Dela Cruz, Jonelvira C.

September 22, 2021

BSN 3-B

Care of Older Adult

Module 1

LESSON 2 Trends and Issues

Think!
1. How many older adults do you know personally?
 There are 8 older adults that I know personally
2. Do you think they are “old”? Do they consider themselves “old”?
 Yes, for me they are old enough to consider as an “old”. And yes all of them consider
themselves as an “old”.
3. How do you personally define “old”?
 For me, old person means you are living a long life.
4. Why is aging an issue today?
 Aging becomes an issue today because of people expectations. They think that if you are old,
you can’t do some work and tasks properly.

Formative test.
A. MULTIPLE CHOICE
b, e, f 1. What are myths related to aging? (Select all that apply.)
a. Most older adults live in institutional settings.
b. Most older adults suffer from a significant loss of intellectual function.
c. Most older adults have frequent interaction with family and friends.
d. Most older adults experience significant personality changes.
e. Most older adults are seriously depressed.
f. Most older adults are sick, frail, and dependent on others.
a 2. Which is true of the Baby Boom generation?
a. Members were born between 1946 and 1964.
b. Members will all be age 65 or older by 2025.
c. Members are reaching age 65 at the rate of about 200 cohort members each day.
d. It comprises about one third of the population today.
d 3. When was the year of declaring a nationwide observance in the Philippines of the
International Year of Older Persons?
a. 1987
b. 1991
c. 1994
d. 1999

B. ESSAY
 1. What will you do if you encounter a suspected elderly abuse in a
HOSPITAL SETTING?
 If a nurse suspects abuse or neglect, she or he should contact a doctor, nurse
practitioner, or physician assistant. Depending on the workplace, notifying a
supervisor may also be required. If the victim is with a suspected abuser, the exam
should take place without that person present. Nurses should provide a calm,
comforting environment and approach the patient with care and concern. A
complete head-to-toe examination should be performed to look for physical signs of
abuse. If possible, a chaperone or witness should be present as well.
2. What will you do if you encounter a suspected elderly abuse in a
COMMUNITY SETTING?
 If the victim is a resident of a long-term care facility, the abuse must be reported to
the Director of the Ministry of Health and Long-Term Care. Long-term care homes
are also known as nursing homes or homes for the elderly. If the victim is a resident
of a retirement home, the abuse must be reported to the Retirement Homes
Regulatory Authority's Registrar.

LESSON 3 Theories of Aging

Formative test.
A. MULTIPLE CHOICE
d 1. According to Erikson, what is the primary developmental task of the older adult
population?
a. Generativity versus stagnation
b. Trust versus mistrust
c. Intimacy versus isolation
d. Integrity versus despair
b 2. A friend tells you she thinks her father is experiencing a “midlife crisis,” because he
purchased a new red sports car, started wearing trendy clothing, and is considering a career
change. Whose theory explains this behavior?
a. Newman’s
b. Jung’s
c. Havighurst’s
d. Erikson’s
a 3. It was developed to explain why aging persons separate from the mainstream of society.
a. Disengagement theory
b. Life learning theory
c. Psychosocial theory
d. Biological theory

B. ESSAY
1. Compare and contrast the Error theory and Somatic Mutation theory.
  Error theory proposing that errors in ribonucleic acid protein
synthesis cause errors to occur in cells in the body, while Somatic
Mutation theory deals with proposing that aging results from
deoxyribonucleic acid (DNA) caused by exposure to chemicals or
radiation.
2. What are the similarities of Crosslink theory to Molecular theory?
 These two theory similarities are it proposes that genetic material
and cell molecules interact with free radicals to form bonds that
reduce tissue's ability to regenerate itself.

LESSON 4 Physiologic Changes

Research Activity (1)

What are the integumentary disorders/ abnormal conditions common with aging?
Skin injury becomes more likely as you get older. Your skin becomes thinner and more
fragile, and some of the protective fat layer is lost. You may also have a reduced ability to detect
touch, pressure, vibration, heat, and cold.
 Skin tears can result from rubbing or pulling on the skin. Fragile blood vessels are prone to
rupture. Bruises, flat collections of blood (purpura), and raised collections of blood (hematomas)
can form after even minor injuries.
Pressure ulcers can be caused by changes in the skin, loss of the fat layer, decreased activity,
poor nutrition, and illnesses. Sores are most visible on the outside surface of the forearms, but they
can occur anywhere on the body.
Skin that is older repairs itself at a slower rate than skin that is younger. Wound healing
can take up to four times longer. This contributes to pressure ulcers and infections. Diabetes, blood
vessel changes, lowered immunity, and other factors all have an impact on healing.

Research Activity (2)

What are the musculoskeletal disorders/ abnormal conditions common with aging?
Bones become brittle and more prone to breaking. Overall height decreases, owing
primarily to trunk and spine shortening.
Joint breakdown can cause inflammation, pain, stiffness, and deformity. Almost all elderly
people experience joint changes. These changes range from minor stiffness to severe arthritis.
The posture may become more hunched (bent). The knees and hips may become more
flexed. The neck may tilt, and the shoulders may narrow while the pelvis expands.
Movement becomes slower and may become limited. The walking pattern (gait) slows and
shortens. Walking may become unsteady, and arm swinging may be reduced. Older people are
more prone to fatigue and have less energy.
Strength and endurance fluctuate. Muscle mass loss reduces strength.

Research Activity (3)

What are the respiratory disorders/ abnormal conditions common with aging?
Aging has effects on the respiratory system as it does on other organs: maximum function
gradually declines. Changes in the lungs caused by aging include
Peak airflow (the rate at which someone can exhale) and carbon dioxide and oxygen
exchange are reduced.
Reduces in lung function measures such as vital capacity (the maximum amount of air that
can be breathed out following a maximum inhalation)
Respiratory muscle weakness
The effectiveness of lung defense mechanisms has declined.
After bacterial or viral infections, older people are more likely to develop pneumonia.

Research Activity (4)

What are the cardiovascular disorders/ abnormal conditions common with aging?
Coronary artery disease can cause angina (chest pain caused by temporarily reduced blood
flow to the heart muscle), shortness of breath with exertion, and heart attack.
Arrhythmias (abnormal heart rhythms) of various types can occur.
Anemia can occur as a result of malnutrition, chronic infections, blood loss from the
gastrointestinal tract, or as a side effect of other diseases or medications.
Arteriosclerosis (hardening of the arteries) is a very common condition. Fatty plaque
deposits within blood vessels cause them to narrow and completely block.
Congestive heart failure is also common in the elderly. Congestive heart failure occurs ten
times more frequently in people over the age of 75 than in younger adults.
 Coronary artery disease is a fairly common condition. It is frequently caused by
atherosclerosis.
High blood pressure and orthostatic hypotension become more common as people get older.
Older people who are taking blood pressure medications should consult with their doctor to
determine the best way to manage their high blood pressure. This is due to the fact that taking too
much medicine may result in low blood pressure and a fall.
Heart valve disease is quite common. The most common valve disease in older adults is
aortic stenosis, or narrowing of the aortic valve.
If blood flow to the brain is disrupted, transient ischemic attacks (TIA) or strokes can
occur.

Research Activity (5)

What are the gastrointestinal disorders/ abnormal conditions common with aging?
The strength of esophageal contractions and the tension in the upper esophageal sphincter
decrease with but food movement is unaffected.
The ability of the stomach lining to resist damage decreases, which may increase the risk of
peptic ulcer disease, particularly in people who use aspirin and other nonsteroidal anti-
inflammatory drugs (NSAIDs). Also, as we get older, the stomach can't hold as much food (due to
decreased elasticity), and the rate at which the stomach empties food into the small intestine slows
down.
Lactase levels decrease, causing many older adults to be lactose intolerant.
The pancreas loses in overall weight and some tissue is replaced by scarring (fibrosis).
The rectum does enlarge slightly. Constipation is becoming more prevalent.

Research Activity (6)

What are the urinary disorders/ abnormal conditions common with aging?
The amount of kidney tissue decreases, as does kidney function.
The number of filtering units (nephrons) shrinks. Nephrons remove waste from the blood.
The blood vessels supplying the kidneys can harden. As a result, the kidneys filter blood
more slowly.
The bladder wall undergoes modification. The bladder becomes less stretchy as the elastic
tissue stiffens. The bladder can no longer hold as much urine as it once did.
The bladder muscles deteriorate.
The urethra can become partially or completely obstructed. This can happen in women
because of weakened muscles that cause the bladder or vagina to fall out of position (prolapse). An
enlarged prostate gland in men can block the urethra.
Bladder control problems, such as leakage or urinary incontinence (inability to hold urine),
or urinary retention (not being able to completely empty your bladder)
Urinary tract infections, including bladder infections (UTIs)
Kidney disease that is chronic

Research Activity (7)

What are the neurological disorders/ abnormal conditions common with aging?
As we get older, we all notice changes in our hair, skin, and joints that tell us we're getting
older. Along with these visible changes, our brains and central nervous systems are aging as well.
This is one of the reasons why, after the age of 65, you are more likely to suffer from a neurological
problem.
Strokes, neuropathy, Alzheimer's disease, and Parkinson's disease are some of the more
common neurological disorders that affect seniors. 
Formative test.
A. MULTIPLE CHOICE
Encircle the letter of the best answer.
c 1. Your older female patient is complaining because she is having frequent urinary tract
infections. Which normal age-related change is most likely to be a contributing factor?
a. Increased nocturnal urine production
b. Decreased perception of the need to void
c. Decreased bladder muscle tone
d. Urinary incontinence
b,d,e 2. Which are the normal age-related changes? (Select all hat apply)
a. Decreased long-term memory
b. Decreased visual acuity
c. Increased heart rate
d. Decreased rate of peristalsis
e. Increased gastric pH
f. Increased calorie requirements

a 3. An older adult is coming to your clinic for treatment for a gastric ulcer. Which
treatment would the nurse expect to be ordered?
a. Antibiotics
b. Stress-reduction classes
c. NSAIDs
d. Iron supplements before breakfast and dinner

d
4. What should the nurse explain when discussing expected changes in the female
reproductive system to an older adult?
a. Increased pubic hair is expected
b. Uterine enlargement is normal
c. Vaginal tissues become more vascular
d. Production of vaginal secretions decreases
d 5. The nurse performs a skin assessment of an older adult. Which finding is abnormal and
needs to be reported?
a. Increased patches of dark pigmentation on exposed skin
b. A dark, elevated patch that bleeds when touched
c. Deep wrinkles and frown lines around the mouth and eyes
d. Numerous brown or flesh-colored skin tags around the neck