Integumentary System:

1. Dryness and itchiness

● Bath oils, moisturizing lotions, and massage are beneficial in treating and preventing pruritus. Vitamin
supplements and a highquality, vitamin-rich diet may be recommended. Topical application of zinc oxide is
effective in controlling itching in some individuals. Antihistamines and topical steroids may also be
prescribed for relief.
Book: page 360

2. Hypothermia
● Maintain the room temperature at 65 degrees Fahrenheit at a minimum; some very frail elderly people will
require higher room temperatures to maintain body warmth and comfort.
● Clothe the person adequately and layer both items of clothing and bedcovers to provide optimum
insulation.
● Limit the time that the elderly person is exposed to a cold area.
● Minimize heat loss from the head by providing a hat or scarf to cover the head and neck when possible,
particularly when the elderly person is outside.
● Whenever it is necessary to remove all the person's clothing, minimize the exposure time
● Cover patients when bathing; a single bath blanket is insufficient protection against hypothermia for a frail
elder.
● Following a bath, dry the person completely, clothe them before leaving the bathing area.
● Dry wet hair quickly with an electric hair dryer; do not let wet hair air dry.
● If the person is incontinent of urine, use absorbent pads, checking often for wet clothing or bedding.
● Encourage exercise to help the person generate heat from muscle activity.
● Provide hot, high protein meals and bedtime snacks to sustain heat production during the day and evening.

Musculoskeletal System:

1. Breakdown of joints
● Often, heat relieves muscle spasms; a warm bath at bedtime and keeping the extremities warm with
blankets and clothing can reduce spasms and cramps throughout the night and promote uninterrupted
sleep.
● Passive stretching of the extremity can be helpful in controlling muscle cramps. Excessive exercise and
musculoskeletal stress should be avoided, as well as situations known to cause pain, such as heavy lifting
or damp weather. Back rubs using slow, long, rhythmic strokes can promote relaxation and comfort. Pain
in the weight-bearing joints can be alleviated by resting those joints, supporting painful joints during
transfers, and using a walker or cane

Book: page 318

2. Involuntary movements
● Canes, walkers, and other assistive devices can often provide significant aid in compensating for handicaps
and should be used when feasible
● Prevention includes paying attention to the area where one is walking; climbing stairs and curbs slowly;
using both feet for support as much as possible; using railings and canes for added balance; wearing
properly fitting, safe shoes for good support.

Book: page 318

Respiratory System:

1. Pulmonary embolisms
● Oxygen therapy should be used prudently to treat respiratory disorders in older adults.
● The nurse should monitor blood gases and observe the patient for symptoms of carbon dioxide narcosis,
which include confusion, muscle twitching, visual defects, profuse perspiration, hypotension, progressive
degrees of circulatory failure, and cerebral depression, which may be displayed as increased sleeping or a
deep comatose state.

2. Less lung expansion and contraction of breathing due to thinning of ribcage

● Once respiratory diseases have developed, close monitoring of the patient’s status is required to minimize
disability and prevent mortality. Close nursing observation can prevent and detect respiratory complications
and should include checking the following:
- respiratory rate and volume
- pulse (e.g., a sudden increase can indicate hypoxia)
- blood pressure (e.g., elevations can occur with chronic hypoxia)
- temperature (e.g., not only to detect infection but also to prevent stress on the cardiovascular and
respiratory systems as they attempt to meet the body’s increased oxygen demands imposed by an
elevated temperature)
- neck veins (e.g., for distention)
- patency of airway
- coughing (e.g., frequency, depth, productivity)
- quality of secretions
- mental status