Nursing 109

N109: Foundations in Nursing Practice Study Guide

1.9 Older Adults: Over 65 Years Physical Development Senescence is the progressive decline in body systems associated with age, and is a natural process. During this stage, it is critical that the nurse understand normal changes that occur in the aging process so that abnormal or disease-related changes can be quickly identified. Neuromuscular: Muscle and bone mass, reaction time, and strength begin to diminish. These changes may result in joint stiffness, loss in height, osteopenia and osteoporosis, and impaired balance. Sensory: All senses begin to decrease and the incidence of cataracts may increase, leading to even further diminishment of visual acuity. Gradual age-related hearing loss (presbycusis) occurs in most individuals. Cardiovascular: Diminished vascular tone and decreased arterial elasticity may result in decreased blood flow to the extremities, causing cool hands and feet and calf pain or tenderness. These changes can also result in orthostatic hypertension (a drop in blood pressure) as the individual stands up from a sitting or lying position. Pulmonary: Respiratory efficiency may be decreased due to diminished lung expansion and vital capacity in the lungs. Dyspnea (difficulty breathing) is often seen with exertion. Gastrointestinal: Indigestion and constipation may become common due to decreased motility in the intestines and decreased digestive enzymes. Urinary: Kidney function may be slowed, causing a slower excretion of wastes. The older adult may experience frequency and urgency as muscle tone diminishes, and they may be unable to completely empty their bladder. Genital: In older men, hypertrophy of the prostate may occur. Older women may notice a decrease in vaginal secretions. Skin: Skin will become less elastic and more fragile. With less subcutaneous fat and muscle tissue, the older adult will experience wrinkling and sagging of the skin and have diminished tolerance for cold temperatures. Common Health Problems Identified in thisStage In the older adult, the individual begins to experience a general decrease in strength, flexibility, and physical reserve. Specific problems might include the following: • Falls are responsible for the majority of fractures in older adults. During this stage, the individual is most at risk for developing and worsening chronic illnesses. Hypertension and heart disease, sensory impairments, arthritis, stroke, pulmonary disease, and cognitive dysfunction may appear or increase during this life stage. • Elder abusemay be an issue during this stage. This abusemay take the formof physical, mental,

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