Changes in the Older Adult Client: Morgan Radcliff

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

1. Reproductive

1.1. Normal Changes

1.1.1. .

1.1.1.1. Pathologic Changes

1.1.1.1.1. Nursing Diagnosis (men)

1.1.1.1.2. Nursing Diagnosis (women)

1.1.1.2. M-erectile dysfunction

1.1.1.3. M- Benign prostatic hyperplasia

1.1.1.4. M- cancer of the prostate

1.1.1.5. M- tumors of the penis, testes, & scrotum

1.1.1.6. F- infections & tumors of the vulva

1.1.1.7. F- vaginitis

1.1.1.8. F- cancer of the vagina

1.1.1.9. F- problems of the cervix (including cancer)

1.1.1.10. F- cancer of endometrium, overuse

1.1.1.11. F- perineal herniation

1.2. M-fluid retaining capacity of seminal vesicles reduces

1.3. M- possible reduction in sperm count

1.4. M- venous and arterial sclerosis of penis

1.5. M- prostate enlargement

1.6. F- Fallopian tubes atrophy and shorten

1.7. F- ovaries become thicker & smaller

1.8. F- cervix becomes smaller

1.9. F- drier less elastic vaginal canal

1.10. F- flattening labia

1.11. F- endocervical epithelium atrophied

1.12. F- uterus becomes smaller

1.13. F- endometrium atrophies

1.14. F- more alkaline vaginal environment

1.15. F- loss of vulvar subcutaneous fat and hair

2. Musculoskeletal

2.1. Normal Changes

2.1.1. .

2.1.1.1. Pathological Changes

2.1.1.1.1. Nursing Diagnosis

2.1.1.2. Fractures

2.1.1.3. Osteoporosis

2.1.1.4. Osteoarthritis

2.1.1.5. Rheumatoid arthritis

2.1.1.6. Gout

2.1.1.7. Podiatric conditions

2.1.1.8. New Topic

2.2. Shortening of vertebrae

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

2.4. Brittle bones

2.5. Slight knee flex ion

2.6. Slight kyphosis

2.7. Slight hip flexion

2.8. Slight wrist flexion

2.9. Impaired flexion & extension movements

3. Nervous

3.1. Normal Changes

3.1.1. .

3.1.1.1. Pathological Changes

3.1.1.1.1. Nursing Diagnosis

3.1.1.2. Parkinson’s disease

3.1.1.3. Transient ischemic attack

3.1.1.4. Stroke

3.2. Decreased conduction velocity

3.3. Slower response & reaction time

3.4. Decreased brain weight

3.5. Reduced blood flow to brain

3.6. Changes in sleep pattern

4. Sensory

4.1. Normal Changes

4.1.1. .

4.1.1.1. Pathologic Changes

4.1.1.1.1. Nursing diagnoses

4.1.1.2. Touch: dyskinesia, bradykinesia, circulatory problems

4.1.1.3. Smell: anosmia, hyposmia, nervous system changes affect smell, nasal polyps, exposure to chemo and radiation.

4.1.1.4. Sight:cataracts and glaucoma, macular degeneration, detached retina, corneal ulceration

4.1.1.5. Hearing: hearing loss

4.1.1.6. Taste: xerostomia, cancer of the mouth

4.2. Touch: reduction of tactile sensation

4.3. Taste: taste impairment

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

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

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

5. Integumentary

5.1. Normal Changes

5.1.1. .

5.1.1.1. Pathologic Changes

5.1.1.1.1. Nursing Diagnosis

5.1.1.2. Pruritus

5.1.1.3. Keratosis seborrheic

5.1.1.4. Skin cancer

5.1.1.5. Vascular lesions

5.1.1.6. Pressure injury

5.2. Flattening of the dermal-epidermal junction

5.3. Degeneration of elastin fibers

5.4. Subcutaneous fat loss

5.5. Reduction of melanocytes

5.6. Skin infections and malignant neoplasms

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

5.8. Fragile fingernails and decreased growth

5.9. Females may grow facial hair

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

5.11. Reduction in perspiration

6. Immune

6.1. Normal Changes

6.1.1. .

6.1.1.1. Pathologic Changes

6.1.1.1.1. Risk for infection related to immunosuppression.

6.1.1.1.2. Risk for impaired mobility related to Guillan Barre syndrome

6.1.1.2. Cancer- lymphoma

6.1.1.3. Crohn’s disease

6.1.1.4. Diabetes type 1

6.1.1.5. Lupus

6.1.1.6. Leukemia

6.1.1.7. IBD

6.1.1.8. Rheumatoid arthritis

6.1.1.9. MS

6.1.1.10. Guillain- Barre

6.2. Depressed immune system

6.3. Increase risk infection

6.4. T cell decreases

6.5. Inflammatory defenses decline

6.6. Improper nutrition r/t negative changes

7. Thermal regulation

7.1. Normal Changes

7.1.1. .

7.1.1.1. Pathologic Changes

7.2. Lower body temperatures, 96.9-98.3 F.

7.3. Insufficient vasoconstriction & reduced peripheral circulation

7.4. Decreased CO

7.5. Diminished shivering

7.6. Reduced muscle mass and subcutaneous tissue

7.7. Impaired sweating

8. Physical Appearance

8.1. Normal Changes

8.1.1. .

8.1.1.1. Pathologic Changes

8.1.1.2. Malignant neoplasms of the skin leading to altered

8.2. Elongated ears

8.3. Argus senilis

8.4. Less muscle mass and skin fold thickness

8.5. Decreased height

8.6. Thicker hair in ears & nose

8.7. Darkening & wrinkling of skin around eyes

8.8. Deepening hollows of axillae

8.9. Narrow gait women wider gait men

8.10. Ectropion of eyelids

8.11. Graying & thinning hair

9. Respiratory

9.1. Normal Changes

9.1.1. .

9.1.1.1. Pathological Changes

9.1.1.1.1. Nursing Diagnoses

9.1.1.2. COPD

9.1.1.2.1. Asthma

9.1.1.2.2. Emphysema

9.1.1.2.3. Chronic bronchitis

9.1.1.3. Pnemonia

9.1.1.4. Influenza

9.1.1.5. Lung cancer

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

9.3. Loss of elasticity and increased rigidity

9.4. Decreased ciliary action

9.5. Exploratory volume reduced

9.6. Blunting cough and reflexes

9.7. 90 years old= 50% increase in residual capacity

9.8. Fewer and larger alveoli

9.9. Rigid thoracic muscles, reduced basilar inflation

10. Cardiovascular

10.1. Normal Changes

10.1.1. .

10.1.1.1. Pathological Changes

10.1.1.1.1. Nursing diagnoses:

10.1.1.2. HTN

10.1.1.3. CHF

10.1.1.4. Hypotension

10.1.1.5. Pulmonary embolism

10.1.1.6. CAD

10.1.1.7. MI/ angina

10.1.1.8. Hyperlipedemia

10.1.1.9. Arrhythmia

10.1.1.9.1. A fib

10.1.1.10. PVD

10.1.1.11. Arteriosclerosis

10.1.1.12. Aneurysm

10.1.1.13. Varicose veins

10.1.1.14. Venous thromboembolism

10.2. Prominent arteries in head, neck, and extremities

10.3. Valves become thicker & more rigid

10.4. SV decreases by 1% q year

10.5. Less efficient O2 utilization

10.6. Aorta becomes dilated & elongated

10.7. CO decreases

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

10.9. Less elasticity of vessels

11. Gastrointestinal

11.1. Normal Changes

11.1.1. .

11.1.1.1. Pathologic Changes

11.1.1.1.1. Nursing Diagnosis

11.1.1.2. Xerostomia

11.1.1.3. Periodontal disease

11.1.1.4. Dysphagia

11.1.1.5. Hiatal hernia

11.1.1.6. Esophageal cancer

11.1.1.7. PUD

11.1.1.8. Cancer of stomach

11.1.1.9. Diverticulitis

11.1.1.10. Colorectal disease/ cancer

11.1.1.11. Chronic constipation/ flatulence

11.1.1.12. Intestinal obstruction

11.1.1.13. Fecal impaction

11.1.1.14. Fecal incontinence

11.1.1.15. Acute appendicitis

11.1.1.16. Cancer of pancreas

11.1.1.17. Biliary tract disease

11.2. Decrease taste

11.3. Dilated esophagus

11.4. Reduced saliva

11.5. Liver smaller in size

11.6. Reduced intestinal blood flow

11.7. Decreased esophageal motility

11.8. Atrophy of gastric mucosa

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

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

11.11. Fewer cells on absorbing surface, slower peristalsis

12. Urinary

12.1. Normal Changes

12.1.1. .

12.1.1.1. Pathologic Changes

12.1.1.1.1. Nursing Diagnosis

12.1.1.2. UTI

12.1.1.3. Urinary incontinence

12.1.1.4. Bladder cancer

12.1.1.5. Renal calculi

12.1.1.6. Gomerulonephritis

12.2. Decrease renal mass

12.3. Decreased tubular function

12.4. Decreased bladder capacity

12.5. Decrease in nephrons

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

12.7. Weaker bladder muscles

13. Endocrine

13.1. Normal Changes

13.1.1. .

13.1.1.1. Pathological Changes

13.1.1.1.1. Nursing diagnoses

13.1.1.2. Diabetes

13.1.1.3. Hypothyroidism

13.1.1.4. Hyperthyroidism

13.1.1.5. Adrenal insufficiency

13.2. Thyroid gland fibrosis, cellular infiltration, increased nodularity

13.3. Lower BMR

13.4. Less thyrotropin

13.5. Total serum iodine is reduced

13.6. Adrenal gland function decreases, less ACTH

13.7. Pituitary gland decreases in volume by 20%

13.8. Decrease TSH, FSH, LH.

13.9. Decrease testosterone, estrogen, progesterone

13.10. Delay/ insufficient release of beta cells by pancreas

13.11. Decrease tissue sensitivity to circulating insulin

13.12. Metabolism of glucose is reduced