Older Adult Client

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Older Adult Client por Mind Map: Older Adult Client

1. Integumentary

1.1. Skin cancer

1.2. reduced melanocytes

1.3. decreased thickness and elasticity of dermis

1.4. eczema

1.5. decreased hair growth

1.6. subcutaneous fat loss

2. Nervous

2.1. Age related changes: loss of nerve cell mass, number of dendrites declines, demyelinization.

2.2. Parkinson's Disease

2.2.1. loss of pigmented dopaminergic receptors in pars compacta, which then results in increasing overall excitatory drive in basal ganglia. S/S: shuffled gait, tremor, hallucinations

2.3. Transient Ischemic Attacks

2.3.1. temporary cessation of cerebral blood flow, the clot dissolves within 24 hours and is temporary.

2.4. CVA/ Stroke

2.4.1. Ischemic and hemorrhagic types,vascular occlusion due to thromboembolic disease causing cell hypoixia and lack of glucose. S/S; Unsymmetrical face, slurred speech, and not able to lift arms at same level.

3. Musculoskeletal

3.1. Age related changes: decline in size and number of muscle fibers, reduction in muscle mass, connective tissue changes, reduced flexibility of joints and muscles, sarcopenia.

3.2. Factures

3.3. Osteoarthritis

3.3.1. primarily disease of the cartilage, proinflammatory cytokines cause further degenerative cartilage and growth factors are inadequate to balance out degeneration.

3.4. Rheumatoid Arthritis

3.4.1. external trigger sets of autoimmune response leading to synovial hypertrophy and chronic joint inflammation.

3.5. Osteoporosis

3.5.1. reduction in skeletal mass caused by an imbalance by bone resorption and bone formation.

3.6. Gout

3.6.1. Uric acid accumulates in blood and tissues forming crystals, common in cold extremities, causing great pain. S/S: swelling, pain, redness, tenderness especially in the great toe

4. Circulatory

4.1. Age related changes: heart valves thicker and rigid, aorta becomes dilated, myocardial muscle less efficient, calcification and reduced elasticity of vessels, less sensitive to baroreceptor regulation of blood pressure

4.2. Hypertension

4.3. Hypotension

4.4. Congestive Heart Failure

4.5. Pulmonary Emboli

4.6. Coronary Artery Disease

4.7. Hyperlipidemia

4.8. Arrhythmias

4.9. Peripheral vascular disease

5. Respiratory

5.1. Age related changes: decreased elastic recoil, alveoli less elastic, reduction in vital capacity, lungs reduce in size and weight

5.2. Asthma

5.3. Chronic Bronchitis

5.4. Emphysema

5.5. Lung Cancer

5.6. Lung Abscess

6. Endocrine

6.1. Age related changes: thyroid gland activity decreases, diminished adrenal function, volume of pituitary gland decreases, insufficient release of insulin, ACTH secretion decreases.

6.2. Diabetes Mellitus

6.2.1. Type 1 beta cells of the pancreas cannot produce proper insulin

6.2.2. Type 2 beta cells produce insulin but body is glucose intolerant. risk factors include unhealthy eating, overweight, and genetics.

6.3. Hypothyroidism

6.4. Hyperthyroidism

7. Digestive

7.1. Age related changes: Atrophy of tongue affects taste buds, saliva production decreases, presbyesophagus results in weaker esophageal contractions and weakness sphincter, stomach motility decreases, stomach has higher pH as result of decline in HCL acid and pepsin

7.2. Dry mouth (Xerostomia)

7.3. Dysphagia

7.4. Hiatal hernia

7.5. Esophageal cancer

7.6. Peptic ulcer disease

7.7. Cancer of the stomach

7.8. Diverticular disease

7.9. Colorectal cancer

7.10. Chronic constipation

7.11. Bowel incontinence

8. Urinary

8.1. Age related changes: hypertrophy of bladder muscle, kidney filtration ability decreases, reduced renal function, retention, decreased tubular function, increase in renal threshold for glucose

8.2. Urinary incontinence

8.2.1. urethral hypermobility due to impaired support from pelvic floor, stress incontinence.

8.3. Bladder cancer

8.3.1. growth of malignant cells of urinary bladder, most common types are squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma. S/S: frequent urination, hematuria, back pain and pelvic pain.

8.4. Renal calculi

8.4.1. Stone growth starts with supersaturated urine and is from calcium oxalate, a big contribution is low fluid intake.

8.5. Glomerulonephritis

8.5.1. inflammation of tiny filters in your kidneys, can be acute or chronic and can be brought on by other diseases like diabetes, or lupus. S/S: hematuria, proteinuria, edema, high blood pressure.

9. Reproductive

9.1. Female

9.1.1. Age related changes: vulva atrophies, flattening of the labia, vaginal epithelium thins, cervix, uterus, and fallopian tubes atrophy, vaginal canal changes, more alkaline vaginal pH,uterus and ovaries decrease in size,

9.1.2. Infections of the vulva more susceptible to irritation and infection, senile vulvitis.

9.1.3. Tumors of the vulva

9.1.4. Atrophic vaginitis increased vaginal fragility increases the risk of irritation leading to vaginitis

9.1.5. Cancer of the vagina more often an area of metastasis rather than the primary site

9.1.6. Cancer of the cervix

9.1.7. Cancer of the endometrium S/S: postmenopausal bleeding

9.1.8. Cancer of the ovaries

9.1.9. Breast cancer

9.2. Male

9.2.1. Age related changes: seminal vesicles develop thinner epithelium, muscle tissue replaced with connective tissue, seminiferous tubule changes, atrophy of testes, less live sperm in fluid, enlargement of prostate.

9.2.2. Erectile dysfunction

9.2.3. Benign prostatic hyperplasia

9.2.4. Cancer of the prostate

9.2.5. Tumors of the penis and testes

9.2.6. Tumors of the scrotum

10. Nutrition

10.1. Age related changes: reduced need for calories, soluable fiber, reduce carbs,

10.2. protein should be ten to twenty percent of calories

10.3. calcium absorption ability decreases with age

10.4. at least five servings daily of fruits and vegetables

10.5. dietary fat intake less than 30 percent of calories

10.6. 1500 minimal required for fluid intake

10.7. decreased stomach motility, less gastric secretion, and slower emptying time

10.8. anorexia

10.9. dysphagia

10.10. malnutrition

10.11. Nursing interventions: food stamps, meals on wheels, home health aides for feedings, shopping and meal preparation assistance

11. Sleep

11.1. Age related changes: phase advance common, more time in stage 1 and 2 and less in 3 and 4 (less deep sleep).

11.2. Insomnia

11.2.1. difficulty falling asleep, staying asleep, or prematurely waking

11.3. Nocturnal Myoclonus

11.3.1. Jerking legs during sleep, five leg jerks or movements per hour during sleep, can be associated with renal failure or tricyclic antidepressants

11.4. Restless leg syndrome

11.4.1. neurological condition of urge to move legs associated with iron deficiency anemia, uremia,, Parkinson's disease, rheumatoid arthritis, diabetes

11.5. Sleep apnea

11.5.1. five episodes of cessation of breathing, lasting 10 seconds , supine position should be avoided

11.6. Depression and other emotional problems

11.7. Drugs affecting sleep: anticholinergics, antidepressants, antihypertensive, benzodiazepines, beta-blocker, diuretics, levodopa, steroids, theophylline, caffeine, alcohol

12. Sexuality

12.1. Menopause in women

12.2. Slef-acceptance

12.2.1. emotions and symptoms used for expression, realize significance for caring and nurturing self

12.3. Hormone therapy

12.3.1. estrogen and progestin increased heart risks

12.4. Andropause

12.4.1. testosterone levels decline in men, can result in reduced muscle mass, energy, strength , and stamina. erectile dysfunction, breast enlargement, osteopenia, osteoporosis, and shrinkage of testes.

12.5. Barriers to sexuality: unavailability of a partner, concerns about body image, fear of losing sexual abilities, negative attitudes from society, physical conditions

12.5.1. interventions to physical conditions: medications, penile prostheses, lubricants, surgery and counseling

12.6. Erectile dysfunction

12.6.1. unable to maintain erection of penis for sexual intercourse. causes: diabetes, hypertension, renal failure, atherosclerosis

12.7. Medications can affect potency, libido, orgasm, and ejaculation

13. Spiritual Needs

13.1. Love

13.2. Meaning and purpose

13.3. Hope

13.4. Dignity

13.5. Forgiveness

13.6. Gratitude

13.7. Transcedence

13.8. Expression faith

13.9. Addressing needs: being available, honoring beliefs and practices, promoting hope, facilitating religious practices, providing opportunities for solitude.