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Chapter 12 Health Care of The Older Adult
Chapter 12 Health Care of The Older Adult
Cardiovascular Changes
Decreased cardiac output Diminished ability to respond to stress Heart rate, stroke volume do not increase with maximum demand Slower heart recovery rate Increased blood pressure
Respiratory System
Increase in residual lung volume Decrease in muscle strength, endurance, vital capacity Decreased gas exchange, diffusing capacity Decreased cough efficiency
Integumentary System
Decreased subcutaneous fat, interstitial fluid, muscle tone, glandular activity, sensory receptors resulting in decreased protection against trauma, sun exposure, temperature extremes
Reproductive System
Female: Vaginal narrowing, decreased elasticity; decreased vaginal secretions Male: Less firm testes, decreased sperm production
Musculoskeletal System
Loss of bone density Loss of muscle strength, size Degenerated joint cartilage
Genitourinary System
Male: Benign prostatic hyperplasia Female: Relaxed perineal muscles, detrusor instability (urge incontinence), urethral dysfunction (stress urinary incontinence)
Gastrointestinal System
Decreased sense of thirst, smell, taste Decreased salivation Difficulty swallowing food Delayed esophageal, gastric emptying Reduced gastrointestinal motility
Nervous System
Reduced speed in nerve conduction Increased confusion with physical illness, loss of environmental cues
Special Senses
Vision: diminished ability to focus on close objects; inability to tolerate glare; difficulty adjusting to changes of light intensity; decreased ability to distinguish colors Hearing: decreased ability to hear high-frequency sounds; tympanic membrane thinning, loss of resiliency Taste and smell: decreased ability to taste, smell
Question
Tell whether the following statement is true or false: The leading cause of injury and preventable source of mortality and morbidity in older adults is falls.
Answer
True. Rationale: The leading cause of injury and preventable source of mortality and morbidity in older adults is falls.
Question
What is an age-related change in the body system of the older adult? A. Decreased blood pressure
Answer
B. Decreased cardiac output Rationale: Age-related changes in body systems include increased blood pressure, loss of bone density, and decreased salivation.
Dementia
Broad term for syndrome characterized by general decline in higher brain functioning (reasoning) with pattern of eventual decline in ability to perform even basic activities of daily living (toileting, eating)
Alzheimers disease
Vascular Dementia
Question
Tell whether the following statement is true or false: The most common affective or mood disorder of old age is Alzheimers disease.
Answer
False. Rationale: The most common affective or mood disorder of old age is depression.
Gerontology: combined biologic, psychological, sociologic study of older adults within their environment
Nursing Management
Supporting cognitive function Promoting physical safety Promoting independence in self-care activities Reducing anxiety, agitation Improving communication
Pharmacologic Aspects
Polypharmacy: administration of multiple medications at same time; common in older persons with several chronic illnesses Aging changes alter drug: Absorption Metabolism Distribution Excretion
Nursing Implications
Need adjustment of dosage due to age; start low, go slow Assess medication knowledge, use
Geriatric Syndromes
Impaired mobility Dizziness Falls, falling Urinary incontinence Susceptibility to infection Altered pain, febrile responses Altered emotional impact Altered systemic response
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