Exam VI: Older Adult - growth and development
Terms in this set (47)
one older than 65 years of age
Name the four groups that make up the older adult period.
Young-old: 65-74 years
Middle-old: 75-84 years
Old-old: 85-99 years
Elite old: 100 or more
is a form of prejudice in which older adults are sterotyped by characteristics found in only a few members of their group
a sense of being alone and lonely as a result of having fewer meaningful relationships.
the use of many medications at the same time
What causes the older adult to be at risk for accidental injuries?
Changes in vision and hearing, loss of mass and strength of muscles, slower reflexes and reaction time and decreased sensory ability.
refers to various organic disorders that progressively affect cognitive functioning.
the most common degenerative neurologic illness and the most common cause of cognitive impairment.
an older adult habitually becomes confused, restless, and agitated after dark
downward spiral or sequence of adverse events often triggered by a medical or surgical intervention during the hospitalization of an older adult
a temporary state of confusion, is an acute illness that can last from hours to weeks and resolves with treatment.
involves interventions to redirect the patient's attention to what is real in the environment.
the scientific and behavioral study of all aspects of aging and its consequences.
the ability to carry out usual and desired daily activities
refers to the diseases and medical conditions common to older people
What changes to the integumentary system do you see in older adults?
Thinned epidermis and dermis.
Decreased blood supply.
Decreased sebaceous and sweat glands.
Extracellular fluid is stable but intracellular fluid decreases
Clustering of melanin at surface and loss in hair
What would you see as normal during a physical assessement of skin on an older adult?
Dry, fragile skin
Pale skin with progressive sagging and wrinkling.
Easily bruised skin
Age spots and graying
What should you do if you see that your older adult patient is more prone to dehydration?
Observe for dizziness, lethargy
What should you do if you see that your older adult patient is a high risk for skin damage?
Turn, handle with care
Special protection devices in hospital
What should you do if you see that your older adult paitent is having difficulty tolerating colder temperatures?
Extra clothing, linen, etc.
What should you do if you see that your older adult paitent is having difficulty tolerating higher temperatures?
Educate regarding preventing heat stroke
What changes do you see in an older adult in the cardiovascular system?
Heart valves thicken and become stiffer.
Heart and arteries lose elasticity.
Deposits of calcium and fat in the arteries.
Decrease in contractility of heart.
Reduced sensitivity of BP regulating baroceptors.
What should you do if you see that your older adult patient is having issues with decreased filling and emptying of the heart?
Look for signs of heart failure
Sleeps with extra pillows
Lung sounds with rales
Peripheral vascular disease
Monitor pulses, prevent injury
What should you do if you see that your older adult patient is having issues with orthostatic hypotension?
OOB slowly, observe for SOB with exertion
Monitor BP and Pulse
What nursing interventions can you do to help an older adult with circulation?
Pneumatic devices for the lower extremities
Activity at maximum as tolerated
Monitor skin color
What changes are occurring in the older adult with the pulmonary system?
Calcification of costal cartilage (Increase chest wall stiffness)
Cardiovascular and pulmonary system are inter- dependent
O2 diffusion to the tissues is decreased (lung tissue more rigid, fewer alveoli, less elasticity)
Decreased ciliary action
Decreased cough response
Weaker thoracic muscles (respiratory muscles)
Increase in A-P diameter (barrel chest and kyphosis)
What changes are occurring in the older adult with hearing?
Structural changes and changes in the nerve tissues causes progressive hearing loss. High frequency sounds lost first.
As a result, there is a greater risk for injury and confusion.
What changes are occurring in the older adult with smell?
The olfactory bulb at the brain base atrophies causing a decrease in smell in the aged.
This may cause a decrease in the taste of food and a decrease in appetite.
Dangerous chemicals and smoke may not be detected
What changes are occurring in the older adult with taste?
There is a decrease in taste related to fewer taste buds and decreased sense of smell.
There is a decreased sense of taste, especially the sweet sensations at the tip of the tongue.
Decrease in appetite.
What changes are occurring in the older adult with the gastrointestinal system?
fewer cells on absorbing surface of intestines
blood flow to intestines
What changes are occurring in the older adult with vision?
Loss of accommodation, blurred vision
Decrease in peripheral vision
Decreased responsiveness to light
Glaring, decreased night vision
Altered color perception, especially with blue, green, violet
Decreased depth perception
Increased risk for glaucoma
There is a decrease in visual acuity. This puts the person at risk for injury.
fatty deposits occur
What are some things you need to think about when it comes to the older adult and nutrition?
Takes a longer time to eat.
More reports of indigestion.
Higher incidence of diabetes mellitus.
Liver detoxifies slower
smaller doses of medications.
What are the changes that occur in an older adult with touch?
There is a decreased sensitivity to touch, temperature, pressure, and pain.
Take precautions with heat applications, baths, showers, and pressure to tissues when in bed or chair. There is a potential for injury.
What changes occur in the older adult and the reproductive system?
Decrease in sex hormones secretion
Atrophy of reproductive organs
Reduced vaginal lubricating secretions
Atrophy of breasts
What changes occur in the older adult and the urinary system?
At 80, the blood flow to the kidneys is half of what it was at age 35.
There is a decrease in the: number of nephrons, glomerular filtration rate (GFR), and ability to concentrate or dilute urine.
There is a decrease in muscle tone of bladder and bladder capacity, and a delayed micturition reflex.
What should the nurse be aware of when it comes to the urinary system and the older adult?
Waste products are filtered and excreted more slowly.
Urinary urgency, and frequency are common as is incomplete emptying.
what changes occur in the older adult and the nervous system?
There is a decrease in:
Cerebral blood flow
Nerve conduction velocity
Delayed reaction time
Slowed mental/thought process; short term memory is less efficient
What should nurses consider with older adults and the nervous system?
Avoid heating pad.
Decrease in touch sensation.
Orientate to surrounds.
Ambulate with assistance if needed.
Allow more time to perform.
What changes occur in the older adult and the musculoskeletal system?
Muscle fibers atrophy, there is a decrease in muscle tone.
Muscle mass, strength and movements decrease.
Tendons shrink and sclerose.
Bone mineral and mass decrease—bone brittleness.
Discs thin, vertebrae shorten.
Slight hip and knee flexion.
What skeletal changes occur in an older adult?
Total joint replacements
What should nurses think about with an older adult and the musculoskeletal system?
Safety-Bed low with rails high.
Floor uncluttered and clean.
Move rugs, toys, etc. in and around homes.
Orient to surroundings.
Encourage calcium intake, sunshine.
Encourage physical activity ( but at slower pace).
What changes occur in the older adult and the endocrine system?
The pancreas secretes less adequate amounts of insulin leading to diabetes mellitus. The body's immune system is less effective in the older person.
-screening for diabetes
What health maintenance and promotion can you teach to an older adult?
Eat a diet low in fat & cholesterol, including fruits, vegetables & fiber.
Use sugar, salt and sodium in moderation.
Make regular exercise a part of life.
Drink alcohol in moderation, if at all.
Do not smoke.
Get regular dental cleanings & checkups.
Follow recommended guidelines for health-related screenings.
Keep vaccinations (including seasonal flu and pneumonia) up to date.
What are the possible indication of illness in an older adult?
Cognitive changes and agitation
Loss of bladder control
Eating and nutritional changes
Why is polypharmacy an issue with older adults?
Are on several prescription medications
Frequent use of OTC drugs
Hoarding of medications
Noncompliance perhaps due to:
Lack of understanding about importance
Undesirable side effects
Lack of transportation to get Rx
Need to ask older adults about altered drug responses:
Reduced gastric acid, increased pH
Reduced gastric motility
Decreased albumin sites
Reduced cardiac output
Impaired peripheral blood flow
Increased percentage of body fat
Decreased lean body mass
Decreased perfusion of the liver
Decreased renal blood flow & efficiency
What psychological changes will you see in older adults?
Intelligence and learning ability are unaltered.
Short-term memory is less efficient. Long-term memory is usually unaltered.
Being in an unfamiliar situation can cause confusion.
Usually functions well because of abundant reserves in the number of brain cells.