NR 601 Week 4 Midterm Study Guide- Review

$25.00

Institution	Chamberlain
Contributor	Chantara

Description

Developmental changes

o Review Kennedy readings for age related changes

Physiological

Age related Change	Functional Change	Implications
Integumentary System
Loss of dermal and epidermal thickness	Loss of subcutaneous tissue and thin epidermis.	Prone to skin breakdown and injury
Decreased vascularity see	• Atrophy of sweat glands resulting in decreased sweat production • Decreased body odor • Decreased heat loss • Dryness	• Alteration in thermoregulatory response • Fluid requirements may change seasonally • Loss of skin water • Increased risk of heat stroke
Respiratory System
Decreased lung tissue elasticity	Decreased vital capacity	Reduced overall efficiency of ventilatory exchange
Cilia atrophy	Change in mucociliary transport	Increased susceptibility to infection
Decreased respiratory muscle strength	• Reduced ability to handle secretions and reduced effectiveness against noxious foreign particles • Partial inflation of lungs at rest	Increased risk of atelectasis
Cardiovascular System
Heart valves thicken and become fibrotic	Reduced stroke volume, cardiac output; may be altered	Decreased responsiveness to stress
Fibroelastic thickening of the sinoatrial node; decreased number of pacemaker cells	Slower heart rate	Increased prevalence of arrhythmias
Decreased baroreceptor sensitivity (stretch receptors)	Decreased sensitivity to changes in blood pressure	Prone to loss of balance, which increases the risk for falls
GI
Liver becomes smaller	Decreased storage capacity
Decreased muscle tone	Altered motility	Increases risk of constipation, functional bowel syndrome, esophageal spasm, diverticular disease
Decreased basal metabolic rate (rate at which fuel is converted into energy)		May need fewer calories

NE CONDE)

Lab results

Lab Test	Normal	Changes with age	Comments
UA
Protein	0-5mg/100ml	Rises slightly	May be due to kidney changes with age, urinary tract infection, renal pathology
Specific Gravity	1.005-1.020	Lower max in elderly 1.016-1.022	Decline in nephrons impairs ability to concentrate urine
Hematology
ESR	Men: 0-20 Women: 0-30	Significant increase	Neither sensitive nor specific in aged
Iron Binding	50-160mcg/dl 230-410mcg/dl	Slight decrease Decrease
Hemoglobin	Men: 13-18g/100ml Women: 12-16g	Men: 10-17g Women: None noted	Anemia common in the elderly
Hematocrit	Men: 45-52% Women 37-48%	Slight decreased speculated	Decline in hematopoiesis
Leukocytes	4,300–10,800/mm3	Drop to 3,100–9,000/mm3	Decrease may be due to drugs or sepsis and should not be attributed immediately to age
Lymphocytes	00–2,400 T cells/mm3 50–200 B cells/mm3	T-cell and B-cell levels fall	Infection risk higher; immunization encouraged
Platelet	150,000–350,000/	No change in number
Blood Chemistry
Albumin	3.5–5.0	Decline	Related to decrease in liver size and enzymes; protein-energy malnutrition common
Globulin	2.3–3.5	Slight increase
Total serum protein	6.0–8.4 g	No change	Decreases may indicate malnutrition, infection, liver disease
Blood urea nitrogen	Men: 10–25 Women: 8–20 mg	Increases significantly up to 69 mg	Increases significantly up to 69 mg
Creatinine	0.6–1.5 mg	Increases to 1.9 mg	Related to lean body mass decrease
Creatinine clearance	104–124 mL/min	Decreases 10%/decade after age 40 years	Used for prescribing medications for drugs excreted by kidney
Glucose tolerance	62–110 mg/dL after fasting; >120 mg/dL after 2 hours postprandial	Slight increase of 10 mg/dL/decade after 30 years of age	Diabetes increasingly prevalent; drugs may cause glucose intolerance
Alkaline phosphatase	13–39 IU/L	Increase by 8–10 IU/L	Elevations >20% usually due to disease; elevations may be found with bone abnormalities, drugs (e.g., narcotics), and eating a fatty meal

o Atypical disease presentations

Acute abdomen

Absence of symptoms or vague symptoms, acute confusion, mild discomfort and constipation, some tachypnea and possibly vague respiratory symptoms, appendicitis pain may begin in right lower quadrant and become diffuse