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DISORDERSRELATED
TO AGINGLuzviminda C.
Cardino RN MAN
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AGING
aging process occurs in all living things
Causes physical, psychological and
social changes that increase as a persongets older
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THE 6TH DECADE
physiologic changes in the eye- night
vision
Ability to hear higher tone diminishes-difficulty understanding conversations
Pancreas function less efficiently-
higher glucose levels
Joints stiffen as cartilage deteriorates
from wear and tear- pain in movement
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THE 8TH DECADE
risk of falls increases- hip fractures
Bone mass decrease by half in many
women Cognitive ability decreases and 50% over
85 years show some signs of Alzheimers
disease
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COMMON PHYSICAL CHANGES
Presbycusis- hearing loss
Cataracts- opacity of lens
Nutritional deficits- tooth loss and alterations
in taste, smell and GI function
Muscle strength, agility and reaction times
decrease. Reflexes and vibratory sense lessen.
Position sense may decline- unsteady gait andincreased of falling
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COMMON PHYSICAL CHANGES
Cognitive ability does not diminish greatly-
short term memory and the ability to retrieve
information from long term memory decreases
Personality does not change with age
Sleep deprivation may occur due to decreases
in stage IV sleep and total sleep time and
increases in the time it takes to fall asleep Brain weight decreases by 7% and cerebral
blood flow is reduced by 20%
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NURSING MANAGEMENT
Help prevent falls in a patient withtremors or decreased motor ability bykeeping the side rails up and enforcing
other safety measures Reduce environmental stimuli when
talking to the patient
Ensure adequate sleep Orient the patient frequently to time,
date and his surroundings
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CARDIOVASCULAR DISORDERS
HTN and CAD are major CV diseases
CV dysfunction caused by diseases
rather than aging per se
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NURSING MANAGEMENT
Monitor the BP and HR and check for
orthostatic changes
Review meds of patient. Side effects may be
exacerbated in the elderly
Administer meds as prescribed, ensuring that
VS are within designated parameters
Make sure that patients taking diuretics canget to the Bathroom easily and safely without
falling
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PULMONARY SYSTEM DISORDERS
Minor alterations in pulmonary functionsassociated with aging
smoking, environmental exposures and
bacterial/viral infections Skeletal changes such as kyphosis can alter
pulmonary function
Pneumonia and TB common among elderly-
impaired host-defense mechanisms Tachypnea and tachycardia- 1st signs of
pulmonary compromise
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NURSING MANAGEMENT
Obtain accurate history of previous
pulmonary conditions
Observe for pursed lip breathing, use ofaccessory muscles and tachypnea
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GASTROINTESTINAL DISORDERS
Changes in GIT range from tooth loss (poor
dental hygiene or lack of dental care) to
malabsorption
Poor nutritional intake is compounded by lossof taste buds and smell- malnutrition common
Diminished peristalsis- constipation and
alterations in drug absorption Constipation immobility, poor hydration
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NURSING MANAGEMENT
Assess nutritional status of patient
(eating habits, bowel habits)
Ensure adequate hydration and fiberintake
Review meds and monitor for any GI
side effects
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URINARY SYSTEM
Incontinence, frequent urination and prostatichypertrophy in men
Incontinence- 15-30% of elderly
In hospitalized patients, urinary incontinence oftenoccurs because the patient who need help going tothe bathroom dont receive it on time
Diuretics, hypnotics, alpha-adrenergic agents andanticholinergics - urinary incontinence
Creatinine clearance decrease after age 40 at a rateof 1% every year- increase risk of having toxicitywhen taking drugs excreted by the kidneys
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NURSING MANAGEMENT
Ask the patient about nocturia, urinaryfrequency and incontinence
Make sure that the patient with nocturia has
safe and easy access to the bathroom toprevent falls and secondary complications
Help prevent drug toxicity by monitoringpatients medications
Monitor I & O and renal function as ordered Ensure privacy
Tell patients limit late night fluid intake
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MUSCULOSKELETAL DISORDERS
associated with changes in bonedensity, muscle mass and jointflexibility
Falls occur in 25% of elderly patients
Changes in bone occur 2ndary todemineralization
Bone density declines with more rapidloss in women than in men-osteoporosis, pathologic fractures
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MUSCULOSKELETAL DISORDERS
Malnutrition occurs because bedridden
patients have poorer nutritional intake-
CHON and Vit. deficiencies, weakness
and decreased muscle mass
Pressure ulcers are caused solely by
immobility and can be prevented 100% of
the time by prompt nursing action
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MUSCULOSKELETAL DISORDERS
Orthostatic hypotension may be caused or
exacerbated by bedrest which slows normal
postural compensatory mechanisms resulting in
changes in heart rate, stroke volume andcardiac output
Contractures can occur in 3-4weeks when joint
ROM does not occur
Falls can be caused by decreased peripheral
vision, depth perception and acuity especially
at night
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NURSING MANAGEMENT
Recognize that pt may take longer to
complete tasks due to decreased flexibility
and pain from degenerative diseases
Decrease the incidence of falls and fracturesby removing obstacles in the patients path
and improving lighting
Assess and document patients functional
capacity and level of mobility and offer
assistive devices
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NURSING MANAGEMENT
Encourage the bedridden patient to walk ASAP
to prevent complications of immobility
Perform daily ROM to prevent venous stasis,
muscle weakening and contractures
Ensure adequate nutrition, hydration and
dietary fiber
Evaluate patients meds to ascertain whichones might intensify fall risk or impair mobility
by limiting CNS responsiveness
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NURSING MANAGEMENT
Inspect the skin for breakdown and adhere to a
turning schedule
Monitor for orthostatic hypotension and move
slowly
Help the patient to go the Bathroom frequently
because many patients fall when trying to get
out of bed to use the BR
Encourage patient to perform ADLs but provide
assistance as needed
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PRACTICE
EXAMINATION
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1. The nurse would give a phosphate,bisocodyl or enema of patients
choice if he had not had a bowelmovement in ______ days, perroutine Hospice Orders.
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2.It is important to assess for andtreat underlying causes of insomnia.List 5 possible contributing factors.
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3.The nurse is performing an assessment onan older adult client. Which assessmentdata would indicate a potential
complication associated with the skin ofthis client?
a.Crusting
b.Wrinkling
c.Deepening of expression lines
d.Thinning and loss of elasticity in the skin
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4.The home health nurse is visiting a client for thefirst time. While assessing the clientsmedication, it is noted that there are at least 19prescription and several over-the-counter
medications that the client has been taking.Which intervention should the nurse take first?
a. Check for drug-drug interaction.
b.Determine whether there are any adverse side effects.
c. Determine whether there are medication duplications.
d.Call the prescribing physician and report anypolypharmacy.
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5.The home care nurse is performingan environmental assessment in thehome of an older client. Which of thefollowing, if observed by the nurse,requires immediate attention?
a.Unsecured scatter rugs
b.Clear exit passageways
c.An operable smoke detector
d.A prefilled medication cassette.
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6.The nurse is providing medication instructions toan older client who is taking digoxin (Lanoxin)daily. The nurse notes that which age-relatedbody changes could place the client at risk for
digoxin toxicity?a. Decreased muscle strength and loss of bone density
b.Decreased cough efficiency and decreased vital capacity
c. Decreased salivation and decreased gastrointerstinalmotility
d.Decreased lean body mass and decreased glomerularfiltration rate
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7.The home care nurse is visiting an olderfemale client whose husband died 6months ago. Which behavior by the client
indicates ineffective coping?a.Neglecting her personal grooming
b.Looking at old snapshots of her family
c.Participating in a senior citizens program
d.Visiting her husband s grave once a month
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9.The nurse is performing anassessment on an older client who ishaving difficulty sleeping at night.
Which statement, if made by theclient, indicates that teaching aboutimproving steep is necessary?a.I swim three times a week.
b.I have stopped smoking cigars.
c.I drink hot chocolate before bedtime.
d.I read for 40 minutes before bedtime.
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10.The nurse develops a nursing diagnosis of self-care deficit for an older client with dementia.Which of the following is an appropriate goal forthis client?
a. The client will function at the highest level ofindependence possible.
b. The client will complete all activities of daily livingindependently within a 1-hour time frame.
c. The client will be admitted to a long-term care facility tohave activities of daily living needs met.
d. The nursing staff will attend to all the clients activitiesof daily living needs during the hospital stay.