1. Physical appearance
1.1. Hair loss in men
1.2. Grey hair and wrinkles
1.2.1. Loss of elasticity
1.3. Bony appearance
1.4. Body fat atrophies
1.5. Double chin and baggy eyelids
1.6. Loss of subcutaneous fat
1.6.1. Decrease in skin thickness
1.6.2. More sensitive to cold temp
1.6.2.1. Risk for hypothermia
1.7. Decrease in height
1.7.1. Decrease hydration
1.7.2. Loss of cartilage and curvature of spine
1.7.2.1. Kyphosis
2. Respiratory system
2.1. Connective tissue changes
2.1.1. Relaxation of tissue
2.1.1.1. Tip of nose rotates downward
2.2. Septal deviations
2.3. Mouth breathing while sleeping
2.3.1. Snoring
2.3.2. Obstructive sleep apnea
2.4. Decreased secretions
2.4.1. Reducing ability to dilute secretions
2.4.1.1. Thicker secretions
2.5. Calcification of costal cartilage
2.5.1. Trachea and rib cage more ridge
2.5.1.1. Kyphosis
2.6. Inspiratory and expiratory muscles are weaker
2.7. More difficult to expel mucus and debris
2.8. Lungs become smaller and have less recoil
2.8.1. Harder to breathe
2.9. Exhale less efficiently
2.9.1. Increased residual volume
2.9.1.1. Vital capacity is decreased
2.10. Pneumonia
2.10.1. Pathophysiology
2.10.2. Infection caused by virus or bacteria
2.10.2.1. Causes inflamed air sacs in lungs
2.10.2.1.1. Sacs fill with fluid and pus
2.10.2.2. Cause bacteremia
2.10.2.3. Meningitis
2.10.3. Signs and symptoms
2.10.3.1. Confusion
2.10.3.2. Weakness
2.10.3.3. Chest pain
2.10.3.4. Fever and chills
2.10.4. Prevalence
2.10.4.1. 52.3 cases per 1000 people in those 85 or older
2.10.4.1.1. Mortality is increased in older adults
2.10.5. Diagnostics
2.10.5.1. Chest x-ray
2.10.5.2. CBC
2.10.6. Nursing interventions
2.10.6.1. Assess cough productivity
2.10.6.2. Observe sputum for color, odor, viscosity
2.10.6.3. Elevate head of bed
2.10.6.4. Encourage ambulation
2.10.7. Medications
2.10.7.1. Antibiotics
2.10.7.2. Penicillins
3. Gastrointestinal system
3.1. Decreased taste sensations
3.1.1. Encourage seasonings
3.2. Esophagus more dilated
3.2.1. Esophageal emptying is slower
3.3. Decrease in saliva
3.3.1. Difficult to swallow and chew
3.4. Liver decreases in size
3.5. Decrease intestinal blood flow
3.6. Decrease in stomach peristalsis and emptying time
3.7. Less acidic
3.7.1. Less production of enzymes
3.8. Less cells on absorbing surface of intestines
3.9. Colorectal cancer
3.9.1. Pathophysiology
3.9.1.1. Malignant tumors develop
3.9.1.1.1. Common sites are sigmoid colon and rectum
3.9.2. Signs and symptoms
3.9.2.1. Rectal bleeding
3.9.2.1.1. Bloody stool
3.9.2.2. Changes in bowel patterns
3.9.2.3. Nausea
3.9.2.4. Abdominal discomfort
3.9.2.5. Unexplained weight loss
3.9.2.6. Anemia
3.9.3. Prevalence
3.9.3.1. Common with advancing age
3.9.3.2. Third most common cancer for adults
3.9.4. Diagnostics
3.9.4.1. Annual stool occult
3.9.4.2. Digital rectal exam
3.9.4.3. Colonoscopy every 10 years
3.9.5. Interventions
3.9.5.1. Assess and treat pain
3.9.5.2. Provide support group resources
3.9.5.3. Surgery
3.9.6. Medication
3.9.6.1. Chemotherapeutic agents
4. Cardiovascular system
4.1. Left ventricular hypertrophy
4.2. Valves become thick and rigid
4.2.1. Fibrosis of blood vessels
4.2.1.1. Lipid accumulation in vessels
4.3. CO decreases
4.4. Resistance to peripheral blood flow
4.5. BP increases
4.6. SV decreases
4.7. Decreased elasticity of arteries
4.7.1. Vascular changes to heart and kidney
4.8. Congestive heart failure
4.8.1. Pathophysiology
4.8.1.1. Coronary artery disease
4.8.1.1.1. Heart becomes weak and stiff
4.8.1.2. Hypertension
4.8.2. Signs and symptoms
4.8.2.1. SOB
4.8.2.2. Fatigue
4.8.2.3. Arrhythmias
4.8.2.4. Cough/ wheezing
4.8.2.5. Edema in extremities
4.8.3. Prevalence
4.8.3.1. I’m people age 75 or older! Occurs 10 times more often than in younger adults
4.8.4. Diagnostics
4.8.4.1. Medical and family hx
4.8.4.2. CBC or thyroid tests
4.8.4.3. Metabolic tests
4.8.5. Interventions
4.8.5.1. Control salt intake
4.8.5.2. Limit water retention
4.8.5.3. Smoking cessation
4.8.6. Medications
4.8.6.1. Diuretics
4.8.6.2. ACE inhibitors
4.8.6.3. Vasodilators
5. Urinary system
5.1. Decreased size of renal mass
5.1.1. Atherosclerosis can cause atrophy
5.2. Decreased tubular function
5.3. Weak bladder muscles
5.3.1. Difficult to empty bladder
5.3.1.1. Retention of urine
5.4. GFR decreases
5.4.1. Reduces renal blood flow
5.5. Less ability to conserve sodium
5.5.1. Hyponatremia
5.6. UTI
5.6.1. Pathophysiology
5.6.1.1. E. coli in urethra
5.6.1.1.1. Bacteria proliferates
5.6.2. Signs and symptoms
5.6.2.1. Cloudy urine
5.6.2.2. Bloody urine
5.6.2.3. Frequent urination
5.6.2.4. Pressure and pain in pelvis and when urinating
5.6.2.5. Strong smelling odor
5.6.2.6. Hallucinations
5.6.2.7. Agitation and confusion
5.6.3. Prevalence
5.6.3.1. Increase in UTIs with older age
5.6.4. Diagnostics
5.6.4.1. Urinalysis
5.6.5. Interventions
5.6.5.1. Drink fluids
5.6.5.2. Avoid caffeine
5.6.5.3. Wipe from front to back for women
5.6.5.4. Change wet incontinence pads right away
5.6.6. Medications
5.6.6.1. Antibiotics
5.6.6.2. IV antibiotics
6. Reproductive systems
6.1. Men
6.1.1. Reduced sperm count
6.1.2. Fluid retaining capacity of seminal vesicles decreases
6.1.3. Enlarged prostate
6.1.4. Decrease in testosterone
6.1.5. Increase in LH and FSH
6.1.6. Atrophy of testes
6.1.7. Orgasm and ejaculation are less intense
6.2. Women
6.2.1. Atrophy of the vulva
6.2.1.1. Hormonal changes
6.2.2. Loss of hair and subcutaneous fat
6.2.3. Loss of elastic tissue in vagina
6.2.3.1. Vagina is pink, dry and a vascular
6.2.4. Flora changes and decrease in secretions
6.2.4.1. Vagina becomes more alkaline
6.2.5. Not palpable
6.2.5.1. Ovaries shrink
6.2.6. Decrease in estrogen
6.3. BPH
6.3.1. Pathophysiology
6.3.1.1. Idiopathic
6.3.1.1.1. Could be due to lower testosterone levels and higher proportion of estrogen
6.3.2. Signs and symptoms
6.3.2.1. Frequent urination
6.3.2.2. Urgency
6.3.2.3. Retention
6.3.2.4. Incontinence
6.3.2.5. Urine with a foul odor
6.3.2.6. Nocturia
6.3.2.7. Dribbling after urination
6.3.3. Prevalemce
6.3.3.1. 3/4 of men 65 or older have some degree of BPH
6.3.3.2. Effects 90% of men 80 and older
6.3.4. Diagnostics
6.3.4.1. Medical hx
6.3.4.2. Physical exam
6.3.4.3. Urinalysis
6.3.4.4. PSA blood test
6.3.5. Interventions
6.3.5.1. Void often
6.3.5.2. Drink fluids
6.3.5.3. Sits baths
6.3.6. Medications
6.3.6.1. Alpha blockers
6.3.6.2. Finasteride
6.3.6.3. Silodosin
7. Musculoskeletal systems
7.1. Muscle fibers atrophy
7.1.1. Fibrous tissue replaces muscle tissue
7.2. Muscle mass and strength decreases
7.3. Vertebrae shortens
7.4. Bones become brittle
7.5. Bone mass decreases
7.6. Kyphosis may occur
7.7. Decreased flexion and extension
7.7.1. Less flexibility
7.8. Osteoporosis
7.8.1. Pathophysiology
7.8.1.1. Osteoclasts break down bone faster than osteoclasts build bone
7.8.1.1.1. Bone mass decreases
7.8.2. Signs and symptoms
7.8.2.1. Bone fractures
7.8.2.2. Loss of height
7.8.2.3. Back pain
7.8.2.4. Bad posture
7.8.3. Prevalence
7.8.3.1. Higher in women
7.8.4. Diagnostics
7.8.4.1. DEXA scan
7.8.4.2. Bone x-Ray
7.8.4.3. CT or MRI scan
7.8.5. Interventions
7.8.5.1. Smoking and alcohol cessation
7.8.5.2. Physical activity
7.8.5.3. Increase calcium intake
7.8.5.4. Balanced and healthy diet
7.8.6. Medication
7.8.6.1. Antacids
7.8.6.2. Bisphosphonates
7.8.6.3. Hormone therapy
8. Nervous system
8.1. Decrease in blood flow to the brain
8.1.1. Reduction in glucose use and metabolic rate of oxygen
8.2. Decrease in neurons and nerve fibers
8.3. Decrease in nerve conduction velocity
8.3.1. Slower reflexes and delayed responses
8.4. Balance declines
8.4.1. Falls
8.5. Decrease in nerve reinnervation of injured nerves
8.5.1. Slow response to stimuli
8.6. Hypothalamus regulates temperature less efficiently
8.7. Brain cells decline
8.8. Sleep wake cycle is acfected and sleep regulation is altered
8.8.1. Stages III and IV become less prominent
8.8.1.1. Phase advance
8.9. Dementia
8.9.1. Pathophysiology
8.9.1.1. Impairment of at least two brain functions
8.9.1.1.1. Irreversible and progressive
8.9.2. Signs and symptoms
8.9.2.1. Memory loss
8.9.2.2. Confusion and disorientation
8.9.2.3. Anxiety
8.9.2.4. Jumbled speech
8.9.2.5. Personality changes
8.9.3. Prevalence
8.9.3.1. 4.5 million adults are affected
8.9.4. Diagnostics
8.9.4.1. Medical hx
8.9.4.2. Day to day function
8.9.4.3. Memory tests
8.9.5. Interventions
8.9.5.1. Patient safety
8.9.5.2. Controlled environment
8.9.5.3. Items that trigger memory
8.9.5.4. Therapy and activity
8.9.6. Medication
8.9.6.1. Cholinesterase inhibitors
9. Sensory organs
9.1. Sight
9.1.1. Decreased pupil size
9.1.2. Presbyopia
9.1.2.1. Stiffening of muscle fibers
9.1.2.2. Can’t focus on close objects or adapt to light
9.2. Smell
9.2.1. Impaired ability to identify odors
9.2.1.1. Decrease in sensory cells
9.3. Taste
9.3.1. Taste impairment
9.3.1.1. Use Seasoning!
9.3.2. Atrophy of tongue
9.3.3. Reduced saliva production
9.4. Touch
9.4.1. Decrease in tactile sensation
9.5. Hearing
9.5.1. Presbycusis
9.5.1.1. Loss of hair cells
9.5.1.2. Decreased blood supply
9.5.2. Increased cerumen
10. Immune system
10.1. Depressed immune response
10.1.1. Increase in infections
10.2. T cell activity decline
10.2.1. Immature T cells
10.3. Inflammatory response decreases
10.3.1. Minimal pain
10.3.2. Low grade fever
10.4. Interventions
10.4.1. Exercise
10.4.2. Multivitamin
10.4.3. Healthy diet
11. Personality
11.1. Consistent with early years
11.2. Changes may be due to events that alter attitude
11.3. Long-term memory can be slowed
11.3.1. Use of memory aids
11.4. Basic intelligence is maintained
12. Endocrine system
12.1. Decreased thyroid activity
12.1.1. Thyroid atrophies
12.1.2. Reduction of T3
12.2. Decreased adrenal gland activity
12.2.1. ACTH is decreased
12.2.2. Less aldosterone is produced
12.2.3. Estrogen and progesterone is reduced
12.3. Pituitary gland decreases in volume
12.3.1. Gonadal secretion decreases
12.3.2. FSH, LH decreases
12.4. Insufficient and delayed insulin release
12.4.1. Decreased tissue sensitivity to insulin
12.4.2. Higher blood glucose levels
12.5. Hypothyroidism
12.5.1. Fibrosis of thyroid gland
12.5.1.1. Lower basal metabolic rate
12.5.1.1.1. Reduced radioactive iodine uptake
12.5.2. Increased nodulars
12.5.3. Signs and symptoms
12.5.3.1. Fatigue
12.5.3.2. Constipation
12.5.3.3. Dry skin
12.5.3.4. Weight gain
12.5.3.5. Cold intolerance
12.5.4. Prevalence
12.5.4.1. Common with older age
12.5.5. Diagnostics
12.5.5.1. Blood tests
12.5.5.2. Analyzing symptoms
12.5.6. Interventions
12.5.6.1. Manage weight
12.5.6.2. Manage appetite
12.5.6.2.1. Food with fiber
12.5.7. Medication
12.5.7.1. Levothyroxine
12.5.7.2. Hormone replacement