Care of Older Person

Activity 6: Please answer the following based on the instructions provided. Submit your output in either
Encoded (PDF) or Photo (Clear and readable format) for handwritten copy.

Identify and enumerate the data that should be taken during the assessment of the different systems.

Systems Assessment Data

Circulatory Auscultate:
- Aortic, Pulmonic, Erb’s point, Tricuspid, Mitral
- Auscultate apical pulse for one minute. Note the rate and rhythm.

Palpate:
- Inspect and palpate of the heart
- Bilateral radial, brachial, dorsalis Pedi’s, and posterior tibialis pulses.
- Skin turgor
- Edema

Inspect
- Face, lips, and ears for cyanosis
- Chest for deformities, scars, visible pulsations
- Bilateral arms/hands, noting color, warmth, movement, sensation
(CWMS), edema, color of nail beds, nail shape, and capillary refill
- Bilateral legs, noting CWMS, hair distribution, edema to lower legs and
feet, color of nail beds, and capillary refill, numbness/tingling
- Calf size/pain for signs of deep venous thrombosis (DVT)

Respiratory • GATHER VITAL SIGNS

- Evaluate the respiratory rate and pulse oximetry readings to verify the
patient is stable before proceeding with the physical exam.

• INSPECTION
- Assess level of consciousness
- Observe breathing pattern
- Observe the patient’s color in their lips, face, hands, and feet.
- Observe pattern of expiration and patient position
- Inspect the fingers for clubbing if the patient has a history of chronic
respiratory disease.

Gastrointestinal - Auscultate Bowel Sounds

- Palpate Lightly in All Four Quadrants for Distension, Firmness, Masses,
Pain
- Observe stool to identify important characteristics.

Genitourinary PALPATION
- Palpate the bladder for distention. Note the patient response to
palpation, such as pain, guarding, rigidity, or rebound tenderness

AUSCULTATION
 - Check for Hypoactive bowel sounds, may be related to constipation

Reproductive PHYSICAL ASSESSMENT

- breast examination
- abdominal examination
- examination of the external genitalia
- pelvic examination
- bimanual examination
- rectovaginal examination

INSPECTION
- inspect external genitalia

PALPATION
- inspect external genitalia

Nervous - Mental status

- Motor function and balance
- Sensory exam
- Newborn and infant reflexes
- Reflexes in the older child and adult
- Evaluation of the nerves of the brain
- Coordination exam
Musculoskeletal - Assess gait
- Inspect the spine
- Observe range of motion of joints
- Inspect muscles and extremities for size and symmetry
- Assess muscle strength
- Palpate extremities for tenderness
Sensory - Mechanical nociceptors (pinch, pinprick)
- Heat nociceptors (>45°C)
- Polymodal nociceptors ( mechanical, heat, and chemical noxious stimuli)

Integumentary - Inspect overall skin color

- Inspect for skin lesions and wounds
- Palpate extremities for edema
- Temperature
- Capillary refill
Endocrine ASSESSMENT for:
- Energy level
- Tolerance
- Weight changes
- Thirst
- Urinary frequency
- Sleeping pattern disturbance
- Changes in mood
Immune and IMMUNE
Hematologic - Joints are assessed for tenderness and swelling and for limited range of motion
HEMATOLOGIC
- Blood test
- Palpation of liver and spleen

CRITICAL THINKING

Situation:
Mr. Barbers is an 86-year-old man who presents to a comprehensive geriatric assessment center with
early signs of dementia. He lives alone, takes five daily medications, and until recently has been able to
independently complete his ADLs. However, last winter his furnace broke and his home radiator was
frozen for 5 days. His daughter came to visit and found him living in the cold.

1. What dimensions does a comprehensive geriatric assessment generally involve?

A comprehensive geriatric assessment is a multifaceted procedure created to evaluate an older
person's functional ability, health (physical, cognitive, and mental), and socio-environmental
situation.

2. What challenges do you anticipate in assessing Mr. Barbers?

The difficulties that I foresaw mostly have to do with Mr. Barbers evaluation of the early
symptoms of dementia. Even though he takes his medication on a regular basis, I still fear that in
the coming years he may suffer from memory loss, have trouble focusing, and have trouble
performing routine daily tasks, such as forgetting the right change when shopping, finding it
difficult to follow a conversation or find the right words, getting lost in time or place, or
experiencing mood swings.

3. What normal changes of aging may further complicate your assessment of Mr. Barbers?
Mr. Barbers' immune system is not as strong as it once was because he is already 86 years old.
He's going to be more susceptible to ailments, which could make my evaluation of him more
difficult.

4. What are the most important components of assessment for Mr. Barbers?
The evaluation of judgment and safety, physical examination with an emphasis on general
appearance, speech, neurologic and cardiovascular examination, and general mental status
assessment are the most crucial elements in Mr. Barbers case.