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Gerontological

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Pathologic conditions. Aging. Aging starts at birth. Continues throughout. life span ... Free Radical- Oxidation of fats, proteins and carbohydrates creates free ... – PowerPoint PPT presentation

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Title: Gerontological


1
Gerontological Community Based Nursing
Physiologic Changes of Aging
2
Physiologic Changes of Aging
  • Physical Changes
  • Normal Aging
  • Pathologic conditions

3
Aging
  • Aging starts at birth
  • Continues throughoutlife span
  • It is universal, progressive, intrinsic, and
    unavoidable

4
Biologic Theories of Aging
  • Stochastic theories
  • Nonstochastic theories

5
Stochastic Theories
  • Stochastic- Aging occurs randomly and progresses
    over time.
  • Error- DNA/RNA Cell replication errors causes
    failure of cellular activity and thus the changes
    we see with aging.
  • Free Radical- Oxidation of fats, proteins and
    carbohydrates creates free radicals that attach
    to other molecules/cells and damage them. Random
    damage accumulates, aging results, and eventually
    death of the damaged person.
  • Wear Tear- Repeated and random overuse and
    injury of the human body cells, tissues, organs
    or body systems.

6
Nonstochastic Theories
  • Nonstochastic- Cell aging in the body is
    genetically programmed for the life span of an
    organism. Includes the following
  • Programmed- Biological clock in each cell
    determines number of replications and eventual
    death of cell and organism.
  • Immunological- Alteration in cell is recognized
    as a foreign body and antibody are produced to
    fight them just as in autoimmune diseases.
  • Neuroendocrine- Over time, the ability of a cell
    to auto regulate itself becomes altered or lost
    resulting in aging and death.

7
Normal Changes of Aging Integument
8
Normal Changes of Aging Integument
  • The largest most visible organ of the body think
    protection, personal identity, security, temp.
    regulation
  • Integumentary- Skin Changes due to intrinsic and
    extrinsic factors such as
  • _____________
  • _____________
  • _____________
  • _____________

9
Normal changes of Aging Hair and Nails
  • Hair (head)
  • Thinner
  • Coarser
  • Dryer
  • Facial hair
  • Nails
  • Harder, thicker, more brittle, dull and opaque

10
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11
Normal changes of Aging Musculoskeletal
  • Influencing Factors
  • Age
  • Gender
  • Race
  • Environment
  • Average loss
  • 2 inches between ages 40-80

12
Normal changes of Aging Musculoskeletal
  • Bone strength/Bone mineral density

This graph shows how the bone density of the
total hip decreases with age. The units are
standardized bone density in (mg/cm2). The lines
show the average values, and for each age, race
and gender a range of values occurs in the
ordinary population.
13
Osteoporosis
  • Kyphosis

14
Osteoporosis
  • Affects women 4x more often than men
  • ? Estrogen loss after menopause
  • ? Long term steroid use

15
Normal Changes of Aging
  • Ligaments, Tendons, Joints
  • gtrigid, hardened, stiff
  • Arthritis is the 1 cause of disability in
    elderly

16
  • Did you know?During the course of your lifetime,
    your heart will typically beat 2.5 billion
    times--about once a second, every minute of your
    life. The heart pumps about five or more quarts
    of blood a minute, nearly 2,000 gallons of blood
    throughout your body. A healthy heart is strong
    enough to drive a single drop of blood throughout
    your entire body in about 24 seconds

17
Normal Changes of Aging Cardiovascular System
  • Presbycardianormal changes in the healthy heart
  • ? stroke volume
  • ? cardiac output
  • Left ventricle wall thickens
  • As much as 50 by age 80
  • Left atrium enlarges (to compensate)
  • Possible development of a fourth heart sound (S4)

18
Normal Changes of Aging Cardiovascular System
  • The maximum heart rate decreases and it takes
    longer for heart rate and blood pressure to
    return to normal resting levels after exertion.
  • The aorta and other arteries becomes thicker and
    stiffer which may bring a moderate increase in
    systolic blood pressure with aging. In some
    individuals, this may result in hypertension.
  • The valves between the chambers of the heart
    thicken and become stiffer. As a result heart
    murmurs are fairly common among older adults.
  • The pacemaker of the heart loses cells and
    develops fibrous tissue and fat deposits. These
    changes may cause a slightly slower heart rate
    and even heart block. Aberrant heart rhythms and
    extra heart beats become more common.
  • The baroreceptors which monitor blood pressure
    become less sensitive. Quick changes in position
    may cause dizziness from orthostatic hypotension.

19
Peripheral Vascular Changes
  • Arteries become less elastic and more brittle
  • Calcium leaving the bones is deposited in the
    blood vessels
  • Lumen size of the vessels is ?d
  • May lead to increased blood pressure

20
Normal Changes of Aging in the Respiratory System
  • The lungs become stiffer, muscle strength and
    endurance diminish, and the chest wall becomes
    more rigid.
  • Total lung capacity remains constant but vital
    capacity decreases and residual volume increases.
  • The alveolar surface area decreases by up to 20
    percent.
  • Alveoli tend to collapse sooner on expiration.
  • There is an increase in mucus production and a
    decrease in the activity and number of cilia.
  • The body becomes less efficient in monitoring and
    controlling breathing.

21
Urinary System Changes with Aging
  • Kidney mass decreases by 25-30 percent and the
    number of glomeruli decrease by 30 to 40 percent.
  • These changes reduce the ability to filter and
    concentrate urine and to clear drugs.
  • With aging, there is a reduced hormonal response
    (vasopressin) and an impaired ability to conserve
    salt which may increase risk for dehydration.
  • Bladder capacity decreases and there is an
    increase in residual urine and frequency.
  • These changes increase the chances of fluid
    electrolyte imbalances, urinary infections,
    incontinence, and urinary obstruction.

22
Age-related Changes in the Endocrine System
  • Insulin resistance may prevent efficient
    conversion of glucose into energy.
  • A decrease in aldosterone and cortisol may affect
    immune and cardiovascular function

23
Major Gastrointestinal Changes with Aging
  • Decreased peristalsisgtreflux and hiatal hernias
  • Increased stomach pH gt increase susceptibility
    to gastric irritation ulcers.
  • The liver is less efficient in metabolizing drugs
    and repairing damaged liver cells.
  • Diverticuli from weakened intestinal walls in the
    colon may cause pain.
  • Reduced peristalsis of the colon can increase
    risk for constipation.

24
Age-related Changes in the Female Reproductive
System
  • Ovulation ceases and estrogen levels drop by 95.
  • Vaginal walls become thinner and lose elasticity
  • Most women experience a decrease in the
    production of vaginal lubrication.

25
Age-related Changes in the Male Reproductive
System
  • In some men, testosterone levels drop by up to
    35.
  • The size of the testes decreases.
  • There is a decline in the rate of sperm
    production although the extent varies among
    individuals.
  • Erectile dysfunction (impotence), in which an
    erection cannot be achieved is experienced by 15
    of men by the age of 65 and increases to 50 by
    age 80

26
Normal Age-related Changes in the Neurological
System
  • Delayed neurological function
  • NOT the loss of cognitive function
  • Intellectual performance remains intact
  • Performing tasks may take longer

27
Normal Age-related Changes in the Central Nervous
System
  • The brain and spinal cord lose nerve cells and
    weight
  • Nerve cell transmission may slow
  • Waste products may collect in the brain tissue
    causing plaques and tangles
  • Reflexes may be reduced or lost
  • Slight slowing of thought, memory and thinking
    are part of normal aging

28
Normal Age-related Changes in the Peripheral
Nervous System
  • ? in tactile sensitivity
  • Loss of nerve endings in skin
  • ?risk for injuries and burns
  • Altered kinesthetic sense (ones position in
    space)
  • ?risk for falling

29
Normal Age-related Changes in the Eyes
  • Drooping eyelids (senile ptosis)
  • ? orbicular muscle strength
  • Arcus senilis
  • Gray/white/silver ringinside the outer edge of
    iris
  • Decrease in number of goblet cells producing eye
    lubrication

30
Normal Age-related Changes in the Eyes contd
  • Presbyopia-the crystalline lens begins to have so
    many layers of accumulated tissue built up that
    it becomes stiff and the iris muscles must work
    harder to bring near objects into focus
  • Increased time to accommodate to changes in light
  • ? sensitivity to glare
  • Pupils decrease in size
  • Require increased lighting

31
Cataracts
  • A cataract is a clouding of the normally clear
    lens of the eye. It can be compared to a window
    that is frosted or "fogged" with steam.
  • Common symptoms of cataract include
  • Painless blurring of vision
  • Glare, or light sensitivity
  • Frequent eyeglass prescription changes
  • Double vision in one eye
  • Needing brighter light to read
  • Poor night vision
  • Fading or yellowing of colors

32
Intraocular Changes of Eye
33
Intraocular Changes of Eye
  • Sclera may become yellowish (imitating jaundice)
  • Floatersbits of vitreous that have broken off
    the retina
  • Retina becomes dull
  • Glaucoma is an abnormal condition resulting when
    intraocular pressure becomes higher than what is
    healthy for the optic nerve

34
Aging Changes in Ears Hearing
  • Function of Ears
  • Hearing
  • Maintenance of balance

35
Aging Changes in Ears Hearing
  • Presbycusis
  • age-related hearing loss
  • ? hearing acuity
  • ? speech intelligibility
  • ? auditory threshold
  • ? discrimination of pitch

36
Classroom activity
  • Changes of Aging Activity
  • This activity is intended to simulate the feeling
    of some of the physical changes of aging and the
    potential difficulties they can produce.
  • Stand with feet apart at least 14 inches (to
    provide a wide base) and do the following
  • Round the shoulders and upper back
  • Tuck the buttocks and relax the abdominal
    musculature, making the umbilicus point toward
    the ceiling
  • Remaining in this position, take a deep breath
    (simulating the change in respiratory function
    that accompanies change in stature)
  • Still remaining in this position, bend the knee
    while keeping the foot of that leg on the ground
  • Take a few steps forward (simulation of slowed
    mobility with aging)
  • Have students discuss what they were feeling,
    physically and emotionally, and thinking during
    various steps of this exercise. Ask them to
    consider and share with the rest of the class how
    they might feel if these physical changes were
    permanent. What challenges can they anticipate
    these physical limitations will cause?

37
NURSING DIAGNOSIS OF THE ELDER ADULT IN THE
COMMUNITY
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