GERIATRIC NURSING Cardiac system

Terminologies: ARTERY:
• Gerontology – science & study of the High deposit: fat and calcium
aging process constriction
• Gerontologic Nursing – care & attention
to the elderly 1. poor circulation
• Geriatrics – science & study if the 2. Hypertension
physiologic & pathologic problems of the
elderly 3. high risk for vascular disorders
• Senescence – normal aging process Intervention:
• Senility – aging process characterized by
1. FAT: low fat diet
severe mental deterioration
2. low sodium diet
▪ Biological Theories of Aging
CAUSE RESULT
*Avoid:
IMMUNLOGIC Change/ decresease High risk for infection
THEORY function of the C- any caffeine containing drinks
immune system
WEAR AND TEAR Increase age overtime Decreased function A- alcohol
ENDOCRINE THEORY Changes in Changes in hormone
hypothalamus & production - decrease S- smoking
pituitary gland
FREE RADICAL Waste products
accumulating in the
Irreversible damage to
the body and cells
Vascular system
body
CROSS LINKING Changes in protein Stiffness adversely
VEINS:
(collagen theory) which affects flexibility affects functions
or elasticity Venous valves weaken
GENETIC Cell production Body is programmed
continue to decrease to expire blood return
Pooling of blood in LE
▪ Psychosocial Theories of Aging
1. Edema
Activity Theory one must constantly remain
functional and take on new 2. Thrombo embolism
activities to replace lost one

Continuity Theory continue good habits from young

Intervention:
age and not limit self to change
1. elevate the legs to promote backflow to the
Disengagement Theory old age must leave their place and heart = lessens the risk of edema and
role in society
thromboembolism
Ego Integrity vs Despair to achieve ego integrity, the elderly
must have: B. Respiratory
To achieve ego integrity, the elderly must have:
Lung compliance ( RR is normal, RR= activity)
a. atleast 1 companion in life
Vital Capacity (volume air exhaled after
b. stable financial status
inhalation)
c. productive social, civic, religious activity
Residual Volume (vol of air remain after max
I. Physiologic Changes in Late Adulthood
exhalation)
A. Cardiovascular cardiac output
1. Fatigue
1. poor response to stress
elasticity of cardiac muscles
2. low energy & low 2. Shortness of breath
endurance

Intervention: Exercise
ALVEOLI Decrease Coughing efficiency
Heart Valves: thick and stiff
size = number Increase mucus; accumulation
gas exchange Risk for Respi infection
O2 (Pneumonia)
Intervention:
Dec O2: Deep Breathing exercise
Coughing efficiency: coughing exercises
Inc mucus accumulation: Inc OFI
POPE: Postural
C. Integumentary
1. Epidermis
a. Keratinocytes: keratin – nails, skin,
hair
- if low keratin= elderly is at risk for
pressure ulcer
Intervention:
- change position every 2 hours
b. Melanin: skin & hair color
- serves as protection from UV rays
which cause skin cancer
- if low melanin= elder skin and
hair pigmentation will be
decreased: Risk for skin cancer
Intervention:
- use sunblock minimum of SPF 50
2. Dermis
a. Collagen and elastin – skin
elasticity if low = wrinkling
b. Capillaries – skin blood supply if
low = pallor
c. Hair follicles – hair growth if low =
alopecia
d. Sweat gland – temp regulation
(sweat) if low = dec sweating
e. Sebaceous gland – skin moisture
(sebum) if low = dryness
Intervention:
1. Inc. OFI
2. Moist trapping
3. Subcutaneous
a. Cushion – protects vital organs, if
low cushion = easy bruising
b. Thermoregulation – heat & cold,
risk for hypothermia or heat stroke
• Seborrheic Dermatitis (scaling)
• Keratosis (Overgrowth) – inc keratin in a
single spot
• Slow nail growth resulting to a thick but
brittle nails
• Solar lentigo/ liver spots/ lentigo senilis –
inc melanin in a single spot
D. Reproductive System
1. Uterus and Ovaries – atrophy > dec
hormones = HPT (Hormone Replacement
Theraphy) : Raloxifine
2. Vagina - decrease secretion > dryness >
H2o based lubricant (ky jelly)
3. Perineum muscle – dec waste tone >
Kegel’s exercise (contract 15 secs; relax 15
secs.) repeat 30-80 reps per day
4. Penis and testes – atrophy > dec
production of testosterone
5. Sexual Desire – “Persist”
1. slow arousal
2. slow erection
3. slow ejaculation
Intervention: use sittenafil (Viagra)
Potent vasodilator
E. Gastrointestinal
1. Mouth – dec salivary flow (dry mouth)
- lack of teeth leads to diff chewing
and swallong resulting to risk for aspiration
Management: Aspiration Precaution
1. Ensure upright position
2. Soft diet
2. Small Intestine - diminished absorption of
calcium and vitamin D (if without Vit D, only 10-
15% calcium is absorbed) =
Osteoclastic Activity ( bone to blood) > Weak and
brittle bones > risk for fractures
Intervention:
1. Priority: safety
2. Increase calcium and Vit D
supplements
3. CONSTIPATION
Predisposing Factors:
1. Lack of dietary bulk (fiber)
2. Prolonged use of laxatives
3. Inactivity (decrease peristaltis
movement)
4. Insufficient fluid intake
4. Excessive dietary fat:
Symptoms: Abdominal discomfort and
flatulence
Management:
1. Inc fiber diet
2. Use laxative as prescribed
3. Promote mod exercise
4. Increase GFI
5. Limit fat in diet
F. Renal
1. Size and function of the kidneys
If decreased size & function:
Decreased GFR leads to concentration of urine:
diluted > decrease excretion of medication which
causes elderly high risk for drug toxicity: drug
dose: ½ or 1/3 normal dose
Intervention:
1. Assess for Duplication
2. Report to HCP
3. Watch out for Polypharmacy
2. Bladder Capacity and emptying
G. Musculoskeletal
H. Neurologic
I. Sensory
Intervention:
*Exercise***
1. Abrasions, bruises, or lacerations
2. Torn or stained underclothing
3. Puncture wounds
4. Disheveled appearance
5. Discomfort or bleeding in the genital area
6. Sprains, dislocations, or fractures
7. Inability to pay bills and fearful when discussing
finances
8. Difficulty in walking or sitting
9. Fearful and agitated
10. Unexplained genital infections or disease
11. Withdrawn and loss of interest in self and
social activities

1. Wear proper clothing according to temperature 12. Lacking physical needs, such as glasses,
hearing aids, and dentures
2. Appropriate room temp.
II. Mental Health Concerns: “DIGS”
A. Psychological profile of Victim: “ACCIDENT”
1. Depression - often caused by death of
loved ones - cover up the abuser (often family member)
2. Isolation – seld isolation/ family members B. Psychological Profile of Abuser:
3. Grief – ineffective coping sign:
- hesitant to provide medical care to the family
1. Slef neglect/ self care deficit
2. Substance abuse **Nursing Responsibilities:
4. Suicide – take any suicidal ideations • Assess and Treat – wounds and injuries
sensitively • Safety – remove elderly from danger
III. Abuse of Older Adults “PENES” • Report – to authority ( social worker & police)
• Document – evidence of legal case
Factors:
1. Individual’s dependence
2. caregiver stress
3. history of family violence
CATEGORIES:
1. Domestic – family member
2. Institutional - caregiver
3. Self neglect - instinuated
Abuse of Older Adults “PENES”
P – hysical
E – motional
N – eglect
E – conomic
S - exual