Term
| Review of structure and function of the following: skin, skin layers and accessory structures; eye; ear. |
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Definition
| Skin function: regulates: body fluids, temperature, immune function; production of Vitamin D; sensory reception: (touch, pressure, temperature, pain) |
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Term
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Definition
| epidermis, dermis, subcutaneous layer, fat tissues |
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Term
| accessory structures of the skin |
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Definition
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Term
| structure and function of the epidermis |
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Definition
| up to 5 layers, major cells: keratinocytes: produce keratin which provides a tough outer barrier of skin, Langerhans: immune response. Does not have its own blood supply, provides vehicle for synthesis of vitamin D |
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Term
| structure and function of the dermis |
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Definition
| 2nd layer of skin, made up of connective tissue rich in blood supply, lymph & neurosensory receptors (lymphocytes--> immune response), provides nourishment/support for the epidermis. Meissners corpuscles detect light touch/vibration. |
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Term
| structure and function of the subcutaneous layer |
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Definition
| (superficial fascia) specialized connective tissue below dermis and attaches to muscle, contains blood vessels, lymphatic channel, hair follicles, sweat glands and adipose (fat cells) Pacinis corpuscles detect deep pressure. |
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Term
| structure and function of the fat tissue |
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Definition
| gives body shape, provides cushioning for bones, protects delicate internal organs, insulates (most on lower back, butt) |
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Term
| structure and function of hair |
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Definition
| each strand grows independently in a cyclic fashion, rates differ in growth depending on its location on the body. Temperature regulation |
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Term
| structure and function of nails |
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Definition
| rapidly dividing extensions of keratin-produced epidermal layer, the crescent shaped portion at the proximal end of the nail plate is the nail matrix. (specialized nonkeratinized cells differentiate into keratinized cells which form nail protein. Protection (toe nails grow slower) |
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Term
| structure and function of glands |
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Definition
| sebaceous glands secrete sebum, oily substance that lubricates skin, makes hair supple, sebum protects the skin from water loss. Apocrine sweat glands - after puberty - axilla, perineum, breast areolae: produce a milky substance which, when acted on by bacteria present on the skin, causes odor. Eccrine glands - produces sweat, a dilute form of plasma; stimulated by exercise, heat. Regulates heating/cooling of the body. |
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Term
| Normal age related changes in the integumentary system and potential effects on self-perception and self-esteem. |
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Definition
| pigmentation changes - photoaging (skin becomes darker), decrease in eccrine, apocrine, sebaceous glands --> dry skin, decrease in number of blood vessels, loss of eyelid elasticity (droopy eyelid), decreased elasting: ineffective decreased quality, adipose tissue redistributes to waist/hips, decrease touch receptors, corresponding slowing of reflexes and pain sensation. Skin/hair changes most visible and may affect self perception/body image. (lower self esteem) |
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Term
| Risks associated with normal age related changes in the integumentary system. |
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Definition
| skin contains less moisture (up to 30%) increased risk of skin tears, increase in itchy skin. Nails are thicker/ragged - increased risk in skin tears. Epidermal mitosis slows (healing takes longer/increased risk of infection), thinning skin (rete ridge - between epidermis and dermis flattens --> fewer contact points) increased risk of skin tears, |
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Term
| Distinguishing characteristics and incidence/prevalence of actinic keratosis |
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Definition
| erythematous, macular, ill-defined border, multiple,sun-damaged areas |
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Term
| Distinguishing characteristics and incidence/prevalence of basal cell carcinoma |
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Definition
| waxy, pigmented, may be erythematous, papular or scaly macular (metastasis is rare) |
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Term
| Distinguishing characteristics and incidence/prevalence of squamous cell carcinoma |
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Definition
| firm to hard, erythematous, nodular or ulcerated nodular, especially on dorsum of hands, forearms and face ( can metastasize - most common) |
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Term
| Causes, risk factors for and classification of skin disruptions in the elderly client. |
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Definition
| fragile skin that damages easily, poor nutritional status (not enough money, note able to get to the store, not educated to nutritional needs), reduced sensations of pressure and pain, more frequent encounter with conditions that contribue to skin breakdown, immobility - don't move around as much |
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Term
| Stages and guidelines for nursing management of pressure ulcers: Stage 1 |
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Definition
| Stage 1 - presistent redness (erythema or hyperemia - will not turn white if you press on it), ischemia [erythema with edema and induration(lack of blood flow)], skin still intact. Interventions: hyperemia - relieve pressure, use of adhesive foam, ischemia - skin protectant solution, clean w/normal saline at least daily if skin broken |
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Term
| Stages and guidelines for nursing management of pressure ulcers: Stage 2 |
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Definition
| Stage 2 - partial skin thickness loss, appearance of an abrasion, a blister, a shallow ulcer (may look like a scrape). Interventions: transparent film, hydrogel, hydrocolloid |
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Term
| Stages and guidelines for nursing management of pressure ulcers: Stage 3 |
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Definition
| full skin thickness loss, subcutaneous tissue(yellow) is exposed, appearance of deep ulcer, may or may not be undermining of surrounding tissue (lateral). Interventions: Wet to dry saline dressings (sterile), or hydrogel, moistenedgauze or calcium alginate, cover with gauze or foam wafer, use least irritating taping method pg. 356 |
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Term
| Stages and guidelines for nursing management of pressure ulcers: Stage 4 |
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Definition
| Full skin thickness loss (down to bone), subcutaneous tissue loss, muscle and/or bone is lost, deep ulceration, may be accompanied by: necrosis, exudate (comes out of), sinus (cavity), infection. Interventions: Necrosis - transparent dressing permeable to oxygenand water vapor, irrigate thoroughly [wet to dry dressing (sterile) remove when dry], topical antibiotics. Ulceration - debridement is required. |
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Term
| Pathophysiology of tissue breakdown and the effects of extrinsic and intrinsic factors on the development of skin breakdown. |
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Definition
| Extrinsic factors - ultraviolet light exposure, smoking, environmental pollutants. Intrinsic factors - genetic make-up, normal aging process. Actinic damage - exposure/damage by the sun |
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Term
| Use of the Braden Scale for Predicting Pressure Sore Risk. |
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Definition
| Used upon hospital admission - Sensory perception - pain/pressure; moisture; activity - totally bed ridden; mobility; nutrition; friction and shear |
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Term
| The major stages of wound healing. |
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Definition
| Inflammatory phase - about 5 days; Proliferation phase - up to 3 weeks; Maturation phase - 3 weeks - 2 years; |
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Term
| Duration, symptoms, and processes of the Inflammatory (and destruction) phase of wound healing. |
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Definition
| about 5 days - redness, heat, pain and edema/swelling. The damaged tissue releases histamine and other chemicals resulting in vasodilation. This enhances blood supply to the area, provides additional nutrients and promotes tissue rebuilding. Neutrophils and macrophages control bacteria and remove debris from the wound. Macrophages secrete growth factors essential for initiation and control of wound repair. |
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Term
| Duration, symptoms, and processes of the Proliferation stage of wound healing. |
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Definition
| up to 3 weeks - rebuilding damaged tissue by three processes: epithelialization, granulation and collagen synthesis. Shallow/partial thickness wound - hair follicles often provide main source for epidermal regeneration. Epidermal cells migrate across the wound surface/cover/protect it from bacteria. full thickness wounds - granulation tissue formed by new blood vessels/collgen strands. support matrix of collagen proveds strength to the new tissues. (oxygen, vitamin C, dietary amino acids and trace elements are essential in this process). Granulation tissue becomes beefy red and grainy in appearance as capillary bed builds. Wound healing usually fills from the wound bottom: depth decreases before width is decreased. |
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Term
| Duration, symptoms, and processes of the Maturation stage of wound healing. |
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Definition
| 3 weeks up to 2 years - process of collagen synthesis continues, the wound becomes thicker and more compact. Contraction - results in a healed scar that is smaller than original wound, initiated by myofibroblasts, important healing mechanism for wounds with tissue loss b/c decreases area to be healed. starts dark red in color in time fades to silver-white color. Scar area is weaker than prewound tissue/prone to reinjury. Width of scar 10% of original wound. |
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Term
| Signs of and contributing factors in delayed healing and chronic wounds. |
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Definition
| Chronic wound - does not heal withing 6 weeks. Signs: wound size increasing; exudate, slough or eschar is present; tunnels, fistula or undermining has developed; epithelial edge is not smooth and continuous and does not move toward the wound. Contributing factors - subclinical bacterial contamination; foreign bodies; inadequate blood supply; inadequate nutrition; immunocompetence; damage to wound |
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Term
| Factors influencing wound healing. |
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Definition
| adequate blood volume and cardiac output (wound blood flow/oxygen delivery); energy (glucose); protein (amino acids); delayed immune function; medications; inadequate or excessive moisture pg 360 |
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Term
| Symptoms for cellulitis in the elderly. |
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Definition
| Sx: inflammation, intense pain, heat redness and swelling. |
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Term
| Contributing organisms for cellulitis in the elderly. |
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Definition
| Contributing Organisms: hemolytic streptococci (group G streptococci and Streptococcus pyogenes) and Staphylococcus aureus. |
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Term
| Risk factors for cellulitis in the elderly. |
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Definition
| Risk Factors: breaks in the skin, leg ulceration or pressure ulcers. predispositing factors: diabetes, obesity, previous history of cellulitis, peripheral vascular disease or tinea pedis. |
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Term
| Pharmacologic and nonpharmacologic nursing actions related to the management of cellulitis in the elderly client. |
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Definition
| Pharmacologic - systemic antibiotics, selected antimicrobials (dose adjusted for elderly), aminoglycosides (dose reduced for elderly). Nonpharmacologic - |
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Term
| Nursing diagnoses pertinent to the care of the elderly client with integumentary problems. |
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Definition
| Impaired Skin Integrity related to lesions and infalmmatory response. Risk for Impared Skin Integrity related to physical immobility. Risk for Impaired Skin Integrity related to decreased skin turgor. Risk for Skin Integrity related to the effects of pressure, friction or shear. Risk for Impaired Tissue Integrity related to decreased circulation. Risk for Infection related to Pressure Ulcer. Pain related to destruction of tissue due to pressure and shear. |
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Term
| Laboratory values useful in determining the elderly client’s risk for pressure ulcer. |
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Definition
| Serum albumin - <3.5 g/dL low, <2.5 g/dL serious depletion of protein; prealbuim (rule of 5s) - >15 mg/dL normal, < 15 mb/dL mild deficiency, < 10 mg/dL moderate deficiency, < 5mg/dL severe deficiency; serum transferrin - ,200 mg/dL low, , 100 mg/dL depletion in protein; lymphocyte count - , 1500 mm indicates loss of energy to skin, moderate decrease 800 - 1200/mm |
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Term
| Components of nursing care of pressure ulcers. |
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Definition
| assessing/staging the wound, debriding necrotic tissue, cleansing the wound, applying dressing--> to provide moist wound bed, preventing/treating infeciton |
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Term
| Teaching guidelines related to skin care in the elderly client. |
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Definition
| 1. Keep the skin clean and dry. 2.lubricate the skin with a moistureizer (massage the area around the reddened area or bony prominence. DO NOT MASSAGE ANY REDDENED AREA. Apply thin layer of petroleum based product, followed by baby powder-cornstarch product-to reduce friction and moisture. 3. Evaluate and manage incontinence. use absorpant under pads to keep moisure away from skin, clean and dry area. 4. Monitor nutrition. Vitamin C and zinc to promote skin healing. |
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Term
| Definitions, prevalence, major causes or risk factors, consequences, nursing implications and interventions, assessment, and associated nursing diagnoses of visual impairment |
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Definition
| Definition: visual acuity of 20/40 or worse while wearing corrective lenses. Prevelance: increases with age, peaks at 85. Causes: cataracts, age-related maculatr degeneration (ARMD), glaucoma, diabetic retinopathy. Assessment: appearance, too much/ill applied make up, stains on clothing, multiple bumps/bruises. Nursing Implications: provide adequate lighting in high traffic areas, recommend motion sensors for lights, look for areas where lighting is inconsistent, proper lampshades to prevent glare, avoid refelctive floors, birght colors for signs, supplementary lamps near work/reading areas, avoid complicated rug patterns. Nursing Dx: Sensory/Perception Disturbed: Visual |
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Term
| Definitions, prevalence, major causes or risk factors, consequences, nursing implications and interventions, assessment, and associated nursing diagnoses of legal blindness (severe visual impairment); |
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Definition
| Definition: visual acuity of 20/200 or more as measured by Snellen Chart at 20 ft. Prevelance: increases with age, peaks at 85. Causes: cataracts, age-related maculatr degeneration (ARMD), glaucoma, diabetic retinopathy. Assessment: appearance, too much/ill applied make up, stains on clothing, multiple bumps/bruises. Nursing Dx: Sensory/Perception Disturbed: Visual |
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Term
| Definitions, prevalence, major causes or risk factors, consequences, nursing implications and interventions, assessment, and associated nursing diagnoses of auditory problems and hearing loss |
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Definition
| Definition: conductive hearing loss - related to problems in the external/middle ear canal, tympanic membrane, bones: outer/middle ear, ossicles, sound is unable to transmit. Sensorineural hearing loss - manifestation of problems within the inner ear, sound transmitted to inner ear, but problems with the cochlea/auditory nerve (cranial nerve VIII) create sound distortion. Cause: presbycusis (loss of hearing due to age related changes in the inner ear. loss of hair cells in the cochlea (sensory loss), degradation of neurons (neural loss) Affect 75% over age 60. Prevalence: 30% age 65-74, 40%-66% over age 75 have some degree of hearing loss. Most common cause: normal aging. Risk Factors: long-term exposure to excessive noise, impacted cerumen(earwax), ototoxic medications, tumors, diseases that affect sensorineural hearing, smoking, history of middle ear infection, chemical exposure (long duration exposure to trichloroethylene). Nursing Interventions: eliminate extraneous background noise, stand 2-3 feet from pt., have patient's attention before speaking; use gentle touch, lower pitch of voice, pause at the end of sentence, speak slowly and clearly, gesture appropriately, ask patient for oral or written response. Nursing Dx: Sensory Perception Disturbed: Hearing |
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Term
| Definitions, prevalence, major causes or risk factors, consequences, nursing implications and interventions, assessment, and associated nursing diagnoses of taste deficit |
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Definition
| Definition: diminished sense of taste, hypogeusia. Salt and sweetness are most severely affected. Causes: Poor dentition/ill fitting dentures affect. Medication can alter taste sensation by affecting peripheral receptors and chemosensory pathways. Medical conditions: various pg. 428. Nerves responsible for transmitting taste info to brain including cranial nerves VII, IX, and X. Nursing Dx: Sensory/Perceptual Alterations: Gustatory; Intake Less Than Necessary for Caloric Requirements |
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Term
| Definitions, prevalence, major causes or risk factors, consequences, nursing implications and interventions, assessment, and associated nursing diagnoses of olfactory dysfunction |
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Definition
| Definition: diminished sense of smell, hyposmia. Prevelance: more common than taste dysfunction, affects 50% adults >60. Causes: age related, medications, tobacco use, poor dentition, olfactory nerve damage (cranial nerve 1), cold, flu, bronchitis, neurodegenerative diseases (Alzheimer's/Parkinson disease) Nursing Dx: Sensory Perception Disturbed: Olfactory |
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Term
| Definitions, prevalence, major causes or risk factors, consequences, nursing implications and interventions, assessment, and associated nursing diagnoses of diminished tactile sensation. |
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Definition
| Definition: decreased perception of pain, extreme temperatures. Cause: Due to slower conduction of nerve impulses/diminished function peripheral nerves. Risk Factors: loss of physical sensation; may not notice pain from pressure ulcers until after Stage 1, may burn hands on stove or hot water. Nursing Dx: Sensory/Perceptual Alterations: Tactile |
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Term
| Safety concerns in the older adult related to: vision changes; auditory changes; changes in taste; olfactory dysfunction; diminished tactile sensation. |
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Definition
| Vision: slower pupillary reaction time, risk of falling/ car accidents, medication errors. Auditory: perform ADLs, communicate, drive/take public transportation, hear alarms/doorbells, engage in activities. Taste: malnourishment, nutrional imbalance, constipation. Olfactory: inability to smell smoke or gas odors, inability to smell spoiled food products, malnourishment. Diminished Tactile: may not notice pain from pressure ulcers until after Stage 1, loss of physical sensation. |
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Term
| Potential adverse reactions and precautions of specific medications on or used for the following: visual changes |
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Definition
| Beta-blockers [Betagan, Timoptic, Ocupress (bottles with blue or yellow caps)]: bradycardia, congestive heart failure, syncope, bronchospasm, depression, confusion, sexual dysfunction. Adrenergics [Lopidine, Alphagan, Epinal (bottles with purple caps)]: palpation, hypertension, tremor, sweating. Miotics/cholinesterase inhibitors [pilocarpine, Humorsol (bottles with green caps)]: bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, excessive lacrimation. Carbonic anhydrase inhibitors [Trusopt, Azopt (bottles with orange caps)]: fatigue, renal failure, hypokalemia, dairrhea, depression, exacerbation of chronic obstructive pulmonary disease. Prostaglandin analogues [Xalatan, Lumigan]: changes in eye color and periorbital tissues and itching |
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Term
| Potential adverse reactions and precautions of specific medications on or used for the following: auditory changes |
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Definition
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Term
| System focused medications: Vitamin A; Vitamin C. |
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Definition
| Vitamin C: 25% reduction in the development of age-related maculare degeneration. |
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Term
| risk factors for valvular disease |
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Definition
| hyperlipidemia, diabetes, & hypertension; as the condition progresses, pts tolerate a decrease in cardiac output & an increase in left ventricular hypertrophy quite well |
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Term
| risk factors for coronary artery disease |
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Definition
| Age, Sex. (Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause), Family history, physical inactivity, diabetes, obesity, high stress |
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Term
| risk factors for coronary artery disease (cont'd) |
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Definition
| Smoking. Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. The incidence of heart attack in women who smoke at least 20 cigarettes a day is six times that of women who've never smoked. For men who smoke, the incidence is triple that of nonsmokers. |
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Term
| risk factors for coronary artery disease (cont'd) |
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Definition
| High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis. High cholesterol can be caused by a high level of low-density lipoprotein (LDL), known as "bad" cholesterol. A low level of high-density lipoprotein (HDL), known as "good" cholesterol, also can promote atherosclerosis. |
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Term
| risk factors for coronary artery disease (cont'd) |
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Definition
| High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow. |
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Term
| risk factors for peripheral vascular disease |
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Definition
| Controllable Risk Factors: Cigarette smoking, lack of exercise, hypertension, hyperlipidemia, diabetes, obesity----Uncontrollable factors: Gender, age, family history |
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Term
| aortic stenosis (Diagnosis, therapy, & nursing considerations) |
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Definition
| the aortic valve doesn't open fully, this decreases blood flow from the heart- may be present at birth (congenital) or develop later in life (acquired); In adults, occurs most commonly in those who've had rheumatic fever; it's not common, but occurs more in men than women. THERAPY: limited activity, medications used to treat symptoms of heart failure or abnormal heart rhythms(most commonly atrial fibrilation)- pts should stop smoking and be treated for high cholesterol- see cardiologist every 3-6months---NURSING CONSIDERATIONS: assist pt in bathing (if necessary), use of bedside commode puts less stress on heart than bedpan, physically undemanding activities, alternate rest times to prevent fatigue & dyspnea, reduce anxiety, elevate pts leg's to improve venous return to heart, upright positions to relieve any dyspnea |
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Term
| Heart failure (Diagnosis, therapy, & nursing considerations) |
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Definition
| the loss of contractility of the myocardium results in the inability of the heart to produce a sufficent cardiac output to meet the needs of the body. The muscles do not receive enough blood supply to respond to increased demand, and the person experiences activity intolerance. THERAPY- STAGE A: manage hypertension, lipid disorders & diabetes mellitus; teach smoking cessation, exercise promotion, diet modifications, moderate EtOH; ace inhibitor(if indicated); NURSING CONSIDERATIONS-conserve energy of pt to maximize the oxygen avail;may need to give supplemental oxygen w/pt in Fowler's position, allot rest time, weigh pt for peripheral edema, monitor IV intake & urine output(especially for pt w/diuretic), frequently monitor blood urea nitrogen & serum creatinine, potassium, sodium, chloride and magnesium levels; provide continous cardiac monitoring during acute & advanced stages to identify & treat arrhythmias promptly |
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Term
| Peripheral Vascular Disease (Diagnosis, therapy, & nursing considerations) |
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Definition
| plaque builds up in the arteries of the legs, arms, and other areas, reducing or blocking blood flow(atherosclerosis); THERAPY- meds, angioplasty, stenting, edarterectomy & bypass grafting; NURSING CONSIDERATIONS- monitor effects of pts using drug therapy, assess neurovascular status of pts legs and report any deterioration in circulation, place lamb's wool btwn pts toes to prevent pressure necrosis, provide wound care as needed |
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Term
| 20. Assessment of the elderly client with cardiovascular disease. |
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Definition
| most likely to have difficulty w/ADLs(bathing, dressing, eating, using toilet, walking, getting in and out of bed), fair to poor health, most likely to stay in bed |
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Term
| 21. Teaching guidelines for the family and elderly client with a cardiovascular disorder. |
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Definition
| pt w/HD will need help w/ADLs & family will need to have patience; family needs to understand that the pt will have minimal energy and may remain in bed five days out of the week; family may need to manage finances, savings & investments, and major decision making |
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Term
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Definition
| first-line diuretic drug of the thiazide class that acts by inhibiting the kidney's ability to retain water; reduces the vol of blood, decreasing blood return to the heart and thus cardiac output, by other mechanisms is believed to lower peripheral vascular resistance (calcium sparing diuretic- it can help the body get rid of excess while obtaining calcium) |
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Term
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Definition
| loop diuretic used in the treatment of CHF & edema; commonly marketed by Sanofi-Aventis under the brand name LASIX |
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Term
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Definition
| selective Beta1 receptor antagonist (beta blocker) drug class used primarily in cardiovascular disease; works by slowing down the heart and reducing its workload |
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Term
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Definition
| (Lotensin)- used to treat hypertension, CHF, & chronic renal failure |
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Term
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Definition
| long-acting calcium channel blocker, used as an anti-hypertensive and in the trtmnt of angina; relaxes the smooth muscle in the arterial wall, decreasing total peripheral resistance, hence reducing BP |
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Term
| 23. Nursing diagnoses and nursing interventions related to the care of the elderly adult with a cardiovascular disorder. |
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Definition
| decreased cardiac output, activity intolerance, risk for impaired gas exchange, risk for skin integrity, deficient knowledge(learning need) regarding condition, trtmnt plan, self-care, & discharge needs- INTERVENTIONS: maintain normal weight, stop smoking, moderate alcohol intake, and exercise |
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Term
| Structure, Fxn, & Anatomy of the Heart |
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Definition
| four-chambered organ positioned slightly left of sternum. Two upper chambers are the atria. Two lower chambers are the ventricles (generate power to pump blood through the body systems) |
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Term
| Structure & fxn of left ventricle |
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Definition
| the left ventricle sends blood out over the greatest area. |
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Term
| System of chambers & valves (right side heart fxn) |
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Definition
| the system of chambers and valves allows for one-way flow of blood from the general circulation, through the right side of the heart, to the lungs where blood gases are exchanged for the release of carbon dioxide and the absorption of oxygen |
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Term
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Definition
| blood returns to the left side of the heart & then to the general circulation where oxygen is delivered to tissue and carbon dioxide and other wastes are removed |
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Term
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Definition
| the mechanical sequence and timing of contraction and relaxation in the heart; is determined by the electrical system of the heart |
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Term
| Inferior & Superior Venae Cavae |
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Definition
| return blood from the general circulation to the right atrium |
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Term
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Definition
| pressures in this chamber are relatively low, which allows for easy return of blood from the peripheral circulation |
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Term
| when the tricuspid valve opens |
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Definition
| pressures in the resting RV are lower than in the RA and blood flows across the tricuspid valve into the RV |
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Term
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Definition
| the resting phase of the ventricle |
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Term
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Definition
| ventricular contraction, pressure rises in the ventricle and the tricuspid valve is forced closed, preventing blood from flowing back into the right atrium |
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Term
| Left ventrical contracts… |
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Definition
| the mitral valve is forced close |
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Term
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Definition
| opens to allow blood to be pumped into the aorta from which it distributes blood to entire systemic circulation. |
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Term
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Definition
| aortic valve closes, preventing blood from flowing back into the left ventricle |
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Term
| Pressure generated on Left side of heart |
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Definition
| are greater than the pressure generated on the right (to ensure adequate flow to & from all body systems) |
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Term
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Definition
| stroke vol/end diastolic vol of left ventricle (left ventricle efficiency-slides) |
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Term
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Definition
| mechanical events related to heart fxn are regulated and coordinated by a series of complex electrical events |
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Term
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Definition
| the period before a cell is at its resting state. Disease states can change the length of the RP. |
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Term
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Definition
| A cell that receives and responds to an impulse during the refractory period may initiate an irregularity of heart rhythm |
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Term
| Mycocardial ischemia, Myocardial infarction, and sudden death (circln pathophys) |
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Definition
| result of atherosclerotic changes in the coronary arteries and the plaque accumulation of coronary artery disease |
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Term
| 4. Significance of atypical presentation of disease in the older person. (ex: Myocardial Infarction) |
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Definition
| Presenting complaint may be heartburn, nausea, fatigue (female present differently than males) |
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Term
| Mental status change (atypical pres) |
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Definition
| confusion, dizziness, agitation, and falls may be first sign of cardiac problems in the older person (Mental status change should never be assumed as dementia)-assess completely & aggressively |
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Term
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Definition
| due to compensatory changes in Vasc. Syst., additional small blood vessels that provide alternate routes for blood to flow |
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Term
| atypical presentation in women |
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Definition
| fatigue, sleep disturbances(increase bp in middle of night-2-3am), epigastric pain |
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Term
| 5. Normal age related changes in the cardiovascular system in the elderly adult. |
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Definition
| stiffening of heart valves, cardiac conductivity altered, decreased baroreceptor sensitivity(stretch receptors) with potential for postural hypotension |
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Term
| 5. Normal age related changes in the cardiovascular system in the elderly adult. (cont'd) |
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Definition
| decreased renin, angiotensin & aldosterone production (related to kidneys)- veins thicken & valvular reflux occurs, arterial stiffening & loss of elasticity |
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Term
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Definition
| major risk factor for developing other cv conditions- it does not always produce its own symptoms, many are unaware they have hypertension, it is easily ignored- #1 headaches & drain of energy system- 120-139/80-89 is prehypertensive; pts should begin lifestyle mods. |
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Term
| Hypertension- RISK FACTORS |
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Definition
| after age 50, SBP>140 more important risk factor than DBP- 90% risk of developing HTN exists even in those age 55 who are normotensive- Thiazide diuretics to treat uncomplicated HTN |
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Term
| Hypertension- POTENTIAL CAUSES OF |
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Definition
| It is unknown if the cause of higher incidence is genetic or environmental |
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Term
| Hypertension- FAILURE to TREAT |
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Definition
| atherosclerosis of the aorta and large vessels accelerates, LV hypertrophy develops, Proteinuria due to increased renal arteriole pressure, vascular changes in the retina (A-V "nicking")- loss of sight & increased stroke risk |
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Term
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Definition
| Frequently associated with medication side effects- decreased responsiveness of sympathetic nervous system w/age affects autoregulation of cardiac output |
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Term
| HYPOtension- RISK FACTORS |
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Definition
| decreased muscle tone in the lower extremities can contribute to postural or orthostatic hypotension (rapid decline in bp when older person rises to stand or sit from lying position) |
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Term
| HYPOtension- POTENTIAL CAUSES OF |
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Definition
| frequent side effect of many cv conditions & many meds. BP varies throughout the day & as a person abilities to autoregulate blood pressure decrease |
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Term
| HYPOtension- FAILURE to TREAT |
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Definition
| will increase the # of falls & fxs |
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Term
| 8. Features of assessment and management goals for the patient with hypertension. |
|
Definition
| evaluate BP bilaterally & in lying, sitting & standing positions, BP varies with time of day & activity, respond to "white coat HTN", must confirm home BP monitoring, assess for target organ damage w/each encounter- HBP screening |
|
|
Term
| 9. Recommended lifestyle changes for the patient with hypertension. |
|
Definition
| promote healthy lifestyles(low fat diet, low sodium diet, weight control, exercise, smoking cessation, controlled alcohol consumption, monitor effects of meds) |
|
|
Term
| 10. Medications used for the management of hypertension. |
|
Definition
| initial trtmnt usually involves diuretics, second med selected pertaining to pts health status |
|
|
Term
|
Definition
| can cause bradycardia, fatigue, exercise intolerance |
|
|
Term
| adrenergic inhibitors and a-blockers |
|
Definition
| postural hypotension can occur |
|
|
Term
| ACE inhibitors & angiotensin receptor blockers |
|
Definition
| dry cough, hyperkalemia(increase in K levels w/a peaked T wave) can occur |
|
|
Term
|
Definition
| may cause decreased cardiac output & slow conduction |
|
|
Term
| 11. The nurse’s role in caring for the older client with hypertension, hypotension. |
|
Definition
| recheck any BP reading taken by CAN's or other med. Pers. To verify abnormally high or low readings. The quality & reliability of BP equipment & techniques vary greatly & when meds or trtmnt will be changed based on these readings, a second check is always worth the effort |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Very High Risk: Coronary heart disease (10-yr >20%) |
|
Definition
| <100 & <70 for very high risk (LDL-C goal mg/dL)---->100 (consider therapy mg/dL) |
|
|
Term
| High Risk: Two or more risk factors, 10-yr risk of CHD 10-20% |
|
Definition
| <130 (LDL-C goal mg/dL)---->130 (consider therapy mg/dL) |
|
|
Term
| Moderate risk: Two or more risk factors, 10-yr risk of CHD<10% |
|
Definition
| <130 (LDL-C goal mg/dL)---->160 (consider therapy mg/dL) |
|
|
Term
| Lower risk: Zero or one risk factor |
|
Definition
| <160 (LDL-C goal mg/dL)---->190 TLC; 160-189 drug optional (consider therapy mg/dL) |
|
|
Term
| HMG-CoA reductase inhibitors (Statins) |
|
Definition
| reduce LDL; side effects- GI distress, elevation of liver enzymes, myopathies |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| reduce LDL; reduce triglycerides; side effects- constipation, bloating, decreased fat-soluble vitamin absorption |
|
|
Term
|
Definition
| (Questran, Questran Light) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| reduce triglycerides; side effects- GI distress, abdominal pain |
|
|
Term
|
Definition
| (Antara, Lofibra, Tricor) |
|
|
Term
|
Definition
|
|
Term
| CHOLESTEROL ABSORPTION INHIBITOR |
|
Definition
| prevent absorption of cholesterol from gut; side effects- back pain, arthralgia, GI distress |
|
|
Term
|
Definition
|
|
Term
| combo statin & cholesterol absorbing inhibitor |
|
Definition
| prevent both absorption & production of cholesterol; side effects-headache, myalgia |
|
|
Term
|
Definition
|
|
Term
|
Definition
| reduce LDL, elevate HDL, reduce triglycerides; side effects- skin flushing, pruritus, GI distress |
|
|
Term
|
Definition
|
|
Term
|
Definition
| reduce LDL, elevate HDL, reduce triglyceridesside effects-flushing, headache, pruritis, myalgia |
|
|
Term
|
Definition
|
|
Term
|
Definition
| reduces triglycerides; sides effects- flu syndrome, dyspepsia, taste alteration, infection |
|
|
Term
| Common causes of Chest Pain |
|
Definition
| when the myocardium is deprived of sufficient blood supply and thereby oxygen, ischemia occurs. Ischemia causes pain & loss of fxn |
|
|
Term
|
Definition
| gradual process of atherosclerosis results in narrowing of the arteries that supply blood to the heart; caused by a mismatch btwn what the body is able to deliver & what the body requires; |
|
|
Term
|
Definition
| due to decreased blood flow to the heart |
|
|
Term
|
Definition
| due to increased demand for oxygen |
|
|
Term
| 15. Relief, management, pertinent nursing interventions related to and significance of failed relief of angina. |
|
Definition
| in stable angina, chest pain is relieved w/rest, if NOT relieved by rest, can progress to myocardial infarction; Nitroglycerine-vasodilator; treatment of choice comes in tablets, sparys, patches, ointment, IV, sublingual |
|
|
Term
|
Definition
| tablets for acute attacks, Transdermal, capsules, ointments do not work rapidly enough during acute attacks, repeat tablet every 5 minutes for acute attack, if NO reolution after 3 tablets, pt must be transported to hospital |
|
|
Term
| 16. Pathology of myocardial infarction (MI). |
|
Definition
| occurs in stages, trtmnt directed to the stage; EKG changes-ST elevation, Q wave represents infarcted tissue, CK-MB elevation 4-6hrs after infarction; Troponin elevation 6-8hrs after infarction; Hemodynamic monitoring necessary if heart failure suspected |
|
|
Term
|
Definition
| arrhythmia(dysrhythmia), conduction blockages, heart failure, plumonary edema (fluid in lungs), ventricular aneurysm, pericarditis |
|
|
Term
| 17. Treatments(anticoagulation) of the elderly adult with MI. |
|
Definition
| anit-inflammatory meds (clot-dissolving drugs have many precautions bec they dissolve all clots in the body and can result in sudden & excessive bleeding) useful within first few hours of event; chew an aspirin while waiting for amublance!---Not all pts are candidates for thrombolytic therapy; some pts benefit from coronary angioplasty procedures |
|
|
Term
| Review of structure of components of the respiratory system |
|
Definition
| lungs, airways leading to the lungs, blood vessles serving the lungs and the chest wall, bronchi, alveoli, mediastinum, bronchioles |
|
|
Term
|
Definition
| movement of the chest wall, elastic recoil of the lungs and airway resistance |
|
|
Term
| structure and function of lungs |
|
Definition
| left lug - 2 lobes (upper and lower), right lung - 3 lobes (upper, middle and lower), consists of segments and lobules; shaped like cones/ textured like fine grain sponge that can inflate with air. Occupy the thoracic cage/stretch from trachea to below heart (2 lungs fill most of the chest cavity) |
|
|
Term
| structure and function of airways leading to the lungs |
|
Definition
| trachea: first branching divides toward the left and right lung |
|
|
Term
| structure and function of blood vessels serving the lungs |
|
Definition
| the oxygen in the lungs passes via alveolar pressure through the capillary beds to enter the circulatory system, then the heart pumps to continuously perfuse the pulmonary circulation. |
|
|
Term
| structure and function of the chest wall |
|
Definition
| muscle and skeletal structure that supports the lungs. Lined w/membrane called the pleura that adheres to the surface of the lungs. Through the process of expanding/contracting it allows movement of air in/out of lungs during ventilation |
|
|
Term
| structure and function of the bronchi |
|
Definition
| pair of tubes that leads air into the the chest. The bronchi divide and subdivide into succesive generations of narrower and shorter tubes of unequal length and diameter. |
|
|
Term
| structure and function of the alveoli |
|
Definition
| network of 3 million air sacs located at the ends of the air passages, final destination for inhaled air |
|
|
Term
| structure and function of the mediastinum |
|
Definition
| space between the lungs that contains the heart, esophagus, trachea, lymph nodes and large blood vessels. |
|
|
Term
| structure and function of the bronchioles |
|
Definition
| the first 16 subdivisions of thebronchi, called the conducting airways. Terminal broncioles are the smallest airways without alveoli; further divide into respiratory bronchioles called alveolar ducts. Alveolar ducts are completely lined with alveoli, where gas exchange occurs. |
|
|
Term
| Normal age-related changes affecting the respiratory system. |
|
Definition
| stiffening of elastin and the collagen connective tissue supportin ght e lungs; altered alveolar shape resulting in increased alveolar diameter; decreased alveolar surface area available for gas exchange; increased chest wall stiffness; -stiffening of the diaphragm |
|
|
Term
| Signs and symptoms of common lung diseases in the elderly adult. |
|
Definition
| wheezing, chest tightness, chronic cough with sputum, nocturnal dyspnea, smoking history |
|
|
Term
| Prevalence of lung disorders common in the elderly population. |
|
Definition
|
|
Term
| Pathophysiology of asthma in the elderly adult. |
|
Definition
| coughing - may be worse at night, wheezing - usually high pitched wheezing sounds on expiration, shortness of breath, chest tightness |
|
|
Term
| Classification of asthma severity and related suggested medications. |
|
Definition
| Mild Intermittent - Step 1 - Preferred med: short acting B-agonist (SABA) prn. Mild Persistent - Step 2 - Preferred med: low dose inhaled corticosteriods (ICS). Moderate Persistent - Step 3 - Preferred med: low dose ICS + LABA or medium dose ICS. Severe Persistent - Step 4- Preferred meds: medium dose ICS + LABA |
|
|
Term
| Goals of therapy for asthma control and COPD. |
|
Definition
| Prevent symptoms that interfere with quality of life. Prevent exacerbations of asthma. Minimize need for emergency department visits. Maintain normal activity levels. Maintain (nearly)normal pulmonary function. Minimize use of 'rescue' medication. Minimize adverse effects of medication. |
|
|
Term
| Nursing assessment and nursing diagnoses for the elderly adult with asthma, COPD, respiratory infections, pulmonary embolism. |
|
Definition
| Activity Intolerance, Ineffective Airway Clearance, Ineffective Breathing Patterns, Impaired Tissue Perfusion: Respiratory, Inneffedtive Management of Therapeutic Regimen |
|
|
Term
|
Definition
| Walls of the small airways and alveoli lose their elasticity and thicken, closing off some of the smaller air passages and narrowing larger ones. Pg 512 |
|
|
Term
| Purpose and principles of specific respiratory treatments, including IPPB, postural drainage, chest percussion, controlled coughing, and tracheal suctioning (see You Tube site). |
|
Definition
| Clearing the air passages of mucus. |
|
|
Term
| Purpose and principles of IPPB (Intermittent positive pressure breathing) |
|
Definition
| clear secretions and stimulate cough reflex |
|
|
Term
| Purpose and principles of postural drainage |
|
Definition
| pt. lies with head and chest over side of the bed. Gravity forces secreation at the bottome of the lungs upward/simulates a cough reflex. Postural drainage is more effective following inhalation of a bronchodilator |
|
|
Term
| Purpose and principles of chest percussion |
|
Definition
| Lightly clapping the chest and back helps loosen secretions |
|
|
Term
| Purpose and principles of controlled coughing |
|
Definition
| Patient can be taught to cough while contracting the diaphragm to maximize the cough response |
|
|
Term
| Purpose and principle of tracheal suctioning |
|
Definition
| This method may be needed during the end-of-life phase for frail older patients who are unable to clear their own secretions. |
|
|
Term
| Patient education points for the elderly adult with COPD and strategies for smoking cessation. |
|
Definition
| never too late to quit, health benefits even for older pt. Behavior modification techniques, nicotine patches and gum |
|
|
Term
| Symptoms and diagnosis of lung cancers. |
|
Definition
| they are vague and mimic syptoms of other pulmonary illness, making diagnosis difficult. Chronic cough, hemoptysis (coughing up of blood or production of bloody sputum), chest pain, shortness of breath, fatigue, weight loss, frequent lung infections - not resolved by antibiotics. |
|
|
Term
| Altered presentation of lung infections in the elderly adult. |
|
Definition
| Because of decreased function in the immune system, older people with lung infections may not cough, exhibit an elevated temperature, or show other classic signs of respiratory infection. They may instead become lethargic, fall, exhibit loss of cognitive or physical function or simply stop eating/drinking. pg 525 |
|
|
Term
| Risk factors for developing respiratory infection in the older adult. |
|
Definition
| History of nosocomial pneumonia w/in last 6 mo - 1yr. Dx of lung disease (COPD), recent hospitalization, nursing home residence, smoking, alcoholism, neurologic disease (dementia, CVA), immunosuppression (corticosteroid use, malignency), use of oxygen therapy, severe protein-calorie malnutrition, heart failure, antibiotic therapy during the previous month, eating dependency, enteral feeding by nasogastric tube |
|
|
Term
| Treatment and prevention of pneumonia in the older population. |
|
Definition
| Treatment: oral macrolide (erythromycin, azithromycin or clarithromycin) or an oral beta-lactam (cefuroxime, amoxicillin or amoxicillin-clavulanate). Prevention: Pneumococcal vaccine (one dose after 65, or a booster after 5 years if initial vaccine received before age 65). |
|
|
Term
| Teaching guidelines for the family and elderly patient with a respiratory disorder. |
|
Definition
| stop smoking, take 10 deep breaths an hour to aerate lungs and loosen secretions, drink plenty of fluids to keep secretions moist, take antibiotics/antivirals as prescribed/finish all medications, report any adverse reactions immediately (diarrhea, gastrointestinal irritation, rash or hives, difficulty breathing), avoid contact with others wo are ill, infants and frail older persons, avoid coughing in public and practice good hand washing, get pneumococcal vaccine and get flu shot yearly. |
|
|
Term
| mechanism of injurt of pulmonary embolism |
|
Definition
| occlusion of a portion of the pulmonary vascular bed by an embolus consisting of a thrombus, an air bubble or a fragment of tissue or lipids. |
|
|
Term
| risk factors/causes of pulmonary embolism |
|
Definition
| clotting disorders, immobility, dehydration, recent surgery, atherosclerotic changes in the circulatory system, atrial fibrilation and obesity |
|
|
Term
| symptoms of pulmonary embolism |
|
Definition
| tachypnea, dyspnea, chest pain, hypoxia, decreased cardiac output, systemic hypotension and possible shock |
|
|
Term
| Review of structure and function of the genitourinary and renal systems. |
|
Definition
| Kidney, bladder, urethra, prostate, penis, scrotum, testes, uterus, ovaries, vagina |
|
|
Term
| Review of structure and function of kidney |
|
Definition
| Functions: removal of waste, fluid/electrolye balance, acid-base balance, blood pressure, red blood cell production. Structure: see pg 541 |
|
|
Term
| Review of structure and function of bladder |
|
Definition
| Structure: ureter, detrusor muscle, ureteral opeining, internal urethral sphincter, external urethral sphincte, urethra, external urethral orfice. Function: store urine, elimination |
|
|
Term
| Review of structure and function of urethra |
|
Definition
| Structure: canal like structure, Function: discharge of urine from the bladder, for males it where semen is discharged |
|
|
Term
| Review of structure and function of prostate |
|
Definition
| Function: secrete proteins and hormones that are added to the ejaculatory fluid produced by the seminal vesicles. Structure: gland |
|
|
Term
| Review of structure and function of penis |
|
Definition
| Function: removing waste fluids from the male body, sexual intercourse |
|
|
Term
| Review of structure and function of scrotum |
|
Definition
| Structure: small muscular sac that contains and protects the testicles, blood vessels, and part of the spermatic cord. It is divided internally into two compartments by a septum, and each compartment contains a testicle. Function: regulates temperature of the testes |
|
|
Term
| Review of structure and function of testes |
|
Definition
| Structure: oval organs about the size of large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord. Function: gland where sperm and testosterone are produced. |
|
|
Term
| Review of structure and function of uterus |
|
Definition
| Structure: three layers: the inner lining (endometrium); the middle muscular layer (myometrium); and the outer layer (perimetrium). The uterus is connected to the fallopian tubes, the cervix and (via the cervix) the vagina. Function: main purpose of the uterus is to nourish a fetus prior to birth. In menstruating females, the ovaries release eggs which travel via the fallopian tubes to the uterus |
|
|
Term
| Review of structure and function of ovaries |
|
Definition
| Structure: ductless reproductive gland. Function: produces females reproductive cells, |
|
|
Term
| Review of structure and function of vagina |
|
Definition
| Structure: muscular passage that connects the uterus to the exterior of the body. Function: |
|
|
Term
| Potential barriers to discussion or teaching regarding elimination and sexuality and the older adult. |
|
Definition
| older adults grew up in an era when genitalia, elimination and sexuality were not discussed and they have carried these attitudes and values into advanced age. Some nurses may find it embarrassing/uncomfortable to discuss with older pts. Or may hold unconscious biases about older adults. |
|
|
Term
| Normal age-related changes affecting the renal systems. |
|
Definition
| renal function starts to decline around 40, not significant in otherwise healthy individual until the 90s. Decreased glomerular filtration rate, renal blood flow, maximal urinary concentration, resonse to sodium loss are marked. Proximal tubules decrease in number and length. Excrete more fluid and electrolytes at night than in the daytime. More urine formed at night-potentially interrupting sleep patterns. One consequence of these changes is an impairment in the excretion of drugs and their metbolite making older adults extremely susceptible to drug overdoses and other adverse medication effects (even within normal dose range). Inability to regulate: fluid, electrolytes, Acid-base balance. Acute-sudden onset, may be reversible. Chronic-occurs over time, damage irreversible. |
|
|
Term
| Normal age-related changes in the bladder/urethra |
|
Definition
| hypertrophy of bladder muscle. Thickening of the baldder wall. Decreased ability of the bladder to expand. Reduced storage capacity. |
|
|
Term
| Normal age-related changes affecting the Male genitourinary. |
|
Definition
| testes become less firm, number of seminiferous tubules that contain sperm decreases dramatically with age. Prolonged arousal time, time before climax and refractory time. Decreased testerone production-->decreased muscle mass and facial/body hair. |
|
|
Term
| Normal age-related changes affecting the Female genitourinary. |
|
Definition
| Decreased/absence of ovarian function--> perimenopause and menopause. cessation of menstruation, hormonal changes that bring on menopause, lack of ovarian function, estrogen levels fluctuate then fall off dramatically for the rest of the woman's life. Decrease estrogen level cause vaginal tissue to thin and become less elastic, less vaginal lubrication -->painful intercourse. Increased risk of urinary incontinence, infection, retention. Decrease in sex drive. Change in sexual response. |
|
|
Term
| Nursing concerns for gay and lesbian older adults. |
|
Definition
| may be hesitant to discuss sexuality for fear of prejudice/rejection. Signs or symptoms may go unreported/unnoticed. |
|
|
Term
| Prevalence of acute and chronic renal failure in older adults. |
|
Definition
| acute renal failure affects 1/5 or 20% of older adults |
|
|
Term
| potential causes of acute and chronic renal failure in older adults. (common causes) |
|
Definition
| Diabetes. Benign prostatic hyperplasia. Hypertension. Long-term NSAID use. |
|
|
Term
| potential causes of acute and chronic renal failure in older adults. (Prerenal causes-Due to decreased blood supply to kidney) |
|
Definition
| Dehydration from loss of body fluid: vomiting, diarrhea, sweating, fever. Poor intake of fluid. Medication eg. Diuretics. Abnormal blood flow to the kidney due to obstruction. (NSAIDs according to the book) |
|
|
Term
| potential causes of acute and chronic renal failure in older adults. (Renal causes - Direct damage to the kidney itself) |
|
Definition
| Sepsis causing inflammation and shutdown. Medications: NSAIDs, Aminoglycosides, Iodine-containing medications. Rhabdomyolosis. Multiple myeloma. Acute glomerulonephritis. |
|
|
Term
| Potential causes of acute and chronic renal failure in older adults. (postrenal causes - Due to factors affecting urine outflow) |
|
Definition
| Obstruction of bladder or ureters. Prostatic hypertrophy, cancer. Tumors of the abdomen. Kidney stones. |
|
|
Term
| Symptoms of renal failure in the older adult. |
|
Definition
| Pruritis. Malaise. Generalized edema. Cognitive changes. Anorexia. Nausea. Weight Loss. |
|
|
Term
| Prevalence of urinary tract infections (UTI) in older adults |
|
Definition
| about 22% of older women experience UTIs and about 7-8% of older men experience UTIs. |
|
|
Term
| Potential causes of urinary tract infections (UTI) in older adults |
|
Definition
| presence of bacteria in the urethra, bladder or kidney. Changes in the urinary tract. |
|
|
Term
| Prevalence of urinary incontinence (UI) in older adults |
|
Definition
| approximately 1/3 of nonistitutionalized older women, 1/5 of community dwelling men, these figures rise to nearly 50% in older men and women in long term settings with older women affected twice as often as older men. |
|
|
Term
| Potential causes of urinary incontinence (UI) in older adults |
|
Definition
| involuntary loss of urine: Stress incontinence, Urge Incontinence, Overflow Incontinence, Neurogenic Incontinence, Funtional incontinence |
|
|
Term
|
Definition
| intra-abdominal pressure is increased and either pelvic floor muscle or urethral sphincter in not strong enough to counter the pressure. (laughing, sneezing, coughing) |
|
|
Term
|
Definition
| detrusor instability, internal sphincer weakness. Irritation of bladder wall: UTI, BPH, tumor. |
|
|
Term
|
Definition
| bladder muscles overextended and have poor tone, overflow of retained urine. Bladder muscles fail to contract or periurethral muscles do not relax, bladder neck obstruction, medications. |
|
|
Term
|
Definition
| inability to sense urge to void: MS, cerbral cortex lesions |
|
|
Term
|
Definition
| physical or psychological factors impair ability to get to the toilet. Prevented from reaching restroom: dementia, disabilities, sedation, inaccessibility |
|
|
Term
| Prevalence of sexually transmitted disease (STD) in older adults |
|
Definition
| >14, 000 older adult diagnosed with AIDS, genital herpes had double since 1994 now affecting 11 in every 100,000; |
|
|
Term
| Potential causes of sexually transmitted disease (STD) in older adults |
|
Definition
| not using safe sex practices, need education on the importance of condom use |
|
|
Term
| Prevalence of BPH (benign prostatic hyperplasia) and erectile dysfunction (ED) in older adult males. |
|
Definition
| BPH: affects 50% of men ages 51-60, 90% of men over 80. ED: affects nearly 70% of men over age 70. rate increases with each decade of life |
|
|
Term
| Potential causes of BPH and erectile dysfunction (ED) in older adult males. |
|
Definition
| BPH: enlargement of the prostate gland. ED: poor arterial blood flow to the penis or poor return of blood through the veins, hypertension, diabetes mellitus, dyslipidemia, smoking. Vasculogenis, neurologic, hormonal or psychogenic factors. |
|
|
Term
| Symptoms of UTI in older adults |
|
Definition
| change in behavior may be the only indicator. Behavioral or cognitive changes. Common symptoms: burning/itching during urination; feeling of urgency; involuntary loss of urine; back pain, fatigue, nausea, dull pain/ache in lower abdomen |
|
|
Term
| Symptoms of UI in older adults |
|
Definition
| involuntary loss of urine |
|
|
Term
| Symptoms of STDs in older adults |
|
Definition
| varies: herpes, gonorrhea… |
|
|
Term
| Symptoms of BPH and ED in older adult males. |
|
Definition
| obstruction of the vesical neck and compression of the urethra; hesitancy, decreased stream, frequency, nocturia; may produce dribbing, poor control, overflow incontinence and bleeding |
|
|
Term
| Treatment of UTI in the older adult. |
|
Definition
| Trimethoprim-sulfamethoxazole has become less effective due to resistance. Fluouroquizolones used instead. Nitrofurantoin 100 mg BID. Men require longer treatment. |
|
|
