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. Reproductive

1.1. Normal Changes

1.1.1. . 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

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. . Pathological Changes Nursing Diagnosis Fractures Osteoporosis Osteoarthritis Rheumatoid arthritis Gout Podiatric conditions 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. . Pathological Changes Nursing Diagnosis Parkinson’s disease Transient ischemic attack 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. . 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

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

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. . 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. . Pathologic Changes 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. . Pathological Changes Nursing Diagnoses COPD Asthma Emphysema Chronic bronchitis Pnemonia Influenza 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. . Pathological Changes Nursing diagnoses: HTN CHF Hypotension Pulmonary embolism CAD MI/ angina Hyperlipedemia Arrhythmia A fib PVD Arteriosclerosis Aneurysm Varicose veins 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. . 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

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. . Pathologic Changes Nursing Diagnosis UTI Urinary incontinence Bladder cancer Renal calculi 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. . Pathological Changes Nursing diagnoses Diabetes Hypothyroidism Hyperthyroidism 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