1. Reproductive systems
1.1. Men
1.1.1. Reduced sperm count
1.1.2. Fluid retaining capacity of seminal vesicles decreases
1.1.3. Enlarged prostate
1.1.4. Decrease in testosterone
1.1.5. Increase in LH and FSH
1.1.6. Atrophy of testes
1.1.7. Orgasm and ejaculation are less intense
1.2. Women
1.2.1. Atrophy of the vulva
1.2.1.1. Hormonal changes
1.2.2. Loss of hair and subcutaneous fat
1.2.3. Loss of elastic tissue in vagina
1.2.3.1. Vagina is pink, dry and a vascular
1.2.4. Flora changes and decrease in secretions
1.2.4.1. Vagina becomes more alkaline
1.2.5. Not palpable
1.2.5.1. Ovaries shrink
1.2.6. Decrease in estrogen
1.3. BPH
1.3.1. Pathophysiology
1.3.1.1. Idiopathic
1.3.1.1.1. Could be due to lower testosterone levels and higher proportion of estrogen
1.3.2. Signs and symptoms
1.3.2.1. Frequent urination
1.3.2.2. Urgency
1.3.2.3. Retention
1.3.2.4. Incontinence
1.3.2.5. Urine with a foul odor
1.3.2.6. Nocturia
1.3.2.7. Dribbling after urination
1.3.3. Prevalemce
1.3.3.1. 3/4 of men 65 or older have some degree of BPH
1.3.3.2. Effects 90% of men 80 and older
1.3.4. Diagnostics
1.3.4.1. Medical hx
1.3.4.2. Physical exam
1.3.4.3. Urinalysis
1.3.4.4. PSA blood test
1.3.5. Interventions
1.3.5.1. Void often
1.3.5.2. Drink fluids
1.3.5.3. Sits baths
1.3.6. Medications
1.3.6.1. Alpha blockers
1.3.6.2. Finasteride
1.3.6.3. Silodosin
2. Musculoskeletal systems
2.1. Muscle fibers atrophy
2.1.1. Fibrous tissue replaces muscle tissue
2.2. Muscle mass and strength decreases
2.3. Vertebrae shortens
2.4. Bones become brittle
2.5. Bone mass decreases
2.6. Kyphosis may occur
2.7. Decreased flexion and extension
2.7.1. Less flexibility
2.8. Osteoporosis
2.8.1. Pathophysiology
2.8.1.1. Osteoclasts break down bone faster than osteoclasts build bone
2.8.1.1.1. Bone mass decreases
2.8.2. Signs and symptoms
2.8.2.1. Bone fractures
2.8.2.2. Loss of height
2.8.2.3. Back pain
2.8.2.4. Bad posture
2.8.3. Prevalence
2.8.3.1. Higher in women
2.8.4. Diagnostics
2.8.4.1. DEXA scan
2.8.4.2. Bone x-Ray
2.8.4.3. CT or MRI scan
2.8.5. Interventions
2.8.5.1. Smoking and alcohol cessation
2.8.5.2. Physical activity
2.8.5.3. Increase calcium intake
2.8.5.4. Balanced and healthy diet
2.8.6. Medication
2.8.6.1. Antacids
2.8.6.2. Bisphosphonates
2.8.6.3. Hormone therapy
3. Nervous system
3.1. Decrease in blood flow to the brain
3.1.1. Reduction in glucose use and metabolic rate of oxygen
3.2. Decrease in neurons and nerve fibers
3.3. Decrease in nerve conduction velocity
3.3.1. Slower reflexes and delayed responses
3.4. Balance declines
3.4.1. Falls
3.5. Decrease in nerve reinnervation of injured nerves
3.5.1. Slow response to stimuli
3.6. Hypothalamus regulates temperature less efficiently
3.7. Brain cells decline
3.8. Sleep wake cycle is acfected and sleep regulation is altered
3.8.1. Stages III and IV become less prominent
3.8.1.1. Phase advance
3.9. Dementia
3.9.1. Pathophysiology
3.9.1.1. Impairment of at least two brain functions
3.9.1.1.1. Irreversible and progressive
3.9.2. Signs and symptoms
3.9.2.1. Memory loss
3.9.2.2. Confusion and disorientation
3.9.2.3. Anxiety
3.9.2.4. Jumbled speech
3.9.2.5. Personality changes
3.9.3. Prevalence
3.9.3.1. 4.5 million adults are affected
3.9.4. Diagnostics
3.9.4.1. Medical hx
3.9.4.2. Day to day function
3.9.4.3. Memory tests
3.9.5. Interventions
3.9.5.1. Patient safety
3.9.5.2. Controlled environment
3.9.5.3. Items that trigger memory
3.9.5.4. Therapy and activity
3.9.6. Medication
3.9.6.1. Cholinesterase inhibitors
4. Sensory organs
4.1. Sight
4.1.1. Decreased pupil size
4.1.2. Presbyopia
4.1.2.1. Stiffening of muscle fibers
4.1.2.2. Can’t focus on close objects or adapt to light
4.2. Smell
4.2.1. Impaired ability to identify odors
4.2.1.1. Decrease in sensory cells
4.3. Taste
4.3.1. Taste impairment
4.3.1.1. Use Seasoning!
4.3.2. Atrophy of tongue
4.3.3. Reduced saliva production
4.4. Touch
4.4.1. Decrease in tactile sensation
4.5. Hearing
4.5.1. Presbycusis
4.5.1.1. Loss of hair cells
4.5.1.2. Decreased blood supply
4.5.2. Increased cerumen
5. Immune system
5.1. Depressed immune response
5.1.1. Increase in infections
5.2. T cell activity decline
5.2.1. Immature T cells
5.3. Inflammatory response decreases
5.3.1. Minimal pain
5.3.2. Low grade fever
5.4. Interventions
5.4.1. Exercise
5.4.2. Multivitamin
5.4.3. Healthy diet
6. Endocrine system
6.1. Decreased thyroid activity
6.1.1. Thyroid atrophies
6.1.2. Reduction of T3
6.2. Decreased adrenal gland activity
6.2.1. ACTH is decreased
6.2.2. Less aldosterone is produced
6.2.3. Estrogen and progesterone is reduced
6.3. Pituitary gland decreases in volume
6.3.1. Gonadal secretion decreases
6.3.2. FSH, LH decreases
6.4. Insufficient and delayed insulin release
6.4.1. Decreased tissue sensitivity to insulin
6.4.2. Higher blood glucose levels
6.5. Hypothyroidism
6.5.1. Fibrosis of thyroid gland
6.5.1.1. Lower basal metabolic rate
6.5.1.1.1. Reduced radioactive iodine uptake
6.5.2. Increased nodulars
6.5.3. Signs and symptoms
6.5.3.1. Fatigue
6.5.3.2. Constipation
6.5.3.3. Dry skin
6.5.3.4. Weight gain
6.5.3.5. Cold intolerance
6.5.4. Prevalence
6.5.4.1. Common with older age
6.5.5. Diagnostics
6.5.5.1. Blood tests
6.5.5.2. Analyzing symptoms
6.5.6. Interventions
6.5.6.1. Manage weight
6.5.6.2. Manage appetite
6.5.6.2.1. Food with fiber
6.5.7. Medication
6.5.7.1. Levothyroxine
6.5.7.2. Hormone replacement
7. Physical appearance
7.1. Hair loss in men
7.2. Grey hair and wrinkles
7.2.1. Loss of elasticity
7.3. Bony appearance
7.4. Body fat atrophies
7.5. Double chin and baggy eyelids
7.6. Loss of subcutaneous fat
7.6.1. Decrease in skin thickness
7.6.2. More sensitive to cold temp
7.6.2.1. Risk for hypothermia
7.7. Decrease in height
7.7.1. Decrease hydration
7.7.2. Loss of cartilage and curvature of spine
7.7.2.1. Kyphosis
8. Respiratory system
8.1. Connective tissue changes
8.1.1. Relaxation of tissue
8.1.1.1. Tip of nose rotates downward
8.2. Septal deviations
8.3. Mouth breathing while sleeping
8.3.1. Snoring
8.3.2. Obstructive sleep apnea
8.4. Decreased secretions
8.4.1. Reducing ability to dilute secretions
8.4.1.1. Thicker secretions
8.5. Calcification of costal cartilage
8.5.1. Trachea and rib cage more ridge
8.5.1.1. Kyphosis
8.6. Inspiratory and expiratory muscles are weaker
8.7. More difficult to expel mucus and debris
8.8. Lungs become smaller and have less recoil
8.8.1. Harder to breathe
8.9. Exhale less efficiently
8.9.1. Increased residual volume
8.9.1.1. Vital capacity is decreased
8.10. Pneumonia
8.10.1. Pathophysiology
8.10.2. Infection caused by virus or bacteria
8.10.2.1. Causes inflamed air sacs in lungs
8.10.2.1.1. Sacs fill with fluid and pus
8.10.2.2. Cause bacteremia
8.10.2.3. Meningitis
8.10.3. Signs and symptoms
8.10.3.1. Confusion
8.10.3.2. Weakness
8.10.3.3. Chest pain
8.10.3.4. Fever and chills
8.10.4. Prevalence
8.10.4.1. 52.3 cases per 1000 people in those 85 or older
8.10.4.1.1. Mortality is increased in older adults
8.10.5. Diagnostics
8.10.5.1. Chest x-ray
8.10.5.2. CBC
8.10.6. Nursing interventions
8.10.6.1. Assess cough productivity
8.10.6.2. Observe sputum for color, odor, viscosity
8.10.6.3. Elevate head of bed
8.10.6.4. Encourage ambulation
8.10.7. Medications
8.10.7.1. Antibiotics
8.10.7.2. Penicillins
9. Gastrointestinal system
9.1. Decreased taste sensations
9.1.1. Encourage seasonings
9.2. Esophagus more dilated
9.2.1. Esophageal emptying is slower
9.3. Decrease in saliva
9.3.1. Difficult to swallow and chew
9.4. Liver decreases in size
9.5. Decrease intestinal blood flow
9.6. Decrease in stomach peristalsis and emptying time
9.7. Less acidic
9.7.1. Less production of enzymes
9.8. Less cells on absorbing surface of intestines
9.9. Colorectal cancer
9.9.1. Pathophysiology
9.9.1.1. Malignant tumors develop
9.9.1.1.1. Common sites are sigmoid colon and rectum
9.9.2. Signs and symptoms
9.9.2.1. Rectal bleeding
9.9.2.1.1. Bloody stool
9.9.2.2. Changes in bowel patterns
9.9.2.3. Nausea
9.9.2.4. Abdominal discomfort
9.9.2.5. Unexplained weight loss
9.9.2.6. Anemia
9.9.3. Prevalence
9.9.3.1. Common with advancing age
9.9.3.2. Third most common cancer for adults
9.9.4. Diagnostics
9.9.4.1. Annual stool occult
9.9.4.2. Digital rectal exam
9.9.4.3. Colonoscopy every 10 years
9.9.5. Interventions
9.9.5.1. Assess and treat pain
9.9.5.2. Provide support group resources
9.9.5.3. Surgery
9.9.6. Medication
9.9.6.1. Chemotherapeutic agents
10. Cardiovascular system
10.1. Left ventricular hypertrophy
10.2. Valves become thick and rigid
10.2.1. Fibrosis of blood vessels
10.2.1.1. Lipid accumulation in vessels
10.3. CO decreases
10.4. Resistance to peripheral blood flow
10.5. BP increases
10.6. SV decreases
10.7. Decreased elasticity of arteries
10.7.1. Vascular changes to heart and kidney
10.8. Congestive heart failure
10.8.1. Pathophysiology
10.8.1.1. Coronary artery disease
10.8.1.1.1. Heart becomes weak and stiff
10.8.1.2. Hypertension
10.8.2. Signs and symptoms
10.8.2.1. SOB
10.8.2.2. Fatigue
10.8.2.3. Arrhythmias
10.8.2.4. Cough/ wheezing
10.8.2.5. Edema in extremities
10.8.3. Prevalence
10.8.3.1. I’m people age 75 or older! Occurs 10 times more often than in younger adults
10.8.4. Diagnostics
10.8.4.1. Medical and family hx
10.8.4.2. CBC or thyroid tests
10.8.4.3. Metabolic tests
10.8.5. Interventions
10.8.5.1. Control salt intake
10.8.5.2. Limit water retention
10.8.5.3. Smoking cessation
10.8.6. Medications
10.8.6.1. Diuretics
10.8.6.2. ACE inhibitors
10.8.6.3. Vasodilators
11. Urinary system
11.1. Decreased size of renal mass
11.1.1. Atherosclerosis can cause atrophy
11.2. Decreased tubular function
11.3. Weak bladder muscles
11.3.1. Difficult to empty bladder
11.3.1.1. Retention of urine
11.4. GFR decreases
11.4.1. Reduces renal blood flow
11.5. Less ability to conserve sodium
11.5.1. Hyponatremia
11.6. UTI
11.6.1. Pathophysiology
11.6.1.1. E. coli in urethra
11.6.1.1.1. Bacteria proliferates
11.6.2. Signs and symptoms
11.6.2.1. Cloudy urine
11.6.2.2. Bloody urine
11.6.2.3. Frequent urination
11.6.2.4. Pressure and pain in pelvis and when urinating
11.6.2.5. Strong smelling odor
11.6.2.6. Hallucinations
11.6.2.7. Agitation and confusion
11.6.3. Prevalence
11.6.3.1. Increase in UTIs with older age
11.6.4. Diagnostics
11.6.4.1. Urinalysis
11.6.5. Interventions
11.6.5.1. Drink fluids
11.6.5.2. Avoid caffeine
11.6.5.3. Wipe from front to back for women
11.6.5.4. Change wet incontinence pads right away
11.6.6. Medications
11.6.6.1. Antibiotics
11.6.6.2. IV antibiotics
12. Personality
12.1. Consistent with early years
12.2. Changes may be due to events that alter attitude
12.3. Long-term memory can be slowed
12.3.1. Use of memory aids