c
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 AGING
‡ aging process occurs in all living things
‡ Causes physical, psychological and
social changes that increase as a person
gets older
 V
6V 
CA

‡ 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
 V
7V 
CA

‡ Blood pressure is 25% higher than that
at age 20- VN
‡ CA- thickening of arterial walls- 50%
‡ Short term memory declines
‡ Sweat glands decrease in number- heat
stroke
 V
8V 
CA

‡ 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 Alzheimer·s
disease
 COMMON P SICAL C ANG
S

‡ 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 and
increased of falling
 COMMON P SICAL C ANG
S
‡ 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%
 NURSING MANAG
M
NV

‡ Assess neurologic status on a regular basis

‡ Assess the patient·s level of understanding
and ability to communicate
‡ Ask about vision and hearing problems and
refer accordingly. Provide info about glasses
and hearing aids
‡ Provide assistance with AL, body function
‡ Monitor physiologic changes, i.e. dysphagia,
intolerance, etc.
 NURSING MANAG
M
NV
‡ elp prevent falls in a patient with
tremors or decreased motor ability by
keeping the side rails up and enforcing
other safety measures
‡ Reduce environmental stimuli when
talking to the patient
‡
nsure adequate sleep
‡ Orient the patient frequently to time,
date and his surroundings
 CARIOVASCULAR ISOR
RS
‡ VN and CA are major CV diseases
‡ CV dysfunction caused by diseases
rather than aging per se
 NURSING MANAG
M
NV
‡ Monitor the BP and R 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 can
get to the Bathroom easily and safely without
falling
PULMONAR SSV
M ISOR
RS
‡ Minor alterations in pulmonary functions
associated with aging
‡ smoking, environmental exposures and
bacterial/viral infections
‡ Skeletal changes such as kyphosis can alter
pulmonary function
‡ Pneumonia and VB common among elderly-
impaired host-defense mechanisms
‡ Vachypnea and tachycardia- 1st signs of
pulmonary compromise
 NURSING MANAG
M
NV
‡ Obtain accurate history of previous
pulmonary conditions
‡ Observe for pursed lip breathing, use of
accessory muscles and tachypnea
GASVROINV
SVINAL ISOR
RS
‡ Changes in GIV range from tooth loss (poor
dental hygiene or lack of dental care) to
malabsorption
‡ Poor nutritional intake is compounded by loss
of taste buds and smell- malnutrition common
‡ iminished peristalsis- constipation and
alterations in drug absorption
‡ Constipation ² immobility, poor hydration
 NURSING MANAG
M
NV
‡ Assess nutritional status of patient
(eating habits, bowel habits)
‡
nsure adequate hydration and fiber
intake
‡ Review meds and monitor for any GI
side effects
 URINAR SSV
M
‡ Incontinence, frequent urination and prostatic
hypertrophy in men
‡ Incontinence- 15-30% of elderly
‡ In hospitalized patients, urinary incontinence often
occurs because the patient who need help going to
the bathroom don·t receive it on time
‡ iuretics, hypnotics, alpha-adrenergic agents and
anticholinergics - urinary incontinence
‡ Creatinine clearance decrease after age 40 at a rate
of 1% every year- increase risk of having toxicity
when taking drugs excreted by the kidneys
 NURSING MANAG
M
NV
‡ Ask the patient about nocturia, urinary
frequency and incontinence
‡ Make sure that the patient with nocturia has
safe and easy access to the bathroom to
prevent falls and secondary complications
‡ elp prevent drug toxicity by monitoring
patient·s medications
‡ Monitor I & O and renal function as ordered
‡
nsure privacy
‡ Vell patients limit late night fluid intake
MUSCULOSK
L
VAL ISOR
RS
‡ associated with changes in bone
density, muscle mass and joint
flexibility
‡ Falls occur in 25% of elderly patients
‡ Changes in bone occur 2ndary to
demineralization
‡ Bone density declines with more rapid
loss in women than in men-
osteoporosis, pathologic fractures
 MUSCULOSK
L
VAL ISOR
RS
‡ Malnutrition occurs because bedridden
patients have poorer nutritional intake-
C ON 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
 MUSCULOSK
L
VAL ISOR
RS
‡ Orthostatic hypotension may be caused or
exacerbated by bedrest which slows normal
postural compensatory mechanisms resulting in
changes in heart rate, stroke volume and
cardiac 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
 NURSING MANAG
M
NV
‡ Recognize that pt may take longer to
complete tasks due to decreased flexibility
and pain from degenerative diseases
‡ ecrease the incidence of falls and fractures
by removing obstacles in the patient·s path
and improving lighting
‡ Assess and document patient·s functional
capacity and level of mobility and offer
assistive devices
 NURSING MANAG
M
NV
‡
ncourage the bedridden patient to walk ASAP
to prevent complications of immobility
‡ Perform daily ROM to prevent venous stasis,
muscle weakening and contractures
‡
nsure adequate nutrition, hydration and
dietary fiber
‡
valuate patient·s meds to ascertain which
ones might intensify fall risk or impair mobility
by limiting CNS responsiveness
 NURSING MANAG
M
NV
‡ Inspect the skin for breakdown and adhere to a
turning schedule
‡ Monitor for orthostatic hypotension and move
slowly
‡ elp the patient to go the Bathroom frequently
because many patients fall when trying to get
out of bed to use the BR
‡
ncourage patient to perform ALs but provide
assistance as needed
O 

 

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