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what are the four dominant theories of aging?

1. Genetic
2. Immunity
3. Cross linkage
4. Free radical

Genetic Theory

- genetic clocks

- we will live longer if our ancestors lived longer

- wear & tear of cells

Immunity Theory

- immune response & T-cells ↓

- ↑ in infections, immune disorders, & cancer

- more prone to things (internal clock)

Cross-Linkage Theory

chemical reactions cause molecules to bind together and damage DNA & cell metabolism

Free Radical Theory****

- cell metabolism produces molecules with high energy electrons that disrupt function of every molecule that eventually damage cell membranes
- effects proteins & lipids

what is ageism?****

- A form of prejudice
- A belief that older people do not experience the same needs desires and concerns that younger people do.

Old age begins at age 65 (True or False)


Approximately half of all hospitalized patients are over the age of 65 (True of False)

It depends

Which theory of aging focuses primarily on cell metabolism & function?

Free Radical Theory

Growth and development: Physiologic

Gradual internal and external non-pathologic changes

Growth and development: Cognitive

Ability to perceive and understand the world

Growth and development: Psychosocial

Self concept remains stable

Growth and development: Spiritual

Reasons for living, meaning of life

What are five physiological changes to the INTEGUMENT system in older adults?

- ↓ pigment of hair & skin
- thinning epidermis (easy tearing & bruising)
- ↓ skin turgor (sagging & wrinkles)
- thinning hair
- ↑ nail thickness (esp. toes), brittle, yellow, ridges

What are four physiological changes to the MUSCULOSKELETAL system in older adults?

- ↓ muscle mass & strength
- ↓ ROM, flexibility, coordination & stability
- Posture changes (stooping) Kyphosis (↓ height)
- bone demineralization, ↑ fractures

What are five physiological changes to the NEUROLOGIC system in older adults?

- ↓ reflex response
- ↓ balance (difficulty) & fine coordination
- ↓ response to multiple stimuli
- ↓ sensation of pain & pressure
- ↓ temperature regulation, becomes less effective

What are three physiological changes to the SENSES system in older adults?

- ↓ visual acuity (reading, glare, darkness, depth perception)
- ↓ hearing, esp. pitch (hear lower voices easier)
- ↓ taste & smell (salt & sweet)
reduce clutter, leave a light on

What are six physiological changes to the CARDIOPULMONARY system in older adults?

- ↓ endurance
- ↓ valves & blood vessels stiffen up from calcium deposits
- ↑ rate & ↓ depth of respirations
- ↓ number of alveoli & cilia = ↑ chance of pneumonia
- ↓ cough reflex & strength = ↑ risk of aspiration
- ↑ orthostatic hypotension

What are five physiological changes to the GI system in older adults?

- ↓ digestive juices & peristalsis = constipation (leading to ileus/colostomy)
- ↓ appetite
- ↓ thirst = ↓ kidney function
- ↑ constipation & complaints of indigestion (suggest they don't lay down until 30 minutes after eating)
- ↑ incidence of insulin resistance & anemia = metformin

What are seven physiological changes to the GENITOURINARY system in older adults?

- ↓ kidney function
- ↓ bladder capacity
- ↑ BUN & creatinine
- ↑ residual urine
- ↑ prostate size = ↑ chance of prostate cancer
- vaginal dryness & thinning
- incontinence is not part of aging

What are four types of adaptions for the older adult?

1. Regular exercise = lubricates joints, bone density
2. Limit or stop driving
3. Assistive devices = cane, walker, w/c, glasses
4. Living conditions

what is psychosocial: Life review?

1. Telling stories of past events = reminiscing
2. Common in ALL cultures
3. Establishes ego integrity or despair

what happens with retirement? (3)

↓ income
↑ time
↓ interactions with other people, but this could ↑

What is reminiscing?

- telling stories of past events
- a way for older adults to relive & restructure life experiences & is part of achieving ego integrity

What is love and belonging (3)?

1. Physical touch = depends on culture
2. Friendships = could either ↑ or ↓
3. Valued and useful = sometimes don't feel this

what is role reversal? (3)

1. Chronic illness and disability requires dependence on spouse or children
2. Emotionally draining = economic needs, assuming new parental roles, while taking care of your family
3. Sandwich generation

what are three types of elder abuse?

1. Physical, emotional, sexual
2. Neglect
3. Economic exploitation

Who is at increased risk for elder abuse? (3)

1. Female
2. Impaired mobility
3. Altered mental status
- 85, female, stroke, impaired mobility

What are four contributing factors to elder abuse?

1. Caregiver stress
2. Family violence
3. Substance abuse
4. Mental illness

Alzheimer's Disease

- progressively serious & fatal
- forgetfulness & impaired judgment
- eventually will forget family & familiar surroundings


- a temporary state of confusion, an acute illness that can last from hours to weeks & resolves with treatment
- confusion triggered by drugs, hospitalization, circulatory or metabolic problems, or illness


- extreme or prolonged sadness
- difficulty concentrating

Sundowning Syndrome

confused, agitated, restless after dark

(can be confused with dementia, it is a common problem with dementia)

What approach should the nurse take when handling a patient with dementia?

Incorporate established behavior patterns

Conventional Spirituality

excepts & follows rules of religion
- follows society roles & expectations

Individuative-reflective Spirituality

develop their own beliefs & attitudes

Conjunctive Spirituality

- integrating faith & truth to see the reality of their own beliefs
integrated other view points into their own


trusts a greater power & believes in the future

What are the nursing goals in relation to risk factors?

Prevent or reduce common risk factors that contribute to functional decline, impaired quality of life and excess disability

What are the four best practice assessment tools?

2. Katz ADL Index
3. Lawton IADL scale
4. The Mini Cog

What are four physical nursing diagnoses?

1. Risk for Injury
2. Risk for Infection
3. Sedentary Lifestyle
4. Ineffective Health Maintenance

What are four cognitive & psychosocial nursing diagnoses?

1. Risk for Loneliness
2. Social Isolation (ex. isolation from kids)
3. Caregiver Role Strain
4. Risk for Disabled Family Coping (everyone is different)

What are three nursing interventions for Risk for injury?

1. Prevention and early identification
(Hendrich II Fall Risk Model)
2. Safety measures
3. Regular exercise

What are the s/s for Risk for ineffective health maintenance?

Signs & symptoms
1. Confusion
2. Apathy, fatigue, self neglect
3. Dyspnea, SOB
4. Incontinence
Teaching = prevention

What is reality orientation (used with Delirium/confusion)? (4)

1. Call patient by name
2. Reorient daily
3. Provide a calendar and clock
4. Establish a daily routine

What are three communication guidelines (used with Delirium/confusion)?

1. Use simple terms
2. Ask simple questions
3. Give simple directions = what for them to follow directions

What are two studies on preventing aging?

1. Hormone replacement
2. Diet

What are five types of hormone replacement?

1. HGH
2. Melatonin = sleep, antioxidant, ↑ immune system
3. DHEA = steroid hormone produced by adrenal gland
4. Testosterone
5. Estrogen and progesterone (↓ estrogen = osteoporosis)

What are three diet strategies used for preventing aging?

1. Calorie restriction
2. Resveratrol
3. Intermittent fasting

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