Changes in the Older Adult Client: Morgan Radcliff
by Morgan morgannradcliff
1. Respiratory
1.1. Normal Changes
1.1.1. .
1.1.1.1. Pathological Changes
1.1.1.1.1. Nursing Diagnoses
1.1.1.2. COPD
1.1.1.2.1. Asthma
1.1.1.2.2. Emphysema
1.1.1.2.3. Chronic bronchitis
1.1.1.3. Pnemonia
1.1.1.4. Influenza
1.1.1.5. 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. .
2.1.1.1. Pathological Changes
2.1.1.1.1. Nursing diagnoses:
2.1.1.2. HTN
2.1.1.3. CHF
2.1.1.4. Hypotension
2.1.1.5. Pulmonary embolism
2.1.1.6. CAD
2.1.1.7. MI/ angina
2.1.1.8. Hyperlipedemia
2.1.1.9. Arrhythmia
2.1.1.9.1. A fib
2.1.1.10. PVD
2.1.1.11. Arteriosclerosis
2.1.1.12. Aneurysm
2.1.1.13. Varicose veins
2.1.1.14. 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. .
3.1.1.1. Pathologic Changes
3.1.1.1.1. Nursing Diagnosis
3.1.1.2. Xerostomia
3.1.1.3. Periodontal disease
3.1.1.4. Dysphagia
3.1.1.5. Hiatal hernia
3.1.1.6. Esophageal cancer
3.1.1.7. PUD
3.1.1.8. Cancer of stomach
3.1.1.9. Diverticulitis
3.1.1.10. Colorectal disease/ cancer
3.1.1.11. Chronic constipation/ flatulence
3.1.1.12. Intestinal obstruction
3.1.1.13. Fecal impaction
3.1.1.14. Fecal incontinence
3.1.1.15. Acute appendicitis
3.1.1.16. Cancer of pancreas
3.1.1.17. 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. .
4.1.1.1. Pathologic Changes
4.1.1.1.1. Nursing Diagnosis
4.1.1.2. UTI
4.1.1.3. Urinary incontinence
4.1.1.4. Bladder cancer
4.1.1.5. Renal calculi
4.1.1.6. 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. .
5.1.1.1. Pathologic Changes
5.1.1.1.1. Nursing Diagnosis (men)
5.1.1.1.2. Nursing Diagnosis (women)
5.1.1.2. M-erectile dysfunction
5.1.1.3. M- Benign prostatic hyperplasia
5.1.1.4. M- cancer of the prostate
5.1.1.5. M- tumors of the penis, testes, & scrotum
5.1.1.6. F- infections & tumors of the vulva
5.1.1.7. F- vaginitis
5.1.1.8. F- cancer of the vagina
5.1.1.9. F- problems of the cervix (including cancer)
5.1.1.10. F- cancer of endometrium, overuse
5.1.1.11. 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. .
6.1.1.1. Pathological Changes
6.1.1.1.1. Nursing Diagnosis
6.1.1.2. Fractures
6.1.1.3. Osteoporosis
6.1.1.4. Osteoarthritis
6.1.1.5. Rheumatoid arthritis
6.1.1.6. Gout
6.1.1.7. Podiatric conditions
6.1.1.8. 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. .
7.1.1.1. Pathological Changes
7.1.1.1.1. Nursing Diagnosis
7.1.1.2. Parkinson’s disease
7.1.1.3. Transient ischemic attack
7.1.1.4. 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. .
8.1.1.1. Pathologic Changes
8.1.1.1.1. Nursing diagnoses
8.1.1.2. Touch: dyskinesia, bradykinesia, circulatory problems
8.1.1.3. Smell: anosmia, hyposmia, nervous system changes affect smell, nasal polyps, exposure to chemo and radiation.
8.1.1.4. Sight:cataracts and glaucoma, macular degeneration, detached retina, corneal ulceration
8.1.1.5. Hearing: hearing loss
8.1.1.6. 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. .
9.1.1.1. Pathological Changes
9.1.1.1.1. Nursing diagnoses
9.1.1.2. Diabetes
9.1.1.3. Hypothyroidism
9.1.1.4. Hyperthyroidism
9.1.1.5. 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. .
10.1.1.1. Pathologic Changes
10.1.1.1.1. Nursing Diagnosis
10.1.1.2. Pruritus
10.1.1.3. Keratosis seborrheic
10.1.1.4. Skin cancer
10.1.1.5. Vascular lesions
10.1.1.6. 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. .
11.1.1.1. Pathologic Changes
11.1.1.1.1. Risk for infection related to immunosuppression.
11.1.1.1.2. Risk for impaired mobility related to Guillan Barre syndrome
11.1.1.2. Cancer- lymphoma
11.1.1.3. Crohn’s disease
11.1.1.4. Diabetes type 1
11.1.1.5. Lupus
11.1.1.6. Leukemia
11.1.1.7. IBD
11.1.1.8. Rheumatoid arthritis
11.1.1.9. MS
11.1.1.10. 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. .
12.1.1.1. 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. .
13.1.1.1. Pathologic Changes
13.1.1.2. Malignant neoplasms of the skin leading to altered