NURS 6901 GERIATRIC EXAM LATEST UPDATE
What are CV physiologic changes in the geriatric population? - ANSWER 1.
Decreased compliance of heart and vasc system
-Increased in afterload (HTN, which can lead to ventricular hypertrophy, which
leads to an issue in diastolic relaxation/filling so the heart depends on the atrial kick
to preserve filling)
-Increased pressure from the atrium leads to diastolic dysfunction
-Decreased vein compliance (which results in decreased venous return)
-Decreased atrial compliance (widening pulse pressure, pulse pressure greater than
or equal to 80 mmHg is risky)
2. Increased circulating catecholamines w/ decreased end organ adrenergic
response (downregulation of alpha/beta receptors, which will result in labile BP
under anesthesia)
3. Prolonged circulation time
-Results in slower onset for IV drugs and faster onset for inhalation agents
4. Calcification of valves/conduction system - a fib
5. MI is the most common cardiac complication and the leading cause of death
What are resp physiologic changes in the geriatric population? - ANSWER 1.
Decreased chest wall compliance (calcification of joints/chest wall, flattened
diaphragm)
2. Loss of elastic recoil (causing there to be a need for increased lung inflation to
prevent atelectasis, easier for smaller airways to collapse)
3. Impaired gas exchanged (decreased PaO2)
, 4. Decreased responsiveness to hypoxia/hypercapnia
5. Decreased protective airway reflex (less effective cough, impaired swallowing)
**These all point to a higher risk of respiratory failure!
What are renal physiologic changes in the geriatric population? - ANSWER 1.
Renal reserve decreases progressively w/ age
-GFR decreases by 1mL/min/yr after 40
-Renal drug clearance is decreased, especially after 60
2. AKI: The geriatric population has a higher mortality rate when they get an AKI
and also have less ability to cope with fluid/electrolyte imbalances
3. Decreased renin and aldosterone production (elderly are less effective at
reserving Na)
What are hepatic physiologic changes in the geriatric population? - ANSWER 1.
Liver mass decreases and thus hepatic blood flow decreases
2. Modest reduction in phase 1 metabolism
3. Function is generally preserved in a healthy, older adult
4. Co-existing diseases and lifestyle have larger implications than physiologic age
What are endocrine physiologic changes in the geriatric population? - ANSWER 1.
Decreased number and function of pancreatic islet beta cells
-Decreased insulin secretion
-Increased insulin resistance
-Increased risk of DM
2. Assess for DM! What type, control of DM (A1C), length of disease, and
complications
What are CV physiologic changes in the geriatric population? - ANSWER 1.
Decreased compliance of heart and vasc system
-Increased in afterload (HTN, which can lead to ventricular hypertrophy, which
leads to an issue in diastolic relaxation/filling so the heart depends on the atrial kick
to preserve filling)
-Increased pressure from the atrium leads to diastolic dysfunction
-Decreased vein compliance (which results in decreased venous return)
-Decreased atrial compliance (widening pulse pressure, pulse pressure greater than
or equal to 80 mmHg is risky)
2. Increased circulating catecholamines w/ decreased end organ adrenergic
response (downregulation of alpha/beta receptors, which will result in labile BP
under anesthesia)
3. Prolonged circulation time
-Results in slower onset for IV drugs and faster onset for inhalation agents
4. Calcification of valves/conduction system - a fib
5. MI is the most common cardiac complication and the leading cause of death
What are resp physiologic changes in the geriatric population? - ANSWER 1.
Decreased chest wall compliance (calcification of joints/chest wall, flattened
diaphragm)
2. Loss of elastic recoil (causing there to be a need for increased lung inflation to
prevent atelectasis, easier for smaller airways to collapse)
3. Impaired gas exchanged (decreased PaO2)
, 4. Decreased responsiveness to hypoxia/hypercapnia
5. Decreased protective airway reflex (less effective cough, impaired swallowing)
**These all point to a higher risk of respiratory failure!
What are renal physiologic changes in the geriatric population? - ANSWER 1.
Renal reserve decreases progressively w/ age
-GFR decreases by 1mL/min/yr after 40
-Renal drug clearance is decreased, especially after 60
2. AKI: The geriatric population has a higher mortality rate when they get an AKI
and also have less ability to cope with fluid/electrolyte imbalances
3. Decreased renin and aldosterone production (elderly are less effective at
reserving Na)
What are hepatic physiologic changes in the geriatric population? - ANSWER 1.
Liver mass decreases and thus hepatic blood flow decreases
2. Modest reduction in phase 1 metabolism
3. Function is generally preserved in a healthy, older adult
4. Co-existing diseases and lifestyle have larger implications than physiologic age
What are endocrine physiologic changes in the geriatric population? - ANSWER 1.
Decreased number and function of pancreatic islet beta cells
-Decreased insulin secretion
-Increased insulin resistance
-Increased risk of DM
2. Assess for DM! What type, control of DM (A1C), length of disease, and
complications
