Between ages 20 & 90, renal blood flow decreases, GFR decreases

4.7. Weaker bladder muscles

5. Reproductive

5.1. Normal Changes

5.1.1. . Pathologic Changes Nursing Diagnosis (men) Nursing Diagnosis (women) M-erectile dysfunction M- Benign prostatic hyperplasia M- cancer of the prostate M- tumors of the penis, testes, & scrotum F- infections & tumors of the vulva F- vaginitis F- cancer of the vagina F- problems of the cervix (including cancer) F- cancer of endometrium, overuse F- perineal herniation

5.2. M-fluid retaining capacity of seminal vesicles reduces

5.3. M- possible reduction in sperm count

5.4. M- venous and arterial sclerosis of penis

5.5. M- prostate enlargement

5.6. F- Fallopian tubes atrophy and shorten

5.7. F- ovaries become thicker & smaller

5.8. F- cervix becomes smaller

5.9. F- drier less elastic vaginal canal

5.10. F- flattening labia

5.11. F- endocervical epithelium atrophied

5.12. F- uterus becomes smaller

5.13. F- endometrium atrophies

5.14. F- more alkaline vaginal environment

5.15. F- loss of vulvar subcutaneous fat and hair

6. Musculoskeletal

6.1. Normal Changes

6.1.1. . Pathological Changes Nursing Diagnosis Fractures Osteoporosis Osteoarthritis Rheumatoid arthritis Gout Podiatric conditions New Topic

6.2. Shortening of vertebrae

6.3. Height decreases by 2 in. Between 20-70

6.4. Brittle bones

6.5. Slight knee flex ion

6.6. Slight kyphosis

6.7. Slight hip flexion

6.8. Slight wrist flexion

6.9. Impaired flexion & extension movements

7. Nervous

7.1. Normal Changes

7.1.1. . Pathological Changes Nursing Diagnosis Parkinson’s disease Transient ischemic attack Stroke

7.2. Decreased conduction velocity

7.3. Slower response & reaction time

7.4. Decreased brain weight

7.5. Reduced blood flow to brain

7.6. Changes in sleep pattern

8. Sensory

8.1. Normal Changes

8.1.1. . Pathologic Changes Nursing diagnoses Touch: dyskinesia, bradykinesia, circulatory problems Smell: anosmia, hyposmia, nervous system changes affect smell, nasal polyps, exposure to chemo and radiation. Sight:cataracts and glaucoma, macular degeneration, detached retina, corneal ulceration Hearing: hearing loss Taste: xerostomia, cancer of the mouth

8.2. Touch: reduction of tactile sensation

8.3. Taste: taste impairment

8.4. Smell: impaired ability to identify and discriminate among odors

8.5. Sight: more opaque lens, decrease pupil size, more spherical cornea

8.6. Hearing: atrophy of hair cells, tympanic membrane sclerosis & atrophy, increase cerumen and concentration of keratin

9. Endocrine

9.1. Normal Changes

9.1.1. . Pathological Changes Nursing diagnoses Diabetes Hypothyroidism Hyperthyroidism Adrenal insufficiency

9.2. Thyroid gland fibrosis, cellular infiltration, increased nodularity

9.3. Lower BMR

9.4. Less thyrotropin

9.5. Total serum iodine is reduced

9.6. Adrenal gland function decreases, less ACTH

9.7. Pituitary gland decreases in volume by 20%

9.8. Decrease TSH, FSH, LH.

9.9. Decrease testosterone, estrogen, progesterone

9.10. Delay/ insufficient release of beta cells by pancreas

9.11. Decrease tissue sensitivity to circulating insulin

9.12. Metabolism of glucose is reduced

10. Integumentary

10.1. Normal Changes

10.1.1. . Pathologic Changes Nursing Diagnosis Pruritus Keratosis seborrheic Skin cancer Vascular lesions Pressure injury

10.2. Flattening of the dermal-epidermal junction

10.3. Degeneration of elastin fibers

10.4. Subcutaneous fat loss

10.5. Reduction of melanocytes

10.6. Skin infections and malignant neoplasms

10.7. Scalp, pubic, and axillary hair thins and grays

10.8. Fragile fingernails and decreased growth

10.9. Females may grow facial hair

10.10. Males increase growth in ear, eyebrow, and nostril hair

10.11. Reduction in perspiration

11. Immune

11.1. Normal Changes

11.1.1. . Pathologic Changes Risk for infection related to immunosuppression. Risk for impaired mobility related to Guillan Barre syndrome Cancer- lymphoma Crohn’s disease Diabetes type 1 Lupus Leukemia IBD Rheumatoid arthritis MS Guillain- Barre

11.2. Depressed immune system

11.3. Increase risk infection

11.4. T cell decreases

11.5. Inflammatory defenses decline

11.6. Improper nutrition r/t negative changes

12. Thermal regulation

12.1. Normal Changes

12.1.1. . Pathologic Changes

12.2. Lower body temperatures, 96.9-98.3 F.

12.3. Insufficient vasoconstriction & reduced peripheral circulation

12.4. Decreased CO

12.5. Diminished shivering

12.6. Reduced muscle mass and subcutaneous tissue

12.7. Impaired sweating

13. Physical Appearance

13.1. Normal Changes

13.1.1. . Pathologic Changes Malignant neoplasms of the skin leading to altered

13.2. Elongated ears

13.3. Argus senilis

13.4. Less muscle mass and skin fold thickness

13.5. Decreased height

13.6. Thicker hair in ears & nose

13.7. Darkening & wrinkling of skin around eyes

13.8. Deepening hollows of axillae

13.9. Narrow gait women wider gait men

13.10. Ectropion of eyelids

13.11. Graying & thinning hair