Objective 4 2023 PDF

This Photo by Unknown Author is licensed under CC BY-ND Objective #4: Common Age-Related Changes Required Readings: Chp. 6 & 11 (p. 153-155) (*3.2: Marieb & Hoehn, 2019) Biological Theories of Aging Proposes why the body functions in the physical way it does. Evolved from early study of changes o...

This Photo by Unknown Author is licensed under CC BY-ND Objective #4: Common Age-Related Changes Required Readings: Chp. 6 & 11 (p. 153-155) (*3.2: Marieb & Hoehn, 2019) Biological Theories of Aging Proposes why the body functions in the physical way it does. Evolved from early study of changes over the lifespan. Provide clues to the aging process. 2 Main Types: • Stochastic Theories • Nonstochastic Theories/Programmed Theories 20XX Presentation title 2 Stochastic (Error) Theories This Photo by Unknown Author is licensed under CC BY-SA 20XX Presentation title • Overtime there are multiple errors that occur in the synthesis of DNA & RNA. • With each replication, more errors occur until the cell is not able to function. • The visible signs of aging such as grey hair is thought to be the result of accumulation of these errors e.g. Wear and Tear Theory, Free Radical Theory & Cross-linked Theory. 3 Nonstochastic Theories (Programmed) Based on the premise that each cell has a natural life expectancy. Each cell is programmed to have a set number of replications, then it stops and dies • As more cells cease to replicate age related changes begin. Example: Neuroendocrine-Immunological Theory: • As one ages, immune function declines. • With aging, the immune system may not even recognize its own tissue or structures, making a person more at risk for autoimmune diseases. • Ex. Rheumatoid Arthritis 20XX Presentation title 4 Age-Related Changes Integumentary System Musculoskeletal System Cardiovascular System Respiratory System Renal System Endocrine System Gastrointestinal System Neurological System Immune System 20XX Presentation title 5 Age-Related Changes: Integumentary The skin is the largest organ in the body. Three layers: Epidermis (outer layer). Dermis (middle supportive layer has connective tissue). Hypodermis (inner fat – subcutaneous tissue containing blood vessels and nerves). 20XX Presentation title 6 Age-Related Changes: Integumentary 20XX Presentation title • The skin becomes thin, loses elasticity & turgor. • Decrease in melanocytes, (colour of skin is lighter). • Nails become harder, brittle & discoloured, (opaque, yellow or grey), flat / concave, vertical ridges. • Environmental exposure of sun & wind contribute to changes. • Hair thins & greys. • Varying degrees of baldness ( mostly males). • In women (after menopause) hair thins, facial hair grows because of reduced estrogen, and a reduction in body hair occurs. • Men grow hair in the ears, nose & course hair in the eyebrows. 7 Age-Related Changes: Integumentary • Senile purpura (purple spots) are common (Middle Picture) • The skin is more prone to being dry (xerosis) - can lead to pruritus (itchiness). • Lentigines (also called ‘liver’ or ‘age spots’ become larger with more sun exposure). (Left) • Brown raised lesions with ‘stick on’ appearance called seborrheic keratoses common. (Right) 20XX Presentation title 8 Age-Related Changes: Integumentary Implications • Absorption of topical agents (medications – applied to skin) is affected. • Increase risk of skin infections & injury because protective barrier compromised. • Higher risk for skin cancer. Promoting Healthy skin: Box 6.2 Pg 70 • • • • 20XX Sunscreen. Avoid excessive sun exposure. Stay hydrated (1500 ml - 2000 ml of water per day). Apply moisturizer to damp skin after bathing to prevents dryness & helps to prevent xerosis Presentation title 9 Age-Related Changes: Musculoskeletal Changes in stature & posture occur b/c of reduction in bone mineral density, muscle wasting (shrinking), & water loss in vertebral disks. Posture changes occur, stooped appearance called kyphosis (loss of height due to intervertebral disk shrinkage). 20XX Presentation title 10 Age-Related Changes: Musculoskeletal Muscle atrophy (shrinking) leads to reduced strength. Bone mass decreases leads to increase risk of fractures. Rapid bone loss after menopause for women – osteoporosis. Joint stiffness, loss of flexibility (cartilage drier & thinner). *Osteoarthritis may develop. 20XX Presentation title 11 Promoting Healthy Bones & Muscles Regular intake of Calcium & Vitamin D (supplements recommended especially for women). Regular weight bearing exercises. Regular flexibility & balance exercises. Regular intake of foods rich in calcium (yogurt, cheese, canned sardines & salmon, spinach, kale). (Box 6-3 pg 70) 20XX Presentation title 12 Age-Related Changes: Cardiovascular Changes referred to as presbycardia. Stiffening & thickening of vessels, heart lining & valves. Left atrium enlarges and left ventricle thickens (adaptive). Decrease in cardiac output. Increase in systolic B/P (blood pressure). The heart is slow to accelerate & return back to resting rate. 20XX Presentation title 13 Age-Related Changes: Cardiovascular Clinical significance of Changes • The changes affecting responsiveness are important for the nurse to be aware of as the heart rate does not increase quickly when patient in pain, febrile (fever) or anxious. • Nurse must assess for other S/S of distress and be aware of signs of rapid decompensation. • Age-related changes do not cause symptoms. • Symptoms arise with the development of CV disorders. • Coronary Artery Disease- leads to reduction in blood supply, poor circulation, SOB (shortness of breath), reduced perfusion (blood supply) to other organs, angina. 20XX Presentation title 14 Promoting Heart Health Engage in regular exercise Eat a low-fat, low-cholesterol, balanced diet Maintain tight control of diabetes Do not smoke; avoid exposure to smoke Avoid environmental pollutants Practice stress management Minimize sodium intake Maintain ideal body weight Box 6-4, Chp. 6 pg 72 20XX Presentation title 15 Respiratory System 20XX Presentation title 16 Age-Related Changes: Respiratory Stiffening of trachea & rib cage. Reduced efficiency of gas exchange. Cilia decrease in number & do not sweep as well. Reduced ability to respond to lowered oxygen levels, some SOB. Respiratory function begins to decline after age 20. Changes occur & do not usually affect function Most problems are due to environmental exposure & lifestyle ( e.g. damage due to smoking & pollution). Muscular changes & rigidity affect ability to cough effectively. Inefficient cough reflex, decreased cilia & immune function make an older adult more at risk for serious respiratory infections. See Box 6-5, Chp. 6, Promoting Healthy Lungs 20XX Presentation title 17 Age-Related Changes: Renal / Urinary Kidneys lose 50% of nephrons starting at age 30 years, kidney gets smaller. • Urine creatinine declines • GFR (glomerular filtration rate) decreased metabolism of wastes as well as drugs. Ureters, Bladder, Urethra • Some muscle tone & elasticity lost • Bladder capacity from approx. 500 - 600 mL of urine in younger adult to about 250 mL in older adult (these changes contribute to incontinence). Increased irritability in bladder, contractions during filling and incomplete emptying. • Leads to frequency, nocturia, urgency & increased risk for infection (urinary tract infections). All these age-related changes contribute to urinary incontinence. 20XX • Urinary Incontinence is not a normal age-related change, however, it is more prevalent with age (covered in objective 5). Presentation title 18 • The digestive system includes the gastrointestinal tract & accessory organs (mouth down through large intestines to the rectum). Age-Related Changes: Digestive • Few age-related changes affect function – but common health problems affect this system. 20XX Presentation title 19 Age-Related Changes: Digestive Contractions (peristalsis) of esophagus not as rhythmic leading to sluggish movement of food into the stomach. Stomach: decrease in gastric motility, shrinks, slower to empty, more acidic environment. Ulcers; indigestion, food intolerances, & GERD may develop. Small bowel: changes in motility & the surface area (villi) where absorption takes place – affects absorption of protein, fats, carbohydrates, vitamins & minerals. Peristalsis slows down through entire GI not enough to cause problems with defecation. Large Bowel: constipation (can be related to a decrease in muscle tone), *Mostly due to diet and inactivity. 20XX Presentation title 20 Age-Related Changes: Neurological Resilient system, changes in cognitive function are not normal. Dendrites (connecting portion of nerve cells) appear to wear out, number of dendrites decrease, brain size & weight decreases (esp. frontal lobe). 20XX Presentation title 21 Age-Related Changes: Neurological 20XX Presentation title • Neurotransmitter (brain chemicals) levels decrease. • Mild memory impairments, difficulty with balance (neurodegeneration). • Intellectual performance intact • Completion of tasks – slower • Peripheral Nervous System – loss of nerve endings in the skin of extremities delayed reaction time, more at risk for injury. 22 Age-Related Changes: Neurological Proprioception is altered – one is less aware of body position (affecting balance) and has less tactile awareness, affects gait, increasing risk for falls. 20XX Presentation title 23 Age-Related Changes: Immune System • Deceased ability to fight infection. • Thinner skin more vulnerable to pathogens. • Reduced cilia in lungs-more risk for pneumonia. • Decrease in T cell function. • Response to foreign antigens decreases. • Altered immune response. • s/s of infections altered. • Often not febrile, confusion may be first symptom of infection. 20XX Presentation title 24