assessment of neurologic gunction_gerontologic

7/29/2019 Assessment of Neurologic Gunction_gerontologic

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ASSESSMENT OF

NEUROLOGIC GUNCTION

GERONTOLOGIC

CONSIDERATION


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STRUCTURAL AND

PHYSIOLOGIC

Loss of neuron occurs, leading to a

decrease in the number of synapse and

neurotransmitters. result slowed nerve

conduction and response time.

Brain weight is decreased and the

ventricle size increases to maintain cranial

nerve volume.


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Cerebral blood flow and metabolism arereduce slower mental function

Temperature regulation less efficient

PNS myelin is lost- decrease conductionvelocity in some nerves

Visual/auditory degenerates loss of

visual acuity and hearing Taste buds atrophy and nerve cells in the

olfactory bulb degenerate


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Nerve cells in the vestibular, cerebellum,proprioception pathways leading to balancedifficulties

Deep tendon reflex

can be decreased or insome absent

Hypothalamic is modified stage IV sleep isreduced

Autonomic nervous response

over slowing

Pupillary responses reduced or may notappear at all in the presence of cataracts.


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MOTOR ALTERATION

Reduced nerve input decreased strength

and agility, with increased reaction time.

Gait is slowed and wide based.

Changes making it difficult in maintaining

balance, predisposing the older person to

falls.


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SENSOR ALTERATION

Tactile sensation dulled due to adecrease in the number of sensoryreceptors.

Sensitivity to glare, decreased peripheralvision and a constricted visual field due todegeneration of visual pathways resulting in disorientation, especially atnight when there is a little or no light in theroom.


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Loss of hearing contribute to confusion,

anxiety, disorientation, misinterpretation of

the environment, feelings of inadequacy

and social isolation.


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TEMPERATURE REGULATION

AND PAIN PERCEPTION

May feel cold more readily than heat

require covering when in bed

Painful stimuli decreased

Two pain syndromes that are common in

the neurologic system in older adults are:

a. Diabetic neuropathiesb. Postherpetic neuropathies


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MENTAL STATUS

Change in mental status should never be

assumed to be a normal part of aging.

Delirium (mental confusion, usually with

delusions and hallucinations) is seen in

elderly who have underling CNS damage

or are experiencing an acute infection

such as infection, adverse medicationreaction or dehydration.


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NURSING IMPLICATION

Visual and hearing deficits requireadaptations in activities such aspreoperative teaching, diet therapy and

instructions about new medications. When using visual materials for teaching

or menu selection adequate lightingwithout glare, contrasting colors, and largeprint are used to offset visual difficultiescaused by


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assessment of neurologic gunction_gerontologic

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