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NUR 229 Study Guide - Midterm Guide: Macular Degeneration, Role Theory, Benign Prostatic Hyperplasia

Mennonite College of Nursing
Course Code
NUR 229
Amie Walker
Study Guide

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NUR 229 - Adult I Nursing
Summer 2018
Exam #3 Blueprint
Aging/Care of the Older Adult (BS – Chapter 11 and T-Chapter 19)
Theories of Aging
Genetic: genes control “genetic clocks”
Immunity: focuses on the functions of the immune system; age -associated changes in the
immune system, immunosenescence
Cross-linkage: chemical reaction produces damage to the DNA and cell death
Free radical: molecules with separated high-energy electrons have adverse effects on adjacent
molecules; focuses primarily on cell metabolism and function
oThe focus of the free radical theory is the free radicals formed during cellular metabolism
that have adverse effects on adjacent molecules. The genetic theory focuses on genetic
inheritance. The immunity theory of aging focuses on the functions of the immune
system. The focus of the cross-linkage theory is a chemical reaction damaging the DNA
and causing cell death.
Demographics of Aging
The proportion of Americans 65 years of age and older has tripled in the past 100 years
Life expectancy varies by gender and race
Life expectancy has risen dramatically in the past 100 years
o1900—47 years of age
o2009—78.8 years of age
Leading Causes of Death in Older Adults
Heart diseases
Malignant neoplasms
Chronic obstructive pulmonary diseases
Alzheimer disease
Development of the Middle Adult
Physiologic: gradual internal and external physiologic changes occur
Cognitive: little change from young adulthood
Psychosocial: time of increased personal freedom, economic stability, and social relationships
Developmental Tasks of Middle Adulthood
Accept and adjust to physical changes.
Maintain a satisfactory occupation.
Assist children to become responsible adults.
Adjust to aging parents.
Relate to one’s spouse or partner as a person.
Leading Causes of Death in Middle Adulthood
Malignant neoplasms
Cardiovascular disease
Unintentional injury including poisoning, motor vehicle accidents, and falls
Diabetes mellitus
Chronic lower respiratory disease
Cerebrovascular causes
Development of the Older Adult
Physiologic: all organ systems undergo some degree of decline, body less efficient
Cognitive: does not change appreciably, may take longer to respond and react
Psychosocial: Self-concept is relatively stable throughout adult life.
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Disengagement theory: An older adult may substitute activities but does not disengage from
Erikson: ego integrity versus despair and disgust; life review
*Havighurst: major tasks are maintenance of social contacts and relationships
oFundamental to ageism is the view that older people are different than younger people;
therefore, they do not experience the same desires, needs, and concerns as other age
Myths of aging
Common Myths of the Older Adults (Ageism)
Old age begins at 65 years.
Most older adults are in long-term care facilities.
Older adults are sick, and mental deterioration occurs.
Older adults are not interested in sex.
Older adults do not care how they look and are lonely.
Bladder problems are a problem of aging.
Older adults do not deserve aggressive treatment for illnesses.
Physiological Changes in older adult and what to do about it
Changes of Older Adulthood
Physical strength and health
Retirement and reduced income
Health of spouse
Relating to one’s age group
Social roles
Living arrangements
Family and role reversal
oSTARTING OFF WITH HEALTH OF SPOUSE: Just like it is stressful for middle-adult
people to care for aging parents, it can be stressful for a spouse to care for an ailing
partner. As time progresses and new developments are made, many older people feel as if
they relate to people in their own age group – but unfortunately, this number diminishes
as people in their age group die. Elderly still need to have roles in society. Remember that
purpose in life – people who can get around may want to maintain part-time employment
or volunteer. Some aging parents decide to go to live in communities where there is less
stress on family (family can come visit, but does not have to worry about tending to
“tasks” like meal prep, yardwork, etc. It is an adjustment to both parents and adult
children when there is a role reversal.
Cardiovascular Changes
Heart disease is the leading cause of death
Myocardial hypertrophy: Decreased cardiac output
Increased fibrosis: Reduced stroke volume
Calcium and fat deposits: hypertension and increased workload
Slower heart recovery rate to stress
Orthostatic hypotension
Respiratory System
Age-related changes may be subtle and gradual
Diminished respiratory efficiency
Reduced maximal inspiratory and expiratory force
Lung mass decreases and residual volume increases-physical: posture, decrease muscle mass
Smoking most significant risk factor-path
Integumentary System
Aging can interrupt all functions of the skin and affect appearance
Epidural proliferation decreases, dermis becomes thinner
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Elastic fibers are reduced and collagen becomes stiffer
Subcutaneous fat diminishes: less likely to conserve body heat
Loss of resiliency with wrinkling and sagging of the skin
Hair pigmentation may change, and balding may occur
Reproductive System
Sexual activity declines with the loss of a partner, primarily for women as a result of widowhood
and for men as a result of poor health, erectile dysfunction, medications, and emotional factors
Female: vaginal narrowing, decreased elasticity; decreased vaginal secretions, involution- goes
back to normal, and decreased tone
Male: less firm testes but may continue to produce viable sperm up to 90 years of age, diminished
production of testosterone
Genitourinary System
Decreased filtration rate
Diminished tubular function with less efficiency in reabsorbing and concentrating the urine
Slower restoration of acid–base balance in response to stress
Male: benign prostatic hyperplasia
Female: relaxed perineal muscles, detrusor instability (urge incontinence), urethral dysfunction
(stress urinary incontinence)
Gastrointestinal System
Decreased sense of thirst, smell, taste
Decreased salivation
Difficulty chewing and swallowing food
Delayed esophageal, gastric emptying
Diminished secretion of gastric acid and pepsin
Reduced gastrointestinal motility
Nutritional Health
Require fewer calories
Require more nutrient-rich, healthy diet in response to alterations in body mass and a more
sedentary lifestyle
Recommendations include reducing fat intake while consuming sufficient protein, vitamins,
minerals, and dietary fiber for health and prevention of disease
Budgetary constraints and physical limitations may interfere with food shopping and meal
Factors that affect sleep quality:
oRespiratory problems
oRestless leg syndrome
Sleep—Consequences of Poor Sleep
Cognitive decline
Increase risk for falls
Daytime fatigue
Reduced physical and mental health
Reduced quality of life
Musculoskeletal System
Alterations in bone remodeling
Loss of bone density
Loss of muscle strength, size
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