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Clinical Nurse Specialist Adult Gerontology First Set – Complete Study Guide
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Clinical Nurse Specialist Adult Gerontology First Set – Complete Study Guide
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Clinical Nurse Specialist Adult Gerontology FirstSet – Complete Study Guide
Barthel index of ADLs ✔️Ans - tool to assess functional ability of older
adults. Assess person's disabililities and need for assistance. 10 categories
scored from 0 to 10-15 or 0 to 1-3.i
10 Categories of Barthel Index of ADLs ✔️Ans - Feeding, mobility, personal
grooming, toileting, urinary control, fecal control, ascending and descending
stairs, ambulatory status on level ground, transferring and sitting up in bed,
bathing.
Cardiovascular changes with aging ✔️Ans - reduction in ability of the
cardiovascular system to pump blood.
decrease in oxygen delivery.
Reduced cardiac output causes circulation time to increase.
left ventricle may enlarge
baroreceptor response may decrease
Diastolic dysfunction may be evident
Reduction in the resting and maximal heart rates
Atria may enlarge
A-fib, Aflutter, CHF
Neurological changes with aging ✔️Ans - Number of nerve cells in the brain
and spinal cord decreases.
slight reduction in brain mass.
loss of neurons occurs particularly in the frontal lobes.
decrease in cerebral blood flow.
short term memory loss may occur.
Cognitive processes are not usually affected unless underlying brain disease.
skeletal muscles may atrophy.
Ability of peripheral nerves to repair themselves is reduced.
Slower reflexes.
Reduced perspiration
Pulmonary changes with aging ✔️Ans - Decrease in elasticity of the lungs.
between 40 and 70 maximum breathing capacity decreases by about 40%.
Alveoli flatten and the alveolar ducts enlarge.
,Air tends to stay in alveolar ducts rather than in alveoli.
Decrease in efficiency of oxygen exchange.
Increase in residual volume of the lungs.
Reduction in forced expiratory volume (FEV) and forced vital capacity (FVC).
Decrease in overall strength, less able to breathe deeply.
cough reflex is reduced.
ciliary action decreases.
Protective laryngeal reflexes may be lost.
total lung capacity does not change.
Eyes with aging ✔️Ans - eyes: cloouding of lens as cells die and accumulate.
cataract incidence is >50% by age 80.
Difficulty focusing
Decreased night vision
Increased photophobia
Tend to become farsighted
Kidney and Bladder with aging ✔️Ans - Kidneys are less efficient at
removing wastes from blood
Bladder capacity declines,often resulting in frequency and urgency.
Fat with aging ✔️Ans - body fat increases until middle age, stablizes, and
decreases in older age.
Fat is redistributed from skin to deeper organs, usually to the abdomen rather
than the hips.
Muscles with aging ✔️Ans - Between ages 30 and 70, males lose 23% of
muscle mass and females 22% without compensatory exercise.
Bones with aging ✔️Ans - Bone mineral loss exceeds replacement in
women > 35, accelerating after menopause, and in males > 65, resulting in
osteoporosis if preventive measures.
Skin with aging ✔️Ans - Skin of an infant is thinner than that of an adult.
Epidermis is fully developed at birth, but the dermis is not.
During adolescence, the hair follicles in the skin become active and the dermis
becomes thinner.
There is a reduction in the number of Langerhans cells thus increasing risk of
skin cancer.
, The sweat glands and blood vessels decrease in number and the amount of
subcutaneous fat decreases.
Skin is drier.
Junction between the epidermis and dermis flattens, increasing the risk of
tearing.
Age and exposure to the sun break down elastin, which gives skin strength
and resilience.
Cognitive changes with aging ✔️Ans - Do not usually occur before age 70.
65% of individuals exhibit slight decline in cognitive abilities by age 81.
fluid intelligence decreases somewhat
crystallized intelligence usually unaffected
Acquired knowledge remains intact.
May find it difficult to apply new information to the solution of complex
problems.
May have trouble paying attention for any length of time.
Longer to react to situations
Longer to complete cognitive tasks
Working memory is affected by age
Implicit memory is unaffected by age
Explicit memory may decline with age.
fluid intelligence ✔️Ans - ability to process information
crystallized intelligence ✔️Ans - ability to solve practical problems
implicit memory ✔️Ans - Skills
explicit memory ✔️Ans - Information
Sensory changes with aging ✔️Ans - Deteriorating vision (presbyopia and
cataract)
Less sensitive to color differences
Night vision decreases
Hearing impairment occurs
taste and smell not significantly affected
sense of touch including the ability to sense vibration, temperature, and pain,
is reduced.
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