49 terms

1255 Older Adult

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