Age related changes

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Age related changes by Mind Map: Age related changes

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 Risk for hypothermia

1.7. Decrease in height

1.7.1. Decrease hydration

1.7.2. Loss of cartilage and curvature of spine Kyphosis

2. Respiratory system

2.1. Connective tissue changes

2.1.1. Relaxation of tissue 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 Thicker secretions

2.5. Calcification of costal cartilage

2.5.1. Trachea and rib cage more ridge 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 Vital capacity is decreased

2.10. Pneumonia

2.10.1. Pathophysiology

2.10.2. Infection caused by virus or bacteria Causes inflamed air sacs in lungs Sacs fill with fluid and pus Cause bacteremia Meningitis

2.10.3. Signs and symptoms Confusion Weakness Chest pain Fever and chills

2.10.4. Prevalence 52.3 cases per 1000 people in those 85 or older Mortality is increased in older adults

2.10.5. Diagnostics Chest x-ray CBC

2.10.6. Nursing interventions Assess cough productivity Observe sputum for color, odor, viscosity Elevate head of bed Encourage ambulation

2.10.7. Medications Antibiotics 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 Malignant tumors develop Common sites are sigmoid colon and rectum

3.9.2. Signs and symptoms Rectal bleeding Bloody stool Changes in bowel patterns Nausea Abdominal discomfort Unexplained weight loss Anemia

3.9.3. Prevalence Common with advancing age Third most common cancer for adults

3.9.4. Diagnostics Annual stool occult Digital rectal exam Colonoscopy every 10 years

3.9.5. Interventions Assess and treat pain Provide support group resources Surgery

3.9.6. Medication Chemotherapeutic agents

4. Cardiovascular system

4.1. Left ventricular hypertrophy

4.2. Valves become thick and rigid

4.2.1. Fibrosis of blood vessels 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 Coronary artery disease Heart becomes weak and stiff Hypertension

4.8.2. Signs and symptoms SOB Fatigue Arrhythmias Cough/ wheezing Edema in extremities

4.8.3. Prevalence I’m people age 75 or older! Occurs 10 times more often than in younger adults

4.8.4. Diagnostics Medical and family hx CBC or thyroid tests Metabolic tests

4.8.5. Interventions Control salt intake Limit water retention Smoking cessation

4.8.6. Medications Diuretics ACE inhibitors 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 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 E. coli in urethra Bacteria proliferates

5.6.2. Signs and symptoms Cloudy urine Bloody urine Frequent urination Pressure and pain in pelvis and when urinating Strong smelling odor Hallucinations Agitation and confusion

5.6.3. Prevalence Increase in UTIs with older age

5.6.4. Diagnostics Urinalysis

5.6.5. Interventions Drink fluids Avoid caffeine Wipe from front to back for women Change wet incontinence pads right away

5.6.6. Medications Antibiotics 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 Hormonal changes

6.2.2. Loss of hair and subcutaneous fat

6.2.3. Loss of elastic tissue in vagina Vagina is pink, dry and a vascular

6.2.4. Flora changes and decrease in secretions Vagina becomes more alkaline

6.2.5. Not palpable Ovaries shrink

6.2.6. Decrease in estrogen

6.3. BPH

6.3.1. Pathophysiology Idiopathic Could be due to lower testosterone levels and higher proportion of estrogen

6.3.2. Signs and symptoms Frequent urination Urgency Retention Incontinence Urine with a foul odor Nocturia Dribbling after urination

6.3.3. Prevalemce 3/4 of men 65 or older have some degree of BPH Effects 90% of men 80 and older

6.3.4. Diagnostics Medical hx Physical exam Urinalysis PSA blood test

6.3.5. Interventions Void often Drink fluids Sits baths

6.3.6. Medications Alpha blockers Finasteride 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 Osteoclasts break down bone faster than osteoclasts build bone Bone mass decreases

7.8.2. Signs and symptoms Bone fractures Loss of height Back pain Bad posture

7.8.3. Prevalence Higher in women

7.8.4. Diagnostics DEXA scan Bone x-Ray CT or MRI scan

7.8.5. Interventions Smoking and alcohol cessation Physical activity Increase calcium intake Balanced and healthy diet

7.8.6. Medication Antacids Bisphosphonates 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 Phase advance

8.9. Dementia

8.9.1. Pathophysiology Impairment of at least two brain functions Irreversible and progressive

8.9.2. Signs and symptoms Memory loss Confusion and disorientation Anxiety Jumbled speech Personality changes

8.9.3. Prevalence 4.5 million adults are affected

8.9.4. Diagnostics Medical hx Day to day function Memory tests

8.9.5. Interventions Patient safety Controlled environment Items that trigger memory Therapy and activity

8.9.6. Medication Cholinesterase inhibitors

9. Sensory organs

9.1. Sight

9.1.1. Decreased pupil size

9.1.2. Presbyopia Stiffening of muscle fibers Can’t focus on close objects or adapt to light

9.2. Smell

9.2.1. Impaired ability to identify odors Decrease in sensory cells

9.3. Taste

9.3.1. Taste impairment 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 Loss of hair cells 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 Lower basal metabolic rate Reduced radioactive iodine uptake

12.5.2. Increased nodulars

12.5.3. Signs and symptoms Fatigue Constipation Dry skin Weight gain Cold intolerance

12.5.4. Prevalence Common with older age

12.5.5. Diagnostics Blood tests Analyzing symptoms

12.5.6. Interventions Manage weight Manage appetite Food with fiber

12.5.7. Medication Levothyroxine Hormone replacement