Age Related Physiological Changes & Nursing Interventions

Overall Nursing Interventions
– Assess thoroughly & individualize care;
– Reduce safety risks and promote health;
– Improve older adults quality of life; and
– Understand age-related changes are major contributors to Geriatric Syndromes.

Integumentary – Epidermis
– Increased risk of skin cancer;
– Slowed wound healing;
– Increased susceptibility to infection; and
– Flattening of epidermal-dermal junction = increased risk of tearing.

Integumentary – Dermis
– Decreased collagen = increased sagging & wrinkling;
– Decreased pain sensation; and
– Increased risk of injury.

Integumentary – Subcutaneous (Hypoermis)
– Decreased SubQ tissue = decreased insulation, decreased protection, and decreased thermoregulation;
– Decreased fat = increased injury & brusing;
– Decreased sebaceous glands = drying of skin, itching; and
– Decreased vitamin D absorption = osteoporosis.

Integumentary Nursing Interventions
– Focus on protecting skin from injury by:
– Daily skin inspection with careful assessment and documentation;
– Protect and prevent tearing;
– Maintain hydration & nutrition;
– Moisturize the skin;
– Frequent position changes if immobile;
– Be aware of heat/cold intolerance;
– Do not rely on verbalization of pain – inspect; and
– Monitor healing of wounds.

– Enlarging chambers/LVH (myocardial – thickening) = increased resting HR, decreased maximum HR (with exercise);
– Decreased elasticity & recoil of artieries = orthostatic hypotension;
– Atherosclerosis, LDL elevation, increased SBP & DBP = Arteriosclerosis; and
– Decreased elasticity in veins = valve stiffness = edema = the heart has to work harder to return blood.

Cardiovascular Nursing Interventions
– Monitor blood pressure elevation and fluid overload;
– Exercise is good but in moderation (don’t over exert);
– Watch for orthostasis, especially with anti-hypertensives;
– Slow down changes of position;
– Dependent edema is common, but *pitting edema is NOT normal*;
– Assess smoking/exposure to environmental pollutants;
– Help with stress management; and
– Help maintain weight & nutrition.

*Weakened inspiratory & expiratory muscles results in:*
– Increased stiffening of chest wall;
– Decreased lung expansion & decreased tidal volume;
– Decreased vital capacity (amount exhaled);
– Increased residual volume;
– Weakened cough reflex, ciliary function = increased risk of pneumonia, aspiration; and
– Decreased number of functional alveoli = decreased alveolar surface area = decreased PaO2 (ABG) & less efficient gas exchange.

Respiratory Nursing Interventions
– Maintain upright position when eating or drinking;
– Encourage physical activity (as tolerated) to maintain lung condition and help expel substances;
– Encourage regular deep breathing & coughing if on bed rest or at risk for respiratory infection;
– Monitor for atypical presentation; and
– Encourage immunizations – influenza & pneumococcal

– Presbyopia: decreased visual acuity (starting in the 40’s);
– Loss of accommodation (dark/light);
– Increased glare sensitivity;
– Decreased peripheral and night vision;
– Yellowing of lens;
– Decreased color discrimination; and
– Decreased contrast sensitivity.
*Vision loss is not normal, just changes/difficulty*

Vision Nursing Interventions
– Ensure good lighting for reading, safe mobility and function;
– Provide larger font print (14pt minimum), high contrast (B/W)
– Use block style printing & avoid cursive lettering;
– Ensure pt’s glasses are within reach / available to pt; and
– Suggest using a magnifier for small print / difficulty reading.

– Increased cerumen in ear canals – hardens & thickens;
– Presbycusis (sensorineural hearing loss)
– High frequency (pitch) hearing loss occurs first / most commonly >>> soft consonants “T&D” and “S&F” are hard to distinguish

Hearing Nursing Interventions
– Assess for hearing prior to speaking loudly;
– Hearing assistive devices (available);
– Lower the pitch/tone of your voice when speaking to the pt;
– Speak directly to the older adult (facing them); and
– Reduce background noise.

Musculoskeletal – Muscular & Connective Tissue
– Loss of muscle mass (sarcopenia) & increased fat:muscle ratio;
– Increased connective tissue; and
– Decreased synovial fluid in joints = decreased joint mobility.

Musculoskeletal – Skeletal
– Decreased bone quality & strength;
– Decreased mineral density; and
– Loss of height (< 2 inches is normal, *2-3+ is not normal*) *Kyphosis is common but not normal*

Musculoskeletal Nursing Interventions
– Assess activity, mobility, gait, and balance;
– Prevent falls (assess risk);
– Daily activity: get OOB to maintain muscle, strength, and balance;
– Encourage weight-bearing; and
– Promote safe walking: proper footwear, de-cluttered room/pathway, wider base of support

Genitourinary (GU) / Renal – Kidneys
– Decreased blood flow to kidneys;
– Decreased kidney size & function; and
– Decreased GFR (impaired ability to concentrate urine).

Genitourinary (GU) / Renal – Bladder
– Increased involuntary bladder contractions;
– Decreased bladder size;
– Increased nocturnal diuresis;
– Decreased urine flow rate & increased residual volume
*Incontinence is common but not normal*

Genitourinary (GU) / Renal Nursing Interventions
– Review physical exam & history for morbidity, medications, surgeries, GU, GYN, diet, constipation, continence hx;
– Prevent dehydration;
– Monitor need to adjust dosages of medications that require renal excretion; and
– Prevent incontinence = increase toiletry frequency d/t less ability to delay.

Gastrointestinal (GI)
Overall, the GI track is well preserved in age

Gastrointestinal (GI) – Upper GI
Mouth, esophagus:
– Decreased appetite & increased difficulty masticating;
– Decreased smell, thirst, and taste;
– Decreased tooth enamel (brittle) & dentin deterioration;
– Diminished oral muscle strength;
– Dry mouth; and
– Less effective swallowing (dysphagia) d/t decreased esophageal propulsion & emptying.

Gastrointestinal (GI) – Stomach
No significant changes

Gastrointestinal (GI) – Small Intestine
-Atrophy of small bowel mucosa = slows absorption of proteins, minerals, fats, carbs, & vitamins;
– Decreased absorption of Ca, lactose, vitamin D, zinc, B12; and
– Increased bacterial overgrowth = malabsorption & malnutrition.

Gastrointestinal (GI) – Large Intestine
-Increased colonic transit time increases the amount of water returned to the body and thus increases the risk of constipation (hard, dried out stools).

Gastrointestinal (GI) Nursing Interventions
– Assess dietary preferences, teeth, mastication, swallowing;
– Maintain upright position if possible;
– Hydration is critical for regular bowel movements;
– Prevent & assess for constipation: monitor medications, especially narcotics;
– Encourage fiber-rich diet – fruits & vegetables;
– Encourage daily physical activity;
– Provide smaller, more frequent meals;
-Ensure glasses, hear aids, and appropriate utensils are available;
– Monitor pain.

Nervous System – CNS
– Decrease in number of neurons;
– Decrease in brain weight & size; and
– Decrease in neurotransmitters.

Nervous System – Peripheral
Overall increase in risk of injury d/t:
– Loss of motor neurons;
– Decrease in vibratory sensation;
– Decrease in tactile sensitivity; and
– Decrease in proprioception & “righting reflex” = increase in body sway.

Nervous System Nursing Interventions
– Assess gait & balance – use walking aids as needed for safety;
– Inspect feet daily;
– Use caution with heat/cold applications;
– Orient frequently, use memory aids;
– Provide social engagement; and
– Use principles of patient education.
*Significant memory loss is not normal*

– Shrinking thyroid gland (healthy adults see little change);
– Decreased pancreatic beta cell function = insulin resistance;
– Increase in ADH release = Na loss & hyponatremia, voiding less volume
– Decreased melatonin = sleep problems.

Endocrine Nursing Interventions
– Monitor for diabetes mellitus;
– Monitor for electrolyte imbalance; and
– Promote restful sleep by maintaining regular wake/sleep schedule, lowered lights/voices at night, minimal interruptions.

Captopril – Nursing Interventions Assess for skin rash, pruritus. Assist with ambulation. Monitor urinalysis for protein uria. Assess for anorexia secondary to altered taste perception. Monitor serum potassium levels in tissue on concurrent diuretic therapy Clonidine – Nursing Interventions Monitor …

Anorexia, Nausea, Vomiting Most commonly observed side effect of chemotherapy Most common side effect of radiation when treatment includes some part of the gi tract nausea and vomiting WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR …

Nursing Interventions are: Purpose: to achieve client outcomes Also called nursing actions, measures, strategies, activities Based on clinical judgement and nursing knowledge Reflect direct and indirect care Independent Interventions treatment that a RN can provide without a MD order WE …

what is the main nursing intervention of croup syndrome? to maintain open airway in hospitalized child nursing interventions trach set readily available if intubated -suction PRN/ DO Not Leave child alone position for comfort- do not force to lie down …

Safe and Effective Care Environment Examine individual patient factors for safety, especially among older adults Apply the principles of asepsis to protect immunocompromised patients Modify the environment to protect patients who have thrombocytopenia Identify appropriate resources for the patient with …

What Are Nursing Interventions? -Purpose: to achieve client outcomes -Also called nursing actions, measures, strategies, activities -Based on clinical judgment and nursing knowledge -Reflect direct and indirect care Nursing Interventions Independent interventions Dependent interventions Interdependent interventions WE WILL WRITE A …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out