Aging process within the
physiological changes both in the field organic and in mind. These changes, which
are normal, over the years predispose a series of pathophysiological events
that lead to the elderly to present different diseases.
General Anatomy
It´s between 30 and 40
years when humans have the maximum height reached, decreasing then 5 mm per
year from the 50, this change is more pronounced in women. It is explained by
postural changes (increased hip and knee flexion), decrease in height of the vertebral
bodies and abnormal intervertebral discs.
Skin and Appendages.
The skin, by extension,
is the organ most susceptible of environmental damage through the years,
especially by the action of sunlight.
Over time it becomes
thinner, drier, more transparent and becomes less elastic, wrinkled and
yellowish tinge.
Common
disorders: Pressure ulcers, Inflamation and infection.
Musculoskeletal System.
Between 30 and 80 years
is lost 30-40% of muscle mass. This loss is not linear and accelerates with age.
-Decrease bone calcium:
osteoporosis, Kyphosis
-Decreased fluid in
intervertebral disks: decreased muscle strength
-Decreased blood supply
to muscle: decreased muscle strength
-Decreased tissue
elasticity: decreased mobility and flexibility of ligaments and tendons
-Decreased muscle mass:
decreased strength, to fell down is increased.
Common
disorders: Osteoporosis, Osteoarthritis, Arthritis rheumatoid,
Bursitis.
Nervous System.
The nervous system is
affected significantly with the passage of time. The brain´s weight decreases
with a cerebral blood flow reduced by 20% causing alterations processes flow
autoregulation.
Care
strategies:
-Slowed thought
processes decreased ability to respond to multiple stimuli and tasks
-Decreased reflexes
decreased coordination decreased propioception
-Decreased perception of
stimuli
-Decreased motor
responses increased risk for ischemic paresthesia in extremities
-Report abnormal
findings to physician. Refer for neurologic evaluation
-Educate regarding
safety precautions and use of assistive devices. Structure tasks to reduce
confusion; allow adequate time to performs tasks.
Changes in the senses with age
As you age, the way your
senses (taste, smell, touch, sight and hearing) can provide information about
the world. Senses become less acute and you may have trouble differentiating
details.
Sensory changes can
affect the way of life. You may have trouble communicating, enjoy the
activities and stay involved with people. Sensory changes can lead to
isolation.
Respiratory system
Vital capacity and FEV
decrease to 30% at 80 years. The effort
independent of the will
expiratory decreases loss of elasticity of the bronchial tree, expiratory
effort depending on ventilation decreases to the extent that it loses strength muscle
of the respiratory muscles.
All these changes result
in a decrease in PaO2.
Here
some of nursing cares that we can provide:
·
Assess breathing depth and effort: position to
facilitate ease of respiration. Encourage incetive spirometry or nebulizer as
ordered.
·
Assess cough and sputum production: encourage adequate
fluid intake. Encourage smoking cessation and avoidance of environmental
pollutants.
·
Assess for signs and symptoms of respiratory
infection: teach avoidance of individuals with active infection. Teach careful
handwasing and disposal of contaminated secretions. Encourage annual influenza
vaccination.
Common disorders : EPOC,
Influenza, Pneumonia, Tuberculosis, Lung cancer
Cardiovascular System.
In the cardiovascular
system is extremely difficult to distinguish between changes own age and
alterations resulting from various pathologies that manifest through the years.
Nevertheless these changes affect other organs variably dependent cardiovascular
system close to their right function.
Nursing
cares:
-Assess apical and
peripheral pulses
-Assess blood pressure
lying, sitting and standing
-Assess ability to
tolerate activity.
-Observe closely for
abnormal sounds: determine presence and strenght of peripheral pulses comparing
both sides of the body.
-Hypotension is likely
to occur while changing position; encourage patient to change positions slowly
and to seek assistance if dizzy
-Instruct patient to
rest if short of breath or fatigued.
Homatopoietic and Lymphatic System
Bloody fluids distribute
essential protective factors, nutrients, oxygen, and electrolytes throughout
the body. The two major fluids of the body are blood and lymph. These fluids
flow through the body within two parallet circulatory systems.
Immunosenescence is a
complex process that involves multiple changes in lymphocyte subsets. These
changes in the elderly increased incidence and severity of infectious diseases
and some cancers.
Nursing
cares:
-Monitor laboratory test
including Hgb, Hct, WBC an differential: report abnormal findings, promptly to
physician.
-Assess nutritional
intake for adequacy for protein iron and vitamins: administer nutritional
supplements as ordered.
Gastrointestinal System
Flood and fluids
containing the nutrients needed for survival normally enter the body through
the GI tract. Although it is possible to live without food for several days,
the cells require a regular supply of nutrients to support their normal
physiologic activities.
Nursing plays an
important role in monitoring the patient preserve their functions properly to
feed themselves.
-Assess oral cavity for
dentition, condition of mucous membranes and hygiene: educate regarding
importance of goog oral hygiene; stress need for adequate fluid intake. Dental
referral as necessary
-Assess swallow and gag
reflexes: encourage posture that facilitates swallowing
-Monitor weight changes:
weight at least one time per month more often if fluid balance issues presents
-Assess intake of
nutrients and fluid: educate regarding recommended dietary intake. Establish
calorie count and intake and output if problems are suspected.
-Assess bowel sounds and
bowel elimination patterns: establish bowel routines. Teach importance of
adequate fluid fiber and activity. Administer laxatives stool softeners suppositories
or enemas as needed to prevent constipation.
Urinary system
The urinary system
supports homeostasis by eliminating wastes and excessive fluid from the body.
Some of the changes that
this system suffers are:
-
Decreased number of functional nephrons: decreased
filtration rate with decreased in dug clearance
-
Decreases blood supply: decreased removal of body
wastes; increased concentration of urine
-
Decreased tissue elasticity: decreased bladder
capacity
-
Delayed or decreased perception of need to void:
increased incidence of incontinence
-
Increased nocturnal urine production: increased need
to awaken to void or episodes of nocturnal incontinence
-
Increased size prostate: increase risk of infection
Changes in intellectual capacity
Personally I am very
hurt when I see older people who suffer impaired mental capacity. Sometimes
they are aware of it, they get sad or angry themselves.
From 30 years old
onwards, a decline in intellectual capacity begins which accelerates with old
age. The capacity to resolve problems becomes slower and there is a lack of
spontaneity in one’s thought processes. Creativity and imaginative capacity
survive, but there are alterations in memory which usually leads to amnesia
over time.
Changes in their family roll
At my age I think that
it gave me time to observe the changes that my grandparents who are still alive
have experienced, like for example:
To be parents of
children adults.
To Be a
grandparent.
Eventually being a
widower or widow.
Sometimes this changes are tolerated well, but
sometimes this adaptation depressed them, we have to provide them all our
support
Changes of role in the community and at work
Getting older modifies
the role that has been developed, but not the individual
Retirement is both a
state that is reached and compelling to assume a new role, as a process that
begins during the same working life and It should be planned to organize many
years of our lives.
REFERENCES:
Wold, Gloria. Basic Geriatric Nursing - Milwaukee,
Elsevier -5th ed.
LANDOWNE M,
BRANDFONBRENER M, SHOCK NW. The relation of age to certain measures of
performance of the heart and the circulation. Circulation. 1955 Oct;12(4):567–576.
[PubMed]
Boss GR,
Seegmiller JE. Age-Related Physiological Changes and their Clinical
Significance. The Western Journal of Medicine. 1981;135(6):434–440. [PMC free
article] [PubMed]
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
