Chapter 41: Assisting in Geriatrics

Digestive System in aging

- Constipation, caused by lack of exercise and poor diet - Fecal incontinence, caused by lack of muscle tone

Signs of Aging in the Cardiovascular System

- Decreased cardiac output, especially during excercise -arteriosclerosis - Postural hypotension, or loss of blood pressure when standing or sitting up abruptly - Increased risk of heart disease

Aging in the Genitourinary System

- Decreased number of nephrons, which are the functional units of the kidneys - The kidneys filtering blood more slowly, causing reduced tolerance to stress, medications, and illness - Loss of voluntary control of urination

Aging of the Endocrine System

- Decreased thyroid function - Loss of estrogen production in postmenopausal females - Decreaseing levels of aldosterone, a hormone that has a role in regulating blood pressure - Increase in the time it takes for levels of the hormone cortisol to return to normal after stressul events. - Deficiencies in response to insulin by various organs

Signs of aging in the respiratory system

- Some loss of elasticity of the lungs - Calcification of the intercostal cartilage (located between the ribs) and the development of kyphosis (curvature of the spine), making it difficult for the lungs to expand properly - Increased shortness of breath, caused by physical changes above

Aging in the Immune System

- Susceptibility to infectious diseases - Susceptibility to autoimmune diseases such as cancer and rheumatiod arthritis

Signs of Aging in the Special Senses

-Impaired vision and hearing -Altered or decreased taste sensations, which contribute to undereating and possible malnutrition

Aging in the Musculoskeletal System

-Osteoporosis, or decreased bone density, leading to increased incidence of fracture, particularly fractures of the hip - Osteoarthritis (OA), or degenerative joint disease (DJD) - Decreased numbers of musculoskeletal fibers

Aging in the Nervous System

-Slower reaction time and thought processing - Decreased blood flow to the brain due to arteriosclerosis, a group of disorders that cause thickening of the artery walls - Shortened attention span and difficulty handling several tasks at one time, caused by decreased frontal lobe size - Shrinkage of temporal lobes, leading to weaker signals to the brain for processing - Impairment of fine motor activities such as writing, caused by shrinkage of the substantia nigra, a layer of gray matter in the brain -Memory loss caused by changes in the part of the brain called the hippocampus and a lack of acetylcholine-a chemical that transmits messages between nerve cells or between nerve cells and muscle cells.

Changes in the integumentary system that occur with aging include:

-Thinning and wrinkling skin due to decreased amounts of collagen and elastin in the dermis. -Atrophy, or degeneration, of the subcutaneous layer of skin due to a decrease in adipose tissue -Decreased number of cells that produce pigment, or melanocytes, which protect against ultraviolet light. Melanocytes that are still present gather in common locations, causing the brown spots known as lentigos or "liver spots." -Graying, thinning hair -Brittle nails -Decreasing inflammatory response, resulting in slower healing

The Food and Nutrition Board of the National Academy of Sciences recommends a ______% decrease in caloric intake for people over age 50, compared with that of young adults.

10

Influenza and influenza-related pneumonia represent a serious health risk for patients older than age ______.

65

What is the general age range of retirement in Western cultures?

65 to 70 years

Which of the following are increased risks of elderly patients on drug therapy?

Adverse effects Lack of therapeutic effects Drug toxicity

What should a medical assistant do as a result of the increased risks of elderly patients on drug therapy?

Be especially alert when assessing an elderly patient on drug therapy.

Postural hypotension and arteriosclerosis are signs of aging in which body system?

Cardiovascular

Which of the following are important preventive measures for elderly patients?

Colonoscopies Regular checkups Immunizations

Which of the following is a sign of aging in the digestive system?

Constipation, caused by lack of exercise and poor diet

Which of the following are challenges presented by elderly patients when performing blood-drawing procedures?

Decreased circulation makes it difficult to collect enough blood. Changes in skin make elderly patients more prone to bruising.

For which of the following reasons are elderly patients more sensitive than others to cold and heat?

Decreased circulation results in a lessened ability to retain heat. The sweat-producing glands of the skin decrease in number.

Which of the following are signs of aging in the integumentary system?

Decreased inflammatory response Decreased number of melanocytes, leading to "liver spots"

Which of the following are signs of aging in the musculoskeletal system?

Degenerative joint disease Decreased bone density, leading to increased incidence of fracture

Fecal incontinence due to lack of muscle tone is a sign of aging in which system?

Digestive

Which of the following is NOT a point to consider when caring for and providing patient education to geriatric patients?

Discourage opportunities for socialization.

How can a medical assistant reassure patients worried about the potential side effects of an immunization?

Emphasize that symptoms are short-lived. Describe the mild symptoms they may encounter. Mention the relatively mild symptoms compared to contracting the infection.

Which of the following effects does fat have on the body?

Enhanced vitamin absorption Development of atherosclerosis

For which of the following reasons are the elderly prone to falling?

Equilibrium problems Vision problems

A decreased number of nephrons, the functional units of the kidneys, is a sign of aging in which system?

Genitourinary

Which of the following is a typical nonverbal sign of elder abuse?

Grimacing

Which of the following is a of aging in the special senses?

Impaired vision and hearing

Which of the following are signs of neglect in an elderly patient?

Inappropriate clothing for the season Poor skin color Soiled clothing

Which of the following are recommended vaccines for patients older than age 65?

Influenza-related pneumonia Shingles Influenza

Which of the following are the basic categories of elder abuse?

Institutional elder abuse Domestic elder abuse Self-abuse

Graying, thinning hair and brittle nails are signs of aging in which system?

Integumentary

Which of the following are risk factors for elder abuse?

Isolation of the victim from family members and friends other than the abuser History of alcoholism, drug abuse, or violence in the family

Which of the following are examples of factors that may impair or impede eating in elderly patients?

Lack of money for food Difficulty chewing and swallowing

Which of the following are tips for effective communication with elderly patients?

Look at patients directly to make sure they understand what you tell or ask them. Speak slightly more slowly than you normally would.

Which of the following are signs of aging in the cardiovascular system?

Loss of blood pressure when standing or sitting up abruptly Increased risk of heart disease

Which of the following are safety precautions for elderly patients to reduce their risk of falling?

Make sure potentially hazardous areas are well lit. Use night lights in the bedroom and bathroom to prevent night falls.

Identify the concerns of elderly patients about vaccinations.

Necessity Cost Side effects

Memory loss caused by changes in the hippocampus of the brain and a lack of acetylcholine are signs of aging in which of the following?

Nervous System

Memory loss caused by changes in hippocampus of the brain and a lack of acetylcholine are signs of aging in which of the following?

Nervous system

Which of the following are resources to consult about possible drug interactions?

Online drug interaction checkers Physician's Desk Reference

Which of the following are safety precautions to discuss with elderly patients and their families to reduce the risk of falling?

Place sturdy banisters along all stairs inside and outside the home. Use a cane or walker if patients are unsteady on their feet.

Which of the following are examples of using physical touch when treating elderly patients?

Placing an arm on a patient's shoulder Offering to hold a patient's hand

Which of the following are guidelines for caring for and providing patient education to geriatric patients?

Question mature adults about their sleeping patterns. Encourage patients to continue to get regular healthcare checkups.

Loss of elasticity of the lungs is a sign of aging in which system?

Respiratory

Which of the following are signs or symptoms of aging in the nervous system?

Shortened attention span Slower reaction time and thought processing

Which of the following are reasons geriatric patients may not take medications?

They find it difficult to keep track of multiple prescriptions. They feel they do not need the medications. They have difficulty swallowing.

Which of the following factors may interfere with collecting a 24-hour urine specimen from geriatric patients?

Uterine prolapse Urinary incontinence Weakening of bladder muscles

How often should a patient's total drug profile be updated in the record?

With every visit to the facility

Recent stressful events and a history of mental illness are risk factors for

elder abuse.

Decreased levels of aldosterone is a sign of aging in which body system?

endocrine

Slowing reflexes is a reason elderly patients are prone to

falling.

Geriatrics is a subspecialty of

family medicine. internal medicine.

Physically, some older adults are ______ which may not make it easy to withstand blood drawing procedures.

frail

Do not stereotype all elderly patients as

frail or confused.

Elderly patients are cared for by a specialist in geriatrics called a

geriatrician.

The field of medicine that is concerned with the problems of aging is called

geriatrics.

Osteoporosis and osteoarthritis are 2 signs of aging in the ______ system.

musculoskeletal

Measures taken to prevent illness are known as

preventive medicine.

Elderly patients who follow a course of treatment for depression gain

relief from symptoms associated with depression. improved physical, mental, and social well-being.

Uterine prolapse is often a result of

several childbirths. weakening of the supports of the uterus.

Decreased taste sensations is a sign of aging in the

special senses.