Gastrointestinal Problems in Older Adults

GASTROINTESTINAL PROBLEMS SIGNS & SYMPTOMS  Pain while swallowing. COMMONLY AFFECTING OLDER ADULTS ...

GASTROINTESTINAL PROBLEMS SIGNS & SYMPTOMS  Pain while swallowing. COMMONLY AFFECTING OLDER ADULTS  Not being able to swallow.  Feeling as if food is stuck in the throat or GASTROINTESTINAL chest - The gastrointestinal (GI) tract also known as the  or behind the breastbone. digestive system is a complex and essential part of  Drooling. the human body responsible for breaking down  Hoarseness. food into nutrients that the body can absorb and  Food coming back up, called regurgitation. use for energy, growth, and repair  Frequent heartburn.  Food or stomach acid backing up into the CONSTIPATION throat.  is a common condition characterized by  Weight loss infrequent and difficult bowel movements. It  Coughing or gagging when swallowing. occurs when stool moves too slowly through the large intestine, also known as the colon, leading NURSING MANAGEMENT to the absorption of too much water from the  Observe for signs of aspiration pneumonia stool.  Keeping suction equipment at the bedside of SIGNS & SYMPTOMS dysphagic patients  Having fewer than three bowel movements  Educate family on the importance of following a Trusted Source per week patient’s diet  Difficulty passing stool  Straining when passing stool GASTROESOPHAGEAL REFLUX DISEASE (GERD)  Passing less stool than usual  GERD or Gastroesophageal Reflux Disease is a  Lumpy, dry, or hard stool chronic digestive disorder that occurs when stomach acid repeatedly flows back up into the Other symptoms include: tube connecting your mouth and stomach  Abdominal pain and cramping (esophagus)  Feeling bloated SIGNS & SYMPTOMS  Nausea  Heartburn: A burning sensation in the chest, often  A loss of appetite after eating, which may worsen when lying down or NURSING MANAGEMENT bending over. 1. Perform a proper assessment of the condition  Regurgitation o Assess change in bowel  Dysphagia o Observe stool characteristics  Chest Pain o Assess the patient’s medical history and  Chronic Cough o medication list  Hoarseness or Sore Throat 2. Perform manual disimpassion  Nausea 3. Administer laxatives or stool softeners as  Wheezing or Asthma-like prescribed  Symptoms: Some individuals may experience 4.. Apply lubricant or anesthetic ointment as respiratory issues due to aspiration of ordered. stomach contents into the lungs. 5. Emphasize the importance of lifestyle changes NURSING MANAGEMENT 6. Encourage a high-fiber diet and increase fluid  Administer prescribed medications as directed intake  Provide emotional support 7. Avoid caffeine and alcohol  Establish a plan for regular follow-up to monitor 8. Advise the patient to do physical activities symptom progression, medication effectiveness, 9. Establish regular bowel movements and toilet and the need for adjustments. training DIVERTICULA DYSPHAGIA  Diverticula are small, bulging pouches that form on  Difficulty or discomfort while swallowing is also the inner wall of the intestine, most commonly in known as Dysphagia. It occurs when there is a the colon. They develop at weak spots in the disruption in this intricate process, making it intestinal wall, often due to increased pressure difficult or impossible for food or liquids to pass from straining during bowel movements. smoothly from the mouth to the stomach  SIGNS & SYMPTOMS  In both types, blood backs up into the lungs,  Abdominal Pain: Typically severe and located in the causing congestion or fluid buildup, hence the term lower left side of the abdomen, but can also occur on (congestive heart failure). CHF affects millions the right side, especially in certain populations globally and can be life-threatening, as the heart's  Fever: Often accompanied by chills, indicating an reduced ability to pump blood often results from inflammatory or infectious process. various heart diseases that progressively weaken  Nausea and Vomiting the heart  Constipation or Diarrhea  Abdominal Tenderness SIGNS & SYMPTOMS  Bloating: Distension of the abdomen may occur due LEFT-SIDED HEART FAILURE to gas or inflammation.  Dyspnea on exertion  Rectal Bleeding  Orthopnea  Changes in Bowel Habits  Paroxysmal Nocturnal Dyspnea  Coughing NURSING MANAGEMENT  Lung Crackles on auscultation  Keep the patient NPO RIGHT-SIDED HEART FAILURE  Prevent inflammation  Peripheral Edema  Rest the bowel  Distended jugular Veins  Encourage to increase OFI  Tachycardia  Institute nasogastric suctioning  Swollen abdomen  Advise supplements OTHER S/SX:  Diet modifications  Fatigue  Administer antibiotics prescribed  Cognitive Deficits  Assist with draining abscesses (if  Chest Pain  present)  Prepare for surgery - if further NURSING MANAGEMENT  complications persist  Relieving fluid overload symptoms  Relieving symptoms of anxiety and fatigue CARDIOPULMONARY PROBLEMS  Promoting physical activity  Increasing medication compliance INTRODUCTION  Decreasing adverse effects of treatment - Number of people over 65 years is continuously  Teaching patient about self-monitoring of increasing and represents an ever growing proportion symptoms of population. Medical treatment of the elderly  Teaching patients about daily weight monitoring implies a massive burden for the healthcare system. CORONARY ARTERY DISEASE Special knowledge is required to provide an appropriate medical care for the elderly. During the  Coronary artery disease (CAD) is a condition in ageing process, several changes accumulate in the which the coronary arteries, which supply blood to body and several chronic diseases develop. Among the heart muscle, become narrowed or blocked these diseases congestive heart failure, coronary due to the buildup of plaque. Plaque consists of artery diseases, hypertension, atrial fibrillation have cholesterol, fat, calcium, and other substances. the greatest significance Over time, this buildup, known as " atherosclerosis" , restricts blood flow to the heart, reducing oxygen and nutrient supply, which can cause chest pain CONGESTIVE HEART FAILURE (angina) or lead to a heart attack (myocardial  Heart failure, also known as "congestive heart failure" infarction). (CHF), occurs when the heart cannot pump enough blood to meet the body's needs. This happens in two SIGNS & SYMPTOMS main ways:  Chest pain, chest tightness, chest pressure and 1. Systolic heart failure – the heart's ventricles chest discomfort, called angina. cannot pump blood forcefully during systole  Shortness of breath. 2. Diastolic heart failure– the ventricles don't fill  Pain in the neck, jaw, throat, upper belly or back. with enough blood during diastole  Pain, numbness, weakness or coldness in the legs or arms if the blood vessels in those body areas are narrowed.  NURSING MANAGEMENT ATRIAL FIBRILLATION  Regularly monitor the patient's vital signs especially  Atrial fibrillation (AF) is a common heart rhythm the heart rate, blood pressure, oxygen saturation disorder characterized by irregular heartbeats. It and respiratory rate. becomes increasingly prevalent with advancing age,  Position the patient to semi fowler's position. making it the most common arrhythmia among  Encourage early, supervised ambulation (as those over 65 years old. The risk of developing AF tolerated) to promote circulation and prevent escalates as individuals age due to various factors, deconditioning. including the natural aging of the cardiovascular  Have dietary restriction. system and the presence of comorbid conditions  Monitor fluid intake, especially if they have heart failure. Monitor for signs of fluid overload and SIGNS & SYMPTOMS adjust intake accordingly. SOMETIMES PEOPLE WITH AFIB HAVE NO SYMPTOMS AND THEIR CONDITION IS ONLY DETECTABLE UPON HYPERTENSION PHYSICAL EXAMINATION. OTHERS MAY EXPERIENCE  High blood pressure (Hypertension) is when the ONE OR MORE OF THESE SYMPTOMS: force of blood pushing against your artery walls is  General fatigue consistently too high. This damages your arteries  A rapid and irregular heartbeat over time and can lead to serious complications like  Fluttering or “thumping” in the chest heart attack and stroke.  Dizziness  “Hypertension” is another word for this common  Shortness of breath and anxiety condition. Healthcare providers call high blood  Weakness pressure a “silent killer” because you usually don’t  Faintness or confusion have any symptoms. So, you may not be aware that  Fatigue when exercising anything is wrong, but the damage is still occurring  Sweating within your body  Chest pain or pressure SIGNS & SYMPTOMS PEOPLE WITH VERY HIGH BLOOD PRESSURE (USUALLY NURSING MANAGEMENT 180/120 OR HIGHER) CAN EXPERIENCE SYMPTOMS  Elevate the head of the bed to a semi-Fowler’s INCLUDING: position to aid in breathing  severe headaches  Educate the patient to avoid caffeine, alcohol, and  chest pain other stimulants that can trigger AF or exacerbate  dizziness symptoms. Encourage adequate hydration but  difficulty breathing caution against excessive fluid intake,  nausea  Encourage light exercises or walking, as tolerated, to  vomiting maintain circulation and prevent deconditioning  blurred vision or other  vision changes STROKE  anxiety  Stroke is a medical emergency or condition in which  confusion poor blood flow to the brain causes cell death. There  buzzing in the ears are two main types of stroke: ischemic, due to lack  nosebleeds of blood flow, and hemorrhagic, due to bleeding.  abnormal heart rhythm Both cause parts of the brain to stop functioning NURSING MANAGEMENT properly. A stroke can cause lasting brain damage,  The patient needs to understand the disease long-term disability, or even death. Signs of a stroke process and how lifestyle changes and medications can range from mild weakness to paralysis or can control hypertension. numbness on one side of the face or body. Other  Encourage the patient to consult a dietitian to help signs may include a sudden and severe headache, develop a plan for improving nutrient intake or for sudden weakness, trouble seeing, and trouble weight loss. speaking or understanding speech  Advised the patient to limit alcohol intake, and tobacco should be avoided because anyone with high blood pressure is already at increased risk for heart disease, and smoking amplifies this risk. Encourage and teach patients to measure their blood pressure at home  SIGNS & SYMPTOMS DISEASE F.A.S.T. WARNING SIGNS USE THE LETTERS IN F.A.S.T. TO SPOT A STROKE PULMONARY FIBROSIS  F = Face Drooping  A lung disease that occurs when lung tissue becomes  A = Arm Weakness damaged and scarred. This thickening and stiffening  S = Speech Difficulty of tissue can make it difficult for your lungs to  T = Time to call 911 function properly, leading to breathing difficulties. Other Stroke Symptoms Watch for Sudden: SIGNS AND SYMPTOMS  Numbness or weakness of face, arm, or leg  Shortness of Breath  Confusion, trouble speaking or understanding  Chronic Dry Cough speech  Fatigue  Trouble seeing in one or both eyes  Unexplained Weight Loss  Trouble walking, dizziness, loss of balance or  Clubbing coordination  Aching Joints and Muscles  Severe headache with no known cause MANAGEMENT NURSING MANAGEMENT  Frequent check-ups to assess lung function and  Monitor the patient’s level of consciousness (LOC), adjust treatment as needed. pupil size and reaction, motor function, and speech  Keeping up with vaccinations against pneumonia using tools like the Glasgow Coma Scale (GCS). and flu to avoid respiratory infections.  Turn the patient every 2 hours to prevent pressure  Supplemental oxygen can help improve oxygen ulcers, especially if they are immobile or have levels and relieve shortness of breath. hemiparesis. Support weakened limbs with pillows  Medications (e.g. antifibrotic drugs, corticosteroids) to prevent contractures.  Healthy Lifestyle  Ensure the environment is safe, assist with transfers and ambulation, and educate the patient on the use TUBERCULOSIS (TB) of mobility aids  A contagious bacterial infection caused by Mycobacterium tuberculosis, primarily affecting the RESPIRATORY SYSTEM PROBLEMS lungs but can also impact other parts of the body. SIGNS AND SYMPTOMS DEFINITION  Persistent cough lasting more than three weeks  The role of the respiratory system is to move air into  Chest pain the body and remove waste products. Body cells  Coughing up blood or sputum require oxygen for respiration. The network of  Unexplained weight loss respiratory organs and eventual gas exchange into  Night sweats the blood enables the oxygen we breathe to reach  Fever and chills our body cells. In turn, carbon dioxide is exhaled.  Fatigue CHANGES CHEST WALL MANAGEMENT - The chest wall becomes stiffer due to calcification of  Individuals with active TB may need to stay isolated cartilage, limiting lung expansion until they are no longer contagious. LUNG ELASTICITY  Nutritional support, management of side effects, - There is a decrease in the lungs' elasticity, which in and monitoring for complications. turn causes a change in the elastic recoil properties  Proper ventilation, wearing masks, and using of the lungs. protective measures in healthcare settings. ALVEOLI  Vaccination - The alveoli become flatter and shallower, and there  Directly Observed Therapy (DOT) is a decrease in the amount of tissue dividing individual alveoli PNEUMONIA DIAPHRAGM  It is an infection that affects one or both lungs. - The diaphragm can become weaker, decreasing the  It causes the air sacs or alveoli, of the lungs to Fill up ability to inhale and exhale. with fluid or pus.  SIGNS AND SYMPTOMS ASTHMA  Productive Cough  A chronic inflammatory disease affecting the lower  Fever airway, characterized by hyper responsiveness and  Sweating or chills bronchospasm leading to airway narrowing  Shortness of breath  Chest pain SIGNS AND SYMPTOMS  Fatigue  Coughing  Nausea or vomiting  Difficulty of breathing (Dyspnea).  Loss of appetite  Chest tightness.  Wheezing MANAGEMENT  Blue or gray coloring in nails, ear lobes, tongue, lips  Encourage clients to increase fluid intake to and skin. prevent dehydration and to liquify the secretions.  Monitor oxygen levels using pulse oximeter. MANAGEMENT  Remove secretions through suctioning if needed  Monitor breathing pattern especially if it interferes in breathing and recovery.  Establish and maintain open airway with adequate  Position client in a Semi-fowler position for easier oxygenation. breathing and lung expansion.  Encourage fluid intake. (to help thin secretions.)  Administer oxygen and medications as prescribed  Educate the patient on avoiding known triggers like by the physician pollen, dust, smoke, or cold air.  Teach or review proper use of metered-dose CHRONIC OBSTRUCTIVE PULMONARY DISEASE inhalers or dry powder inhalers to ensure the patient  COPD is characterized by a decreased ability of the receives the Full benefit of medications. lungs to respire properly.  Is a chronic inflammatory lung disease that causes URINARY SYSTEM PROBLEM obstructed airflow from the lungs SIGNS AND SYMPTOMS  Trouble catching your breath, especially during (Urinary Incontinence) Bladder/Urethra physical activities.  the bladder muscles (detrusor muscles) may  Wheezing or whistling sounds when breathing. become overactive or weak, leading to involuntary  Ongoing cough that may bring up a lot of mucus. urine leakage. When the bladder contracts The mucus may be clear, white, yellow or uncontrollably, it causes the sudden urge to urinate greenish. (urge incontinence).  Chest tightness or heaviness  Lack of energy or feeling very tired. Signs & Symptoms  Frequent lung infections  Leaking Urine  Losing weight without meaning to. This may  Sudden, uncontrollable urges to urinate happen as the condition worsens.  uncontrollable urges to urinate  Swelling in ankles, feet or legs.  Waking up at night to urinate  Urinating during sleep MANAGEMENT  Leaking urine without any warning or urge  Stopping smoking can keep COPD from getting  Inability to reach a toilet in time worse and making it harder to breathe. MANAGEMENT  Bronchodilators are central to management of Lifestyle Changes COPD at all levels of severity.  Bladder Training: involves gradually increasing the  Maintaining Patent Airway Clearance. time between bathroom breaks to help retrain the  Promoting Effective Gas Exchange & Oxygen bladder. Therapy  Pelvic floor exercises: Kegel exercises can  Improving Breathing Pattern Through Breathing strengthen the pelvic floor muscles, which support Exercises. the bladder and urethra.  Administering Medications and Pharmacological  Dietary changes: Reducing caffeine, alcohol, and Support. acidic foods can help manage bladder control.  Promoting Infection Control & Preventing  Weight management: Excess weight can put Complications pressure on the bladder and worsen incontinence.   Avoid irritants: Certain products, such as scented  Treatment of Underlying Conditions: If an soaps or detergents, can irritate the skin and underlying medical condition is contributing to contribute to Incontinence. electrolyte imbalance, addressing it is crucial. Medications  Avoid Excessive Salt Intake: High sodium intake can  Anticholinergics contribute to fluid retention and electrolyte  Alpha blockers imbalances.  Mirabegron  Monitor Potassium Intake: In some cases, excessive potassium intake may need to be restricted. Electrolyte Imbalance) Kidney  As people get older, their kidneys naturally become Urinary Tract Infection (UTI) less efficient. This is because the filtering units in  Urinary tract infection or UTI is an infection that the kidneys. called nephrons, decrease in number occurs within the urinary system, which includes the and function over time. Electrolyte imbalances can kidneys, ureters, bladder, and urethra. While anyone lead to various health issues, such as muscle can develop a UTI, cramps, fatigue, and irregular heart rhythms.  The infection is commonly caused by bacteria such as Escherichia coli (E. coli), which usually originates Signs & Symptoms from the gastrointestinal tract and spreads to the  Fatigue and weakness urethra and bladder, causing cystitis (bladder  Confusion and disorientation infection). If the infection ascends to the kidneys, it  Muscle cramps or twitching can lead to pyelonephritis.  Irregular heartbeat  Nausea and vomiting SIGNS AND SYMPTOMS  Excessive thirst or urination Classic Symptoms  Frequent urination Specific Electrolyte Imbalances  Pain or burning during urination (dysuria) Hyponatremia (low sodium): This can lead to  Cloudy or strong-smelling urine symptoms like confusion, weakness, and seizures.  Blood in the urine (hematuria) Hypernatremia (high sodium): This can cause thirst, Atypical Symptom confusion, and seizures.  Confusion or delirium Hypokalemia (low potassium): This can result in  Generalized weakness muscle weakness, fatigue, and irregular heart  Loss of appetite rhythms.  Fever or chills Hyperkalemia (high potassium): This can lead to  Urinary incontinence heart rhythm disturbances.  Lower abdominal pain or discomfort  Foul-smelling or cloudy urine Management  Regular Medical Check-ups: Frequent visits to a Management healthcare provider are crucial for older adults to Accurate Diagnosis monitor electrolyte levels, kidney function, and  Urine Culture identify potential imbalances early on.  Symptom Review  Medication Review: Regular reviews with a  Avoid Over-Diagnosis healthcare provider can help identify and adjust Hydration medications as needed.  Adequate Fluid Intake  Hydration: Ensuring adequate hydration is essential Symptom Management for maintaining electrolyte balance.  Pain Relief  Dietary Considerations: While a balanced diet is  Fever Management important for overall health, specific dietary Antibiotic Therapy adjustments may be necessary in cases of electrolyte  Targeted Antibiotics imbalance.  Duration of Treatment  Dietary Considerations: While a balanced diet is  Monitor for Side Effects important for overall health, specific dietary Monitoring and Follow-up adjustments may be necessary in cases of electrolyte  Follow-up Urine Tests imbalance.  Watch for Recurrence  Monitoring Electrolyte Levels: Regular blood tests  Follow-Up Appointments can help monitor electrolyte levels and identify any imbalances Prevention Strategies Medications  Address Underlying Conditions  Alpha-Blockers  Catheter Management  Diuretics  Probiotics or Cranberry Products  Stone-Dissolving Medication  Good Personal Hygiene Stone Removal  Special Considerations for Frail or  Extracorporeal Shock Wave Lithotripsy (ESWL) Institutionalized Older Adults  Ureteroscopy  Delirium Prevention and Management  Percutaneous Nephrolithotomy (PCNL)  Coordination with Caregivers  Surgical Options Preventive Measures: Kidney Stones (Nephrolithiasis) in Older Adults  Dietary Modifications:  Kidney stones (nephrolithiasis) are hard mineral and  Calcium Stones salt deposits that form in the kidneys. These stones  Uric Acid Stones can vary in size from tiny grains to large masses that  Struvite Stones can obstruct the urinary tract. Kidney stones are a Monitoring and Follow-Up common condition that affects the urinary system,  Regular Check-Ups and their prevalence increases with age due to  Imaging Studies factors such as decreased fluid intake and changes in Lifestyle Changes: kidney Function.  Regular Hydration  Weight Management The primary types of kidney stones Complications and Management of Complications  Calcium Stones  Obstruction and Infection  Struvite Stones  Kidney Damage  Uric Acid Stones  Cystine Stones Decreased Kidney Function  refers to the decline in the kidneys' ability to filter SIGNS AND SYMPTOMS waste and excess fluids from the blood, a common  Severe Pain issue as people age or develop chronic conditions  Hematuria  Frequent Urination Signs and Symptoms  Urgency  Fatigue  Dysuria  Swelling (edema) in legs or feet  Nausea and Vomiting  Changes in urination (frequency, volume)  Fever and Chills  Elevated blood pressure  Cloudy or Foul-Smelling Urine  Nausea or loss of appetite Management Management Initial Assessment and Diagnosis  Medical History and Physical Examination  Lifestyle Changes: Lowering salt intake, controlling  Urinalysis blood pressure and blood sugar, staying hydrated,  Imaging Tests and maintaining a healthy weight. o Non-contrast CT Scan  Medications: Drugs to control blood pressure, o Ultrasound manage diabetes, or reduce protein in the urine. o X-rays  Dialysis or Transplant: In severe cases of chronic Treatment Options kidney disease (CKD) or kidney failure, dialysis or a  Pain Management kidney transplant may be required to replace  NSAIDS kidney function.  Opioids Hydration  Increased Fluid Intake Changes in Bladder Function Management  Changes in bladder function refer to alterations in  Transurethral Resection of the Prostate (TURP) how the bladder stores and releases urine as which a doctor passes an endoscope (a viewing people age or due to medical conditions. These tube) through the urethra  Injection of hot water under pressure into the changes may include reduced bladder capacity, prostate or insertion of devices through the penis weakened bladder muscles, and altered bladder to help support the internal portion of the urethra sensation, often leading to symptoms like frequent  Alpha-adrenergic blockers (such as terazosin, urination, urgency, or leakage (incontinence). doxazosin, tamsulosin, alfuzosin, or silodosin) relax certain muscles of the prostate and bladder outlet Signs and Symptoms and may improve the flow of urine  Frequent Urination Decreased of Aldosterone Release  Urgency  Incontinence Hormone Changes  Difficulty Emptying the Bladder  This decrease can contribute to lightheadedness  Weak Urine Stream and a drop in blood pressure with sudden position  Pain or Discomfort changes (orthostatic hypotension). Management  Cortisol release also decreases with aging, but the blood level of this hormone stays about the same Behavioral Interventions Signs and Symptoms  Bladder training  Low blood (Hypotension) pressure  Pelvic Floor exercises  Low level of sodium (Hyponatremia) Lifestyle Modifications  High level of Potassium (Hyperkalemia)  Fluid management  Muscle weakness  Dietary Changes  Nausea  Irregular (Arrhythmia) heartbeat Benign Prostatic Hyperplasia Management  problem in Prostate gland  Corticosteroid medicine is used to replace the  is a noncancerous (benign) enlargement of the hormones cortisol and aldosterone that your body prostate gland that can make urination difficult. no longer produces.  The prostate gland enlarges as men age.  Hydrocortisone is usually used to replace the cortisol.  Usually, the diagnosis is based on results of a rectal  Other possible medicines are prednisolone or examination, but a blood sample may be taken to dexamethasone check for prostate cancer.  Add extra salt to your daily diet.  Blood tests and recommend the correct dose. SIGNS AND SYMPTOMS  Adrenalectomy can be performed via a formal  Difficulty starting Urination laparotomy or by using a laparoscopic technique. Urination may feel incomplete, because the bladder doesn't empty completely. FEMALE AND MALE GENITALIA AND ITS  Nocturia- Frequent urination often at night SYSTEM  Having to strain or push out when passing urine  Weak or slow urination flow Problems in the Female Reproductive  Dribbling at the end of urination System VAGINITIS An inflammation of the vagina that can result in discharge, itching and pain. The increased of fragility of the fragile vagina in postmenopausal women causes it to be more easily irritated, which heightens the risk of vaginitis  Sign and Symptoms Sign and Symptoms  Soreness  Nabothian Cysts  Pruritus  Accumulation of Secretion  Burning  Fever  Reddened vagina  Palpable Tender Mass  Discomfort or Pain Nursing Management in Geriatric Approach  Local estrogen in suppository or cream Nursing Management in Geriatric Approach  Boric acid, zinc, lysine, or gentian violet douches  Regular Gynecologic Examinations may be prescribed.  Patient Education  Avoid to use perfumed soaps and sprays in genitalia CANCER OF THE CERVIX  Wear cotton underwear  Cervical cancer originates in the cells of the cervix,  Advised to keep the genital area clean and dry which is the lower part of the uterus connecting to the vagina. The disease develops when abnormal CANCER OF THE VAGINA cells grow out of control, often associated with  Vaginal cancer is an extraordinarily rare form of persistent infection with human papillomavirus cancer that develops in the tissue of the vagina. (HPV). While most cervical cancers are diagnosed The cells multiply quickly and can invade and at a median age of 49, older women still account destroy healthy body tissue. Vaginal cancer occurs for about one-third of cervical cancer deaths. more frequently in women over age 50, and the Ethnic disparities exist, with Hispanic women mean age of diagnosis of vaginal cancer is 60 having the highest incidence, followed by Black, years White, Native American/Alaskan Native, and Sign and Symptoms Asian/Pacific Islander women.  Vaginal discharge or abnormal bleeding - Unusually heavy flow of blood Sign and Symptoms  Bleeding after menopause - Bleeding between  Early-stage symptoms are often subtle, with periods; or any other vaginal bleeding and leukorrhea (thick,whitish, or  Bleeding that is longer than normal - Blood in the yellowish vaginal discharge) being the most stool or urine common symptoms in aged women.  Frequent or urgent need to urinate - Feeling  Pain constipated  Late stage symptoms As the disease progresses,  A lump or growth in the vagina that can be felt. - symptoms may include: Pain during sexual intercourse  Urinary retention or incontinence  Enlarged pelvic lymph nodes can sometimes be  Fecal incontinence palpated  Uremia Nursing Management in Geriatric Approach  Learn enough about your cancer to make decisions Nursing Management in Geriatric Approach about your care  Screening and Prevention  Maintain intimacy with your partner  Assessment and Monitoring  Create a support network  Patient Education  Eat healthy food  Take your medicines exactly as prescribed CANCER OF THE ENDOMETRIUM  Get some physical activity every day, but do not  Is a type of cancer that begins as a growth of cells get too tired. in the uterus. The uterus is the hollow, pear-  Radiation Therapy and Chemotherapy shaped pelvic organ where fetal development happens. It is sometimes called uterine cancer PROBLEMS OF THE CERVIX  As women age, the cervix naturally becomes smaller, and the endo-cervical epithelium undergoes atrophy. A common issue in older women is the formation of nabothian cyst when endocervical glands become blocked or sealed, trapping secretions.  Sign and Symptoms DYSPAREUNIA  Vaginal bleeding after menopause.  It is lasting or recurrent genital pain that occurs  Bleeding between periods. just before, during or after sex. It is a common  Pelvic pain. problem among older women that accompanies  difficult or painful urination hormonal changes due to various physiological and psychological changes associated with aging. Nursing Management in Geriatric Approach Nulliparous women experience this problem more  Pain management frequently than women who have/had children.  Providing education  Postoperative care Sign and Symptoms  Regular follow up  Penetration  Infection prevention  Vaginal Dryness  Aching or Throbbing Pain CANCER OF THE OVARIES  Tightness or Discomfort  Ovarian cancer is an abnormal growth of tissue in the ovary. It is when abnormal cells in the ovary Nursing Management in Geriatric Approach begin to grow and divide in an uncontrolled way.  Assessment Sign and Symptoms  Education and Counseling  Abdominal swelling and discomfort  Promote Lifestyle Modifications  Changes in bowel habits  Promote Vaginal Health  Loss of appetite or weight loss  Lower back pain Problems in the Male Reproductive System  Pain during sexual intercourse  Frequent need to urinate ERECTILE DYSFUNCTION Nursing Management in Geriatric Approach  Erectile dysfunction (ED) is defined as the inability  Pain management - Fluid Management to achieve and maintain an erection sufficient for  Emotional support sexual intercourse. It affects nearly half of men  Patient education over the age of 70, but it is not an inevitable consequence of aging. Instead, Erectile Dysfunction PERINEAL HERNIATION can result from various health conditions, including  It is a result of the stretching and tearing of alcoholism, diabetes, dyslipidemia, hypertension, muscles during childbirth and of the muscle hypogonadism, multiple sclerosis, renal failure, weakness associated with advanced age, perineal spinal cord injuries, thyroid disorders, and herniation is a common problem among older psychological factors. women. Sign and Symptoms Sign and Symptoms Cystocele, rectocele, and prolapse of the uterus are the  Only sometimes being able to get an erection types most likely to occurs; before sexual intercourse.  lower back pain - Difficult or Uncomfortable  Being able to get an erection before sexual Intercourse intercourse but not being able to maintain it  pelvic heaviness - vaginal pressure or mass during sexual intercourse.  pulling sensation - retention. and constipation  Complete inability to get an erection.  Urinary and fecal incontinence  Requiring a lot of stimulation to maintain an erection Nursing Management in Geriatric Approach  Although rectoceles do not tend to worsen with Nursing Management in Geriatric Approach age, the opposite is true for cystoceles, which will  Assessment - Supportive Care cause increased problems with time.  Education and Counseling - Monitoring and Follow-  Surgical repair is the treatment of choice and can Up be successful in relieving these problems.  Pharmacologic Management  Surgical repair is the treatment of choice and can  Non-Pharmacologic Interventions be successful in relieving these problems. ex:  herniorrhaphy Laparoscopy BENIGN PROSTATIC HYPERPLASIA Scrotal masses are lumps or swelling in the scrotum, the  Benign prostatic hyperplasia, also called prostate bag of skin that holds the testicles, build up of enlargement, is a noncancerous increase in size of fluids and growth of irregular tissue. the prostate gland. Most older men have some Signs and Symptoms degree of benign prostatic hyperplasia, which  Unusual lumps causes approximately one in four of them to have  Sudden pain dysuria.  Dull aching Sign and Symptoms  Tender  Frequent urination - Incomplete bladder emptying Nursing Management in Geriatric Approach  Difficulty starting urination - Dribbling at the end  Antibiotics of urination  Radiation therapy  Weak urine stream - Urgency to urinate  Hernia repair surgery  Intermittent urine flow - Inability to urinate in  Chemotherapy and orchiectomy severe cases, leading to acute urinary retention  Straining while urinating - Urinary tract infections PROBLEMS IN THE NERVOUS SYSTEM Nursing Management in Geriatric Approach DEMENTIA  Assessment  is a general term that represents a group of  Encourage Lifestyle Modification diseases and illnesses that affect your thinking,  Medication Management memory, reasoning, personality, mood and  Prevents complications behavior. The decline in mental function interferes  Preoperative and Postoperative Care with your daily life and activities.  Emotional Support  Collaborative Care Different types of Dementia  Patient Education 1. REVERSIBLE DEMENTIA: comprise different groups TUMORS OF THE PENIS, TESTES & SCROTUM of disorders of variable aetiologies, such as  Cancer of the penis is rare and appears as a structural brain lesions or metabolic, infectious, painless lesion or wart like growth on the prepuce toxic, autoimmune, paraneoplastic and psychiatric or glans. The resemblance of this growth to a disorders. chancre can cause a misdiagnosis or reluctance on SYMPTOMS the part of the patient to seek treatment  poor balance  forgetfulness Sign and Symptoms  trouble paying attention  Rash –  mood swings  Painless lump  frequent falls and loss of  Foul smelling fluid  bladder control  Skin thickening 2. VASCULAR DEMENTIA: this is the second most Nursing Management in Geriatric Approach common type of dementia. It’s caused by  Biopsy, irradiation and local excision for small conditions such as strokes or atherosclerosis, lesions and partial or total penile amputation for which block and damage blood vessels in your extensive lesions. brain. SYMPTOMS Testicular tumors are uncommon in older people but are  memory problems usually malignant when they do occur.  confusion  and trouble concentrating and completing Sign and Symptoms tasks.  Testicular enlargement 3. LEWY BODY DEMENTIA: this condition involves the  Pain and enlargement of the testes buildup of clumps of proteins called Lewy bodies — Nursing Management in Geriatric Approach in your brain’s nerve cells. Lewy bodies damage  Chemotherapy nerve cells.  Irradiation SYMPTOMS  Orchiectomy  movement and balance problem  changes in sleep pattern  memory loss  planning and problemsolving difficulties visual hallucination sand delusions  4. Frontotemporal Dementia: this dementia results  Thinking and reasoning: from damage to the frontal and temporal lobes of o difficulty managing finances and making your brain. The damage is caused by the buildup of payments. Unable to recognize and deal abnormal proteins in these areas. with numbers Aphasia SYMPTOMS o Agnosi  changes in social  Making choices and decisions:  behavior o dresses inappropriately for the weather  changes in personality o The person might not be able to make judgment  loss of language skills (speaking, calls while driving or deal with food burning on the understanding or forgetting the meaning of stove. common words) or motor coordination.  Planning and performing familiar tasks: NURSING M A N A G E M E N T o Playing a favorite game or  Cholinesterase inhibitors. These medicines work by o organizing and preparing a meal boosting levels of a chemical messenger involved in  Alterations in behavior, personality, or mood memory and judgment. o Depression.  Memantine. Memantine (Namenda) works by o A decline in activity interest. regulating the activity of glutamate. o Social disengagement.  Other medicines. You might take other medicines o Mood swings. to treat symptoms or other conditions. You may o Mistrust of other people. need treatment for depression, sleep problems, o Hostility or fury. hallucinations, parkinsonism or agitation. o Alterations in sleeping patterns. o Straying. ALZHEIMER o Loss of self-control.  In terms of dementia, Alzheimer's disease is the o Illusions, like thinking you've most prevalent. This is a sickness that progresses, o taken something starting with modest memory loss and perhaps NURSING MANAGEMENT ending with loss of capacity to respond to  Maximize functional abilities to improve quality of surroundings and carry on a conversation. A brain life by: ailment that worsens over time is Alzheimer's  Make a care plan and set up your everyday disease. It is typified by alterations in the brain that schedule. result in protein accumulation.  Help patients with their everyday self-care needs,  The areas of the brain responsible for thought, such as eating, exercising, using the restroom, and memory, and language are affected by Alzheimer's maintaining their cleanliness. disease.  Patients who have severe motor functioning It may significantly impair a person's capacity to do impairments or cognitive impairments should everyday tasks. receive assistance with these everyday activities. SYMPTOMS  Evaluate patient safety and minimize the chance of  Alzheimer’s disease is not a normal part of aging. harm resulting from confusion or disorientation. Memory problems are typically one of the first  Control your anger, anxiety, and behavioral issues. warning signs of Alzheimer’s disease and related Promote socializing with family and friends during dementias. designated times.  Memory Lapses: > For late stage: we do not put mirror inside the room of o Items are frequently misplaced and placed in odd the patient locations. o Become lost in areas they used to be familiar with. SUNDOWN SYNDROME Names of regular things and family people  is the name for a group of behaviors, feelings and eventually slip your mind. thoughts people who have Alzheimer's or o struggle to articulate ideas, describe objects, or dementia can experience as the sun sets. The participate in conversations with the appropriate behaviors start or get worse around sunset or language. sundown. However, this delirium can potentially occur at any time, not just at sunset SYMPTOMS SYMPTOMS  Mood changes  Tremor  Confusion  Slow Movement  Agitation  Rigid muscles  Hallucination Triggers:  Impaired postures and balance  ·Disrupted (sleep-wake cycles).  Speech Changes  ·Insomnia  Writing Changes  ·Infection. NURSING MANAGEMENT  ·Dehydration.  Assist with activities of daily living (ADLs) as  ·Side effects of medications. needed.  ·Physical illnesses.  Encourage regular exercise and stretching to  ·Pain. maintain flexibility  ·Fatigue (tiredness).  Offering emotional support and counseling, as NURSING MANAGEMENT Parkinson's disease can affect mental health and  Keep a daily routine. Routines are comforting for mood people with dementia because they know what to  Encourage the use of simple and clear expect. communication methods  Limit or avoid things that affect sleep.  Monitor skin integrity and provide appropriate  Keep things calm in the evening skin care to prevent pressure ulcers and other skin issues WANDERING  Regularly assess and document changes in  is a common behavior in patients with Alzheimer’s symptoms or side effects disease or other forms of dementia. And once the individual begins to show signs of wandering SCHIZOPHRENIA behaviors, they are at a high-risk of wandering  Is a serious mental health condition that affects away or becoming lost. This behavior can be very how people think, feel and behave and chronic distressing for caregivers, and dangerous for the severe mental disorder that affects the way a individual person thinks, acts, expresses emotions, percieves SYMPTOMS They may say things like: reality, and relates to other SYMPTOMS  I want to go home  I need to go to work  Delusions Hallucinations  I have to go shopping  Disorganized speech and thinking  They may not recognize their house anymore.  Extremely disorganized or unusual motor  They need reminded about the location of their behavior bedroom or bathroom.  Negative symptoms  They may exhibit increased restlessness, pacing. NURSING MANAGEMENT  They do not remember to come back into the  Regular assess for changes in symptoms, including house when they are outside the presence of hallucinations, delusions, or  They cannot stay on task and forget what they are changes in mood and behavior doing or where they are  Use clear, simple, and non- judgmental NURSING MANAGEMENT communication  identifying risk for wandering, including interviews with  Encourage participation in community activities caregivers and social groups  providing appropriate supervision,  Monitor physical health, including weight, blood  reducing environmental triggers for wandering, and glucose levels, and cardiovascular health  using individualized nursing interventions to  Helping patients develop social skills and improve address the causes of wandering behavior interactions with others PARKINSON'S DISEASE  Assess the patient's ability to carry out activities of  Parkinson's disease is a progressive disorder that daily living affects the nervous system and the parts of the  Encourage family involvement in patient treatment body controlled by the nerves. PD gets worse over and teach members to recognize impending time. There is no cure, but therapies and medicines relapse can reduce symptoms. The disease usually occurs in older people, but younger people can also be affected. Men are affected more often than women. DELUSIONAL DISORDER  Use clocks, calendars, and familiar objects to orient  Delusional disorder is a mental health condition the patient. characterized by the presence of one or more  Evaluate current medications for potential causes delusions that persist for at least a month. of delirium and adjust as necessary. Delusions are fixed, false beliefs that are not based  Engage the patient in simple conversations, on reality. Delusional disorder usually first affects activities like puzzles or reading, and orientation people in middle or late adult life exercises SYMPTOMS  Fixed, false beliefs PERIPHERAL NEUROPATHY  Behavior  involves damage to the peripheral nerves, which  Hallucinations transmit signals between the central nervous  Non-bizarre delusions (most obvious symptom) system (brain and spinal cord) and the rest of the  Cranky, angry, or low mood body. It is particularly common in older adults with  Anxiety or depression diabetes, but other causes include alcoholism, NURSING MANAGEMENT chemotherapy, autoimmune diseases, and vitamin  Regularly assess the patient's mental status, deficiencies including their beliefs and perceptions SYMPTOMS . Monitor for and changes in behavior or mood  Numbness or tingling in the hands, feet, or other  Educate the patient and their family about the extremities disorder, its treatment, and coping strategies. Help  Pain or burning sensations them understand the nature of delusions and the  Muscle weakness importance of medication and therapy  Sensitivity to touch  Assist the patient in developing coping skills and  Loss of balance or coordination strategies to manage stress NURSING MANAGEMENT  Identify all the components, triggers related to  Conduct regular assessments of sensation, pain, stress or anxiety and motor function in affected areas. Use tools like  Promote distraction as a way to stop focusing on the monofilament test to check for loss of delusions protective sensation  Promote physical activities Recognize and reinforce  Teach patients to inspect their feet daily for cuts, healthy and positive aspects of personality blisters, or infections, wear appropriate footwear, and avoid walking barefoot DELIRIUM  Promote a healthy diet rich in vitamins and  Is a common, serious, and often underrecognized nutrients, encourage regular physical activity, and condition in older adults, characterized by a assist in managing blood glucose levels. sudden change in mental status. It can be triggered  Include antidepressants (e.g., amitriptyline), by a variety of causes, including infections (UTI, anticonvulsants (e.g., gabapentin, pregabalin), and Pneumonia ), electrolyte imbalances, dehydration, topical treatments (e.g., capsaicin cream) pain, surgery, and adverse drug reactions.  Encourage the use of complementary therapies SYMPTOMS such as acupuncture, physical therapy, or  Acute onset of confusion transcutaneous electrical nerve stimulation (TENS)  Disorientation (to time, place, or person)  Conduct a fall risk assessment and modify the  Agitation or restlessness environment to reduce fall hazards, such as  Hallucinations (seeing or hearing things that aren't removing loose rugs and providing good lighting. there)  Slurred speech STROKE (CVA)  Changes in sleep patterns Reduced attention span  A stroke, or cerebrovascular accident (CVA), occurs NURSING MANAGEMENT when there is a sudden disruption of blood supply  Regularly assess mental status using standardized to a part of the brain, causing brain cells to die due tools (e.g., CAM) to lack of oxygen Strokes can be ischemic (caused  Provide a calm and safe environment, minimizing by a blood clot) or hemorrhagic (caused by stimuli bleeding). Ischemic strokes are more common,  Ensure adequate fluid and nutritional intake while hemorrhagic strokes tend to have a higher mortality rate. SYMPTOMS  Advice to take nutritious food like leafy green  Sudden weakness or numbness in the face, arm, or vegetables and fruits, increase fluid intake (if leg, especially on one side of the body permits), limit sugars and processed foods  Sudden confusion or difficulty understanding  Sudden trouble speaking or understanding speech HEARING  Sudden trouble seeing in one or both eyes Presbycusis  Sudden dizziness or loss of balance or coordination  A progressive hearing loss that occurs as a result of  Sudden severe headache with no known cause age-related changes to the inner ear, including loss NURSING MANAGEMENT of hair cells, decreased blood supply, reduced  Conduct rapid neurological assessments to identify flexibility of basilar membrane, degeneration of stroke symptoms using the FAST acronym (Face, spinal ganglion cells, and reduced production of Arm, Speech, Time) endolymp.  Regularly monitor vital signs and neurological SYMPTOMS status Each person’s symptoms may vary. Some of the most  Administer tissue plasminogen activator (tPA) for common symptoms include: eligible patients with ischemic stroke within the  Other people’s speech sounds mumbled or slurred therapeutic window (typically within 3-4.5 hours of  Having trouble hearing highpitched sounds symptom onset)  Having trouble understanding conversations, often  Use medications like aspirin or clopidogrel for when there is background noise ischemic stroke prevention after the acute phase,  Men's voices are easier to hear than women's or anticoagulants for atrial fibrillation  Some sounds seem very loud and annoying  Monitor for potential complications, such as  A ringing sound (tinnitus) in one or both ears aspiration pneumonia (due to dysphagia), deep NURSING MANAGEMENT vein thrombosis (DVT), or pressure ulcers  Teach patients and their families communication  Assess swallowing ability (swallow study) and strategies to minimize communication difficulties provide appropriate dietary modifications, such as  Hearing aids thickened liquids or pureed diets, if needed  Assistive devices, such as telephone amplifiers or  Provide emotional support, counseling, and technology that changes spoken words to text. resources for coping strategies to the patient and  Training to use visual cues to figure out what is family members. being said (speech reading) VISION  Methods to prevent too much wax in the outer ear Presbyopia TASTE AND SMELL  The inability to focus or accommodate properly  With aging, the number of taste and smell due to reduced elasticity of the lens, is receptors decreases and nerve transmissions are characteristic of older eyes and begins in the slower, although these losses are highly variable. fourth decade of life. The loss of taste and smell receptors means that SYMPTOMS food is not as appetizing to the older adult.  Trouble seeing things up close (blurred vision) SYMPTOMS  Needing to hold reading materials farther away to  Taste focus on them o Food tasting bland  Eye strain (when your eyes feel tired or sore) o Increased salt and sugar intake  Headache o Nutritional deficiencies NURSING MANAGEMENT  Smell  Conduct thorough eye assessments o Inability to detect dangerous smells  Eyeglasses. Encourage them to consult an o Reduced enjoyment of food A optometrist or ophthalmologist for fitting and o Altered eating habits NURSING MANAGEMENT recommendation  Consult a doctor  Environment modifications  Manage underlying conditions  Suggest use of assistive devices for reading small  Smell training therapy print texts  Enhance food flavor  Discuss strategies to prevent falls and injuries  Quit smoking and reduce alcohol intake  Stay hydrated  Use safety measures TOUCH SYMPTOMS  The somatic receptors respond to touch, pressure,  Memory loss cold, pain, and body position. These receptors also  Dizziness become less sensitive as aging occurs.  Aches and Pains SYMPTOMS  Weight loss  Decreased temperature sensitivity  difficulty sleeping or staying asleep (insomnia)  Reduced ability to detect vibration, touch and NURSING MANAGEMENT pressure  Antidepressants medicines  Reduced sensitivity to pain Problems with balance  Electroconvulsive therapy(ECT) and walking  Psychotherapy; cognitive behavioral therapy (CBT) NURSING MANAGEMENT  Complementary therapy  Monitor for any injuries or skin breakdown due to lack of sensations ANXIETY  Teach patients and caregivers about the  An anxiety disorder causes feelings of fear, worry, importance of regular skin checks, especially in apprehension, or dread that are excessive or areas prone to injurie disproportional to the problems or situations that  Encourage regular bathing and provide guidance are feared. Anxiety is a common illness among on gentle cleansing techniques to avoid skin older adults, affecting as many as 10-20 percent of irritation the older population, though it is often  Promote daily moisturizing to maintain skin undiagnosed. Among adults, anxiety is the most integrity common mental health problem for women, and  Monitor for discomfort or neuropathic pain and the second most common for men, after substance provide appropriate interventions abuse. SYMPTOMS PARANOIA OR SUSPICIOUSNESS  Excessive worry or fear  Paranoia can be described as an individual’s  Refusing to do routine activities or being overly unfounded belief that others intend to do them preoccupied with routine harm. For instance, a senior experiencing paranoia  Avoiding social situations may believe that a care giver is stealing from them  Overly concerned about safety or that one friend wishes to hurt them.  Racing heart, shallow breathing, trembling, nausea, SYMPTOMS sweating Sx. of Elderly Paranoia  Poor sleep  Persecutory delusions  Muscle tension, feeling weak and shaky  Paranoid ideation Hoarding/collecting  Increased suspiciousness  Depression NURSING MANAGEMENT  Self-medication with alcohol or other central  Be understanding and patient nervous system depressants  Keep their surroundings calm and quiet NURSING MANAGEMENT  Avoid arguing about anything that is making them  Antidepressants paranoid  Anti-anxiety  Empathize with them and let them know that you  Beta blockers understand why their thoughts would make them  Psychotherapy afraid  Avoid things that can aggravate the symptoms of  Consider if your body language shows them you anxiety disorders: are on their side (for example, sitting next to them - Caffeine (coffee, tea, soda, chocolate) instead of in front of them) - Nicotine (smoking) - Over-eating DEPRESSION - Over-the-counter cold medications  Depression is a mental health condition that can - Certain illegal drugs affect people of all ages including older people. - Certain herbal More than 1 in 10 older people, and more than 3 in - Supplements 10 people living in residential aged-care, experience depression.   Alcohol (While alcohol might initially help a person Insulin Resistance: As we age, our cells become relax, it eventually interferes with sleep and overall less responsive to insulin. wellness, and can even contribute to anxiety, Reduced Pancreatic Function: The pancreas, depression, and dementia.) responsible for producing insulin, naturally declines  Limit news of current events. It is important to in function as we age. stay current, but too much negative news can Changes in Body Composition: Over time, we tend contribute to anxiety. to lose muscle mass and gain fat Allow time for treatment to work SYMPTOMS  Increased thirst and urination CATASTROPIC REACTIONS  Increased hunger  Catastrophic reaction- the overreaction to minor  Unexpected weight changes stresses which occur in patients with advanced  Persistent sores dementia. It is precipitated by fatigue,  Numbness or tingling in the hands or feet overstimulation, an inability to meet expectations,  Tiredness and persistent misinterpretations.  Blurry vision SYMPTOMS TREATMENT AND MANAGEMENT  threatening gestures Lifestyle Management  striking out  Diet and Exercise  increased voice volume  Stress Reduction  agitation Education and Support  increased restlessness hostility  Understanding Endocrine Conditions NURSING MANAGEMENT  Coping Strategies  Maximize the individual’s medical status with an  Early Intervention appropriate physical evaluation and if necessary, Specific Considerations in Geriatrics medication for severe behavioral issues.  Multiple Health Conditions  Simplify tasks, requests, or the environment so  Cognitive Impairment that the confusion does not become overwhelming for the patient with dementia HYPOGLYCEMIA  Recognize the impending signs of a catastrophic  Hypoglycemia, also known as low blood sugar or reaction by close observation of outbursts that are low blood glucose, is a condition where the level of often preceded by restlessness. glucose (sugar) in your blood drops below the  Remove the individual, when warranted, from a healthy range. unwanted stimulus by withdrawing the individual SYMPTOMS to a quiet room or space. Suggest going for a walk, Common Symptoms: which may allow time to calm down or even a  -Shakiness or trembling chance to distract and or forget what may have  -Weakness caused the patient to act out  -Sweating and chills  Plan a consistent daily schedule of several  -Extreme hunger (polyphagia) uncomplicated routines that may include  -Faster heart rate increasingly difficult tasks for when he or she feels  -Dizziness or lightheadedness best and can willingly comply with a request.  -Confusion or trouble concentrating  Listening with respectful attention for any  -Anxiety or irritability opportunity to create dialogue. Communication is  -Color draining from your skin (pallor) an essential component of care  -Tingling or numbness in your lips, tongue, or cheeks Severe Symptoms: ENDOCRINE SYSTEM PROBLEM  -Blurred or double vision  Slurred speech ENDOCRINE DISORDERS ARE MEDICAL CONDITIONS  Clumsiness or difficulty with coordination WHEREIN THE ENDOCRINE SYSTEM, WHICH PRODUCES  -Being disoriented HORMONES, DOES NOT FUNCTION CORRECTLY  -Seizures  -Loss of consciousness DIABETES  is a condition that causes high blood glucose due to the body being unable to either produce or use insulin sufficiently to regulate glucose. Two of the most common types of diabetes are type 1 and type 2  Insulin Resistance: As we age, our cells become Insulin Resistance: As we age, our cells become less responsive to insulin. less responsive to insulin. Reduced Pancreatic Function: The pancreas, Reduced Pancreatic Function: The pancreas, responsible for producing insulin, naturally declines responsible for producing insulin, naturally declines in function as we age. in function as we age. Changes in Body Composition: Over time, we tend Changes in Body Composition: Over time, we tend to lose muscle mass and gain fat to lose muscle mass and gain fat SYMPTOMS SYMPTOMS  Increased thirst and urination  Increased thirst and urination  Increased hunger  Increased hunger  Unexpected weight changes  Unexpected weight changes  Persistent sores  Persistent sores  Numbness or tingling in the hands or feet  Numbness or tingling in the hands or feet  Tiredness  Tiredness  Blurry vision  Blurry vision TREATMENT AND MANAGEMENT TREATMENT AND MANAGEMENT Lifestyle Management Lifestyle Management  Diet and Exercise  Diet and Exercise  Stress Reduction  Stress Reduction Education and Support Education and Support  Understanding Endocrine Conditions  Understanding Endocrine Conditions  Coping Strategies  Coping Strategies  Early Intervention  Early Intervention Specific Considerations in Geriatrics Specific Considerations in Geriatrics  Multiple Health Conditions  Multiple Health Conditions  Cognitive Impairment  Cognitive Impairment HYPOGLYCEMIA HYPOGLYCEMIA  Hypoglycemia, also known as low blood sugar or  Hypoglycemia, also known as low blood sugar or low blood glucose, is a condition where the level of low blood glucose, is a condition where the level of glucose (sugar) in your blood drops below the glucose (sugar) in your blood drops below the healthy range. healthy range. SYMPTOMS SYMPTOMS Common Symptoms: Common Symptoms:  -Shakiness or trembling  -Shakiness or trembling  -Weakness  -Weakness  -Sweating and chills  -Sweating and chills  -Extreme hunger (polyphagia)  -Extreme hunger (polyphagia)  -Faster heart rate  -Faster heart rate  -Dizziness or lightheadedness  -Dizziness or lightheadedness  -Confusion or trouble concentrating  -Confusion or trouble concentrating  -Anxiety or irritability  -Anxiety or irritability  -Color draining from your skin (pallor)  -Color draining from your skin (pallor)  -Tingling or numbness in your lips, tongue, or  -Tingling or numbness in your lips, tongue, or cheeks cheeks Severe Symptoms: Severe Symptoms:  -Blurred or double vision  -Blurred or double vision  Slurred speech  Slurred speech  Clumsiness or difficulty with coordination  Clumsiness or difficulty with coordination  -Being disoriented  -Being disoriented  -Seizures  -Seizures  -Loss of consciousness  -Loss of consciousness Nocturnal Hypoglycemia: TREATMENT AND MANAGEMENT  -Restless sleep  Medication (levothyroxine)  -Sweating through your pajamas or sheets  Regular monitoring  -Crying out during sleep  Lifestyle changes  -Having nightmares  -Feeling tired, disoriented, or confused after HYPERTHYROIDISM waking up  Hyperthyroidism, also called overactive thyroid, is TREATMENT AND MANAGEMENT when the thyroid gland makes more thyroid Immediate Treatment: hormones than your body needs. The thyroid is a  -Consume carbohydrates small, butterfly-shaped gland in the front of your  -Recheck blood sugar levels neck.  -Eat a snack or meal SYMPTOMS Severe Hypoglycemia:  weight loss despite an increased appetite  -Glucagon injection  - rapid or irregular heartbeat  -Emergency medical help  - nervousness, irritability, trouble sleeping, fatigue Long-Term Management:  shaky hands, muscle weakness  Identify and treat the underlying cause -Regular  - sweating or trouble tolerating heat frequent bowel blood sugar monitoring movements  Education and awareness  - an enlargement in the neck, called a goiter Prevention: TREATMENT AND MANAGEMENT  -Regular meals and snacks  Medication  -Careful medication management  Radioactive Iodine Therapy (RAI)  -Exercise planning  Surgery (Thyroidectomy)  -Alcohol moderation  Lifestyle Modifications Hy