The Older Adult

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The Older Adult by Mind Map: The Older Adult

1. Respiratory system

1.1. PO2 reduced as much as 15%

1.2. Loss of elasticity and increased ridgdity

1.3. Decreased Ciliary Action

1.4. Forced Expiratory Volume Reduced

1.5. Blunting cough and laryngeal reflexes

1.6. 50 percent increase in residual capacity

1.7. Alveoli fewer in number and larger in size

1.8. Thoracic muscles are more rigid

1.9. Reduced basilar inflation

1.10. septal deviations

1.11. Select Respiratory problems

1.11.1. Chronic Obstructive Pulmonary Disease PATHO Made up of chronic bronchitis and emphysema S/S productive cough, shortness of breath, and recurrent respiratory infections. Stimulus to breath is low oxygen when it should be high CO2 levels, blue lips, wheezing, chest tightness, swelling in ankles and legs DIAGNOSIS- won't be diagnosed till advanced through a lung function test and chest x-ray, CT, ABGS, and lab test TREATMENT- smoking cessation, inhaled steroids, bronchodilators, lung therapy

1.11.2. Lung Cancer PATHO- malignancy in lungs DIAGNOSIS- imaging, sputum culture, tissue sample SYMPTOMS- a new cough that does not go away, SOB, weight loss, chest pain

1.11.3. Pneumonia SYMPTOMS- include low oxygen, fever, confusion, activity, intolerance, mucous cough and generalized weakness. Typically diagnosed through a chest x-ray. The older adult is a risk due to their less efficient respiratory system as well as a decreased immune system. PATHO- an infection of the lungs that inflames the air sacs in one or both lungs DIAGNOSIS-chest x-ray, blood tests, sputum tests

2. Musculoskeletal systems

2.1. loss of 2 inches by 80 years

2.2. loss of cartilage and thinning of vertebrae

2.3. kyphosis, enlarged joints, flabby muscles

2.4. muscle fibers atrophy

2.5. degeneration of the extrapyramidal system

2.6. Reflexes are lessened

2.7. Tendons decrease and Harden with tendon jerks

2.8. frequent muscle cramping

2.9. loss of bone mineral and bone mass

2.10. Women experience accelerated bone loss

2.11. Selected Musculoskeletal Disorders

2.11.1. Fractures PATHO-caused by brittle bones that fracture more easily and heal at a slower rate TREATMENT-interventions aim at prevention and treatment is to immobolize the injured site DIAGNOSIS-through x-ray

2.11.2. Osteoarthritis PATHO-Progressive deterioration of joint cartilage with the formation of new bone at the joint surface. The wearing down of protective tissue at the ends of bones occurs gradually and worsens over time. TREATMENT-Can be treated with physical therapy and surgery may reduce pain DIAGNOSIS- x-ray and imaging S/S- Pain, tenderness, grating sensation, stiffness, bone spurs

2.11.3. Rhematoid Arthritis PATHO-A chronic inflammatory disorder affecting many joints in the hands and feet. The bodys immune system attacks its own tissue DIAGNOSIS- blood tests and imaging S/S tender, warm, swollen joints, joint stiffness in the mornings, fatigue, fever, weight loss TREATMENT- medications such NSAIDs and steroids, therapy, and surgery

2.11.4. Osteoporosis PATHO asymptomatic decrease in bone density due to inactivity, diseases, reduction in sex hormones, diet and drugs. DIAGNOSIS diagnosed through bone density testing Risk factors include chronic alcoholism, women, diabetes, hyperthyroidism S/S kyphosis, spinal pain, and fractures. TREATMENT hormone therapy, exercise

3. Gastrointestinal system

3.1. decreased gustation

3.2. esophagus more dilated

3.3. reduced saliva and salivary ptyalin

3.4. liver size is smaller

3.5. reduced intestinal blood flow

3.6. slower peristalsis

3.7. fewer cells absorbing surfaces in the intestine

3.8. less production of hydrochloric acid, pepsin, lipase, and pancreatic enzymes

3.9. Common Gastrointestinal system problems

3.9.1. Colorectal Cancer Second most common malignancy in the United states PATHO- malignancy of the large intestine S/S- change in bowel habits, rectal bleeding, weakness, fatigue, weight loss DIAGNOSIS- colonoscopy

3.9.2. Chronic Constipation PATHO- infrequent bowel movement or difficult passage of stool S/S- lumpy hard stools, less than three stools a week, feeling as though there is a blockage DIAGNOSIS- exam of rectum, blood tests, anal sphincter function evaluation

3.9.3. Intestinal Obstruction

3.9.4. Fecal Impaction

3.9.5. Bowel Incontinence The inability to voluntary control of the passage of stool caused by fecal impaction

4. Endocrine System

4.1. thyroid gland atrophies

4.2. diminished adrenal function

4.3. ACTH decreases

4.4. pituitary volume decreases

4.5. Insufficient release of insulin and reduced tissue sensitivity to circulating insulin

4.6. Select Endocrine Problems

4.6.1. Diabetes Mellitus PATHO- a group of diseases that affect how your body uses glucose. S/S- increased thirst, urination, extreme hunger, weight loss, fatigue, irritability, blurred vision DIAGNOSIS- fasting blood sugar test

4.6.2. Hypothyroidism PATHO- thyroid does not produce enough thyroid gland S/S- Fatigues, increased cold sensitivity, constipation, dry skin, weight gain, puffy face, hoarseness DIAGNOSIS- blood tests

5. Cardiovascular system

5.1. Heart declines

5.2. heart valves become thicker and more rigid

5.3. Aorta becomes dilated

5.3.1. may result in ventricular hypertrophy

5.4. Myocardial muscles are less efficient

5.4.1. Decreased contractile strength

5.5. Calcification reduced elasticity of vessels

5.5.1. Decreased Cardiac Output when demands increase

5.6. Less sensitivity to barorecptor

5.7. Physical reconditioning can heighten many of these problems but with regular exercise this can be helped

5.8. Common Cardiovascular disorders in the older population

5.8.1. Hypertension S/S high blood pressure often has no symptoms PATHO- high blood pressure due to the amount of resistance to flow in your arteries DIAGNOSIS- blood pressure monitoring

5.8.2. Myocardial infarction PATHO- Caused by blockage or clot forming in the coronary arteries that occludes the blood flow causing lack of oxygen S/S-neck or jaw pain, shoulder or arm pain, fast heartbeat, N/V, sweating, fatigue, SOB DIAGNOSIS-ECG and other scanning

5.8.3. Dysrythmias Irregular beating of the heart caused by increased workload on the heart this causes an increased risk for MIS, stroke, and Pulmonary embolism

6. Reproductive system

6.1. Males

6.1.1. Possible reduction in sperm country

6.1.2. Vebous and arterial sclerosis of the penis

6.1.3. prostate enlarges

6.1.4. select male problems Erectile dysfunction can not keep and erection firm enough for sexual intercourse Benign Prostatic hyperplasia Age associated prostate enlargement causing urination difficulty, dribbling, and sexual dysfunction. Treat with medication and supportive care. May need surgery

6.2. Females

6.2.1. Fallopian tubes atrophy and shorten

6.2.2. Ovaries become smaller and thicker

6.2.3. cervix becomes smaller

6.2.4. Drier, less elastic vaginal canal

6.2.5. flattening of labia

6.2.6. endocervical epithelium atrophies

6.2.7. uterus becomes smaller in size

6.2.8. more alkaline vaginal environment

6.2.9. loss of vulvar subcutaneous fat and hair

6.2.10. Select Female diseases Ovarian cancer Cancer of the breast


6.3.1. Older adults can and do enjoy sex

6.3.2. Sexual behavior remains consistent throughout life

6.3.3. Nurses should recognize and respect sex specific roles of older adults identity

6.3.4. More than just physical acts- love, intimate words and touch, feeling wanted, caring and sharing

7. Urinary System

7.1. hypertrophy and thickening of the bladder muscles

7.2. Decreased ability of bladders ability to expand

7.3. Reduced storage capacity resulting in daytime frequency and nocturia

7.4. Kidney filtration ability decreases

7.5. Reduced Renal function resulting in high BUN levels

7.6. Decreased tubular function

7.7. Increase in renal threshold to glucose

7.8. Common Urinary System Disorders

7.8.1. Urinary inconctinence treatment-identify cause and fix the underlying cause PATHO- the loss of bladder control be caused by a multitude of factors including functional status, cognition, medications, and neuromuscular functioning in lower extremities Can be due to the presence of fecal impaction. Can be classified as stress, urgency, over flow, neurogenic, functional, and mixed. S/S-leaking urine, sudden urge to go, wetting pants quickly DIAGNOSIS- urinalysis, bladder diary, post void residual

7.8.2. Bladder Cancer PATHO- Malignancy of the urothiel cells S/S-blood in urine, painful urination, pelvic pain DIAGNOSIS- cystoscopy through the urethra

7.8.3. Renal Calculi PATHO small hard deposit that forms in the kidney due to excessive calcium or uric acid S/S- may experience extreme back pain, nausea and vomiting, and sweating DIAGNOSIS- blood tests and urinalysis

7.8.4. Glomerulonephritis PATHO-inflammation of the glomerulus S/S-that causes pink or color colored urine, foamy urine, and fluid retention

8. Nervous System

8.1. Loss of nerve cell mass

8.2. Brain weight decreases

8.3. atrophy of brain and spinal cord

8.4. Number of dendrites declines

8.5. Demylenization which slows nerve conduction, slows reaction times, and reflexes become weaker

8.6. Plaques, tangles, atrophy of the brain

8.7. Free radicals accumulate

8.8. Decrease in cerebral blood flow

8.9. Fatty deposits accumulate in blood vessels

8.10. Ability to compensate declines with age

8.11. intellectual performance is MAINTAINED until at least 80 years

8.12. Slow central processing

8.13. Verbal skills maintained until age 70

8.14. Number and sensitivity of sensory receptors, dermatomes, and neurons- dulling tactile sensation

8.15. Decline in the function of cranial nerves affecting taste and smell

8.16. Selecte Nervous System Problems

8.16.1. Parkinsons disease PATHO- Affects the ability of the CNS to control body movements due to the clients levels of Dopamine treat with anticholinergic medications and technology- maximum level of independence S/S include tremors and shuffling gait

8.16.2. Transient Ischemic Attacks Temporary or intermittent reduction in cerebral perfusion that can last minutes to hours Treatment involves treating the underlying issue

8.16.3. Cerebrovascular Accident Can be ischemic or Hemmorhagic causing compromise and damage to the brain must stabilize the patient and focus on rehabilitation SIgns and symptoms depend on the area of the brian affected

9. Integumentary system

9.1. flattening of dermal-epidermal junction

9.2. reduced thickness and vascularity of the dermis

9.3. reduction of epidermal turnover

9.4. degeneration of elastic fibers

9.5. increased coarseness of collagen

9.6. reduction in melanocytes

9.7. atrophy of hair bulbs and decline in the rate of hair and nail growth

9.8. increased fragility of the skin

9.9. changes affect body image, self concept, reactions from others, socialization, and other psychosocial factors

9.10. Selected Skin issues

9.11. Select integumentary problems

9.11.1. Pruitis Most common dermatological problem amongst adults Excessive itching from this condition can cause infection and skin breakage PATHO- itchy skin due to drones

9.11.2. Pressure Ulcers PATHO- injuries to the skin resulting from prolonged pressure on the skin S/S-swelling, unusual skin color or texture, redness, heat, pus drainage DIAGNOSIS- examination

10. Immune System

10.1. Decreased strength of immune response by T-cell activity, cell mediated immunity

10.2. inflammatory defenses decline and present atypically

10.3. risk for infection becomes significant

10.4. high prevalence of chronic conditions increase the risk for infections

10.5. increased risk of exposure to pathogens with hospitalization and institutionalized

10.5.1. Decreased immune function leads to all cancers