disorders related to aging

8/7/2019 DISORDERS RELATED TO AGING

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DISORDERSRELATED

TO AGINGLuzviminda C.

Cardino RN MAN


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AGING

aging process occurs in all living things

Causes physical, psychological and

social changes that increase as a persongets older


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THE 6TH DECADE

physiologic changes in the eye- night

vision

Ability to hear higher tone diminishes-difficulty understanding conversations

Pancreas function less efficiently-

higher glucose levels

Joints stiffen as cartilage deteriorates

from wear and tear- pain in movement


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THE 8TH DECADE

risk of falls increases- hip fractures

Bone mass decrease by half in many

women Cognitive ability decreases and 50% over

85 years show some signs of Alzheimers

disease


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COMMON PHYSICAL CHANGES

Presbycusis- hearing loss

Cataracts- opacity of lens

Nutritional deficits- tooth loss and alterations

in taste, smell and GI function

Muscle strength, agility and reaction times

decrease. Reflexes and vibratory sense lessen.

Position sense may decline- unsteady gait andincreased of falling


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COMMON PHYSICAL CHANGES

Cognitive ability does not diminish greatly-

short term memory and the ability to retrieve

information from long term memory decreases

Personality does not change with age

Sleep deprivation may occur due to decreases

in stage IV sleep and total sleep time and

increases in the time it takes to fall asleep Brain weight decreases by 7% and cerebral

blood flow is reduced by 20%


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NURSING MANAGEMENT

Help prevent falls in a patient withtremors or decreased motor ability bykeeping the side rails up and enforcing

other safety measures Reduce environmental stimuli when

talking to the patient

Ensure adequate sleep Orient the patient frequently to time,

date and his surroundings


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CARDIOVASCULAR DISORDERS

HTN and CAD are major CV diseases

CV dysfunction caused by diseases

rather than aging per se


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NURSING MANAGEMENT

Monitor the BP and HR and check for

orthostatic changes

Review meds of patient. Side effects may be

exacerbated in the elderly

Administer meds as prescribed, ensuring that

VS are within designated parameters

Make sure that patients taking diuretics canget to the Bathroom easily and safely without

falling


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PULMONARY SYSTEM DISORDERS

Minor alterations in pulmonary functionsassociated with aging

smoking, environmental exposures and

bacterial/viral infections Skeletal changes such as kyphosis can alter

pulmonary function

Pneumonia and TB common among elderly-

impaired host-defense mechanisms Tachypnea and tachycardia- 1st signs of

pulmonary compromise


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NURSING MANAGEMENT

Obtain accurate history of previous

pulmonary conditions

Observe for pursed lip breathing, use ofaccessory muscles and tachypnea


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GASTROINTESTINAL DISORDERS

Changes in GIT range from tooth loss (poor

dental hygiene or lack of dental care) to

malabsorption

Poor nutritional intake is compounded by lossof taste buds and smell- malnutrition common

Diminished peristalsis- constipation and

alterations in drug absorption Constipation immobility, poor hydration


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NURSING MANAGEMENT

Assess nutritional status of patient

(eating habits, bowel habits)

Ensure adequate hydration and fiberintake

Review meds and monitor for any GI

side effects


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URINARY SYSTEM

Incontinence, frequent urination and prostatichypertrophy in men

Incontinence- 15-30% of elderly

In hospitalized patients, urinary incontinence oftenoccurs because the patient who need help going tothe bathroom dont receive it on time

Diuretics, hypnotics, alpha-adrenergic agents andanticholinergics - urinary incontinence

Creatinine clearance decrease after age 40 at a rateof 1% every year- increase risk of having toxicitywhen taking drugs excreted by the kidneys


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NURSING MANAGEMENT

Ask the patient about nocturia, urinaryfrequency and incontinence

Make sure that the patient with nocturia has

safe and easy access to the bathroom toprevent falls and secondary complications

Help prevent drug toxicity by monitoringpatients medications

Monitor I & O and renal function as ordered Ensure privacy

Tell patients limit late night fluid intake


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MUSCULOSKELETAL DISORDERS

associated with changes in bonedensity, muscle mass and jointflexibility

Falls occur in 25% of elderly patients

Changes in bone occur 2ndary todemineralization

Bone density declines with more rapidloss in women than in men-osteoporosis, pathologic fractures


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Malnutrition occurs because bedridden

patients have poorer nutritional intake-

CHON and Vit. deficiencies, weakness

and decreased muscle mass

Pressure ulcers are caused solely by

immobility and can be prevented 100% of

the time by prompt nursing action


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Orthostatic hypotension may be caused or

exacerbated by bedrest which slows normal

postural compensatory mechanisms resulting in

changes in heart rate, stroke volume andcardiac output

Contractures can occur in 3-4weeks when joint

ROM does not occur

Falls can be caused by decreased peripheral

vision, depth perception and acuity especially

at night


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NURSING MANAGEMENT

Recognize that pt may take longer to

complete tasks due to decreased flexibility

and pain from degenerative diseases

Decrease the incidence of falls and fracturesby removing obstacles in the patients path

and improving lighting

Assess and document patients functional

capacity and level of mobility and offer

assistive devices


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NURSING MANAGEMENT

Encourage the bedridden patient to walk ASAP

to prevent complications of immobility

Perform daily ROM to prevent venous stasis,

muscle weakening and contractures

Ensure adequate nutrition, hydration and

dietary fiber

Evaluate patients meds to ascertain whichones might intensify fall risk or impair mobility

by limiting CNS responsiveness


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NURSING MANAGEMENT

Inspect the skin for breakdown and adhere to a

turning schedule

Monitor for orthostatic hypotension and move

slowly

Help the patient to go the Bathroom frequently

because many patients fall when trying to get

out of bed to use the BR

Encourage patient to perform ADLs but provide

assistance as needed


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PRACTICE

EXAMINATION


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1. The nurse would give a phosphate,bisocodyl or enema of patients

choice if he had not had a bowelmovement in ______ days, perroutine Hospice Orders.


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2.It is important to assess for andtreat underlying causes of insomnia.List 5 possible contributing factors.


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3.The nurse is performing an assessment onan older adult client. Which assessmentdata would indicate a potential

complication associated with the skin ofthis client?

a.Crusting

b.Wrinkling

c.Deepening of expression lines

d.Thinning and loss of elasticity in the skin


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4.The home health nurse is visiting a client for thefirst time. While assessing the clientsmedication, it is noted that there are at least 19prescription and several over-the-counter

medications that the client has been taking.Which intervention should the nurse take first?

a. Check for drug-drug interaction.

b.Determine whether there are any adverse side effects.

c. Determine whether there are medication duplications.

d.Call the prescribing physician and report anypolypharmacy.


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5.The home care nurse is performingan environmental assessment in thehome of an older client. Which of thefollowing, if observed by the nurse,requires immediate attention?

a.Unsecured scatter rugs

b.Clear exit passageways

c.An operable smoke detector

d.A prefilled medication cassette.


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6.The nurse is providing medication instructions toan older client who is taking digoxin (Lanoxin)daily. The nurse notes that which age-relatedbody changes could place the client at risk for

digoxin toxicity?a. Decreased muscle strength and loss of bone density

b.Decreased cough efficiency and decreased vital capacity

c. Decreased salivation and decreased gastrointerstinalmotility

d.Decreased lean body mass and decreased glomerularfiltration rate


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7.The home care nurse is visiting an olderfemale client whose husband died 6months ago. Which behavior by the client

indicates ineffective coping?a.Neglecting her personal grooming

b.Looking at old snapshots of her family

c.Participating in a senior citizens program

d.Visiting her husband s grave once a month


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9.The nurse is performing anassessment on an older client who ishaving difficulty sleeping at night.

Which statement, if made by theclient, indicates that teaching aboutimproving steep is necessary?a.I swim three times a week.

b.I have stopped smoking cigars.

c.I drink hot chocolate before bedtime.

d.I read for 40 minutes before bedtime.


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10.The nurse develops a nursing diagnosis of self-care deficit for an older client with dementia.Which of the following is an appropriate goal forthis client?

a. The client will function at the highest level ofindependence possible.

b. The client will complete all activities of daily livingindependently within a 1-hour time frame.

c. The client will be admitted to a long-term care facility tohave activities of daily living needs met.

d. The nursing staff will attend to all the clients activitiesof daily living needs during the hospital stay.

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