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Health & Physical Assessment in Nursing First Edition

Health & Physical Assessment in Nursing First Edition. Donita D’Amico and Coleen Barbarito. Chapter 27 Assessing the Older Adult. LEARNING OBJECTIVE ONE. LEARNING OBJECTIVE ONE. Focus Areas for Older Adult Outlined in the Healthy People 2010 Diabetes Injury and violence prevention

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Health & Physical Assessment in Nursing First Edition

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  1. Health & Physical Assessment in NursingFirst Edition Donita D’AmicoandColeen Barbarito Chapter 27 Assessing the Older Adult

  2. LEARNING OBJECTIVE ONE

  3. LEARNING OBJECTIVE ONE • Focus Areas for Older Adult Outlined in the Healthy People 2010 • Diabetes • Injury and violence prevention • Mental health/mental disorders • Immunization

  4. LEARNING OBJECTIVE ONE • Key Objectives for Diabetes • Increase the number of individuals with diabetes who receive education • Decrease the number of cases of newly diagnosed diabetes • Reduce the number of diabetes-related deaths • Increase the number of individuals who have eye, dental, and foot examinations

  5. LEARNING OBJECTIVE ONE • Key Objectives for Injury and Violence Prevention • Reduce deaths from falls • Reduce hip fractures among older adults • Reduce disability from unintentional injury

  6. LEARNING OBJECTIVE ONE • Key Objectives for Mental Health/Mental Disorders • Increase the number of persons seen in primary healthcare who receive mental health screening and assessment

  7. LEARNING OBJECTIVE ONE • Key Objectives for Immunization • Increase the number of older adults who receive vaccination for influenza and pneumonia

  8. LEARNING OBJECTIVE TWO

  9. LEARNING OBJECTIVE TWO • Theories of Aging • Environmental influences • Cellular changes • Theories • Wear and tear • Cross-linkage • Free radical • Genetic • Apoptosis

  10. LEARNING OBJECTIVE TWO • Wear-and-Tear Theory - The Body Is Likened to a Machine That Wears Out

  11. LEARNING OBJECTIVE TWO • Cross-Linkage Theory - Strands of DNA That Should Remain Separate Are Linked Together

  12. LEARNING OBJECTIVE TWO • Free Radical Theory - Highly Reactive Molecules Interact with and Damage Cellular Components

  13. LEARNING OBJECTIVE TWO • Genetic Theories - Focus on Chromosomal Differences Between Persons

  14. LEARNING OBJECTIVE TWO • Apoptosis Theory - Regulation of Cells Through Growth Restriction

  15. LEARNING OBJECTIVE TWO • Miller (2004) and Biological Aging • Affects all living organisms • Natural, inevitable, irreversible, and progressive with time • Course of aging varies from individual to individual

  16. LEARNING OBJECTIVE TWO • Miller (2004) and Biological Aging • Rate of aging for different organs and tissues varies within individuals • Influenced by nonbiologic factors • Processes are different from pathologic processes • Increases vulnerability to disease

  17. LEARNING OBJECTIVE THREE

  18. LEARNING OBJECTIVE THREE • Impact of Aging on Organs and Body Systems • Integumentary • Mouth, nose, and throat • Eyes • Ears • Respiratory • Cardiovascular

  19. LEARNING OBJECTIVE THREE • Impact of Aging on Organs and Body Systems • Gastrointestinal • Nutrition and fluid intake • Genitourinary • Endocrine • Musculoskeletal • Neurological

  20. LEARNING OBJECTIVE THREE • Skin • Lentigo senilis • Wrinkles • Baldness • Decrease in sweat production

  21. LEARNING OBJECTIVE THREE • Mouth, Nose, and Throat • Smell and taste diminish • Cheilitis • Loss of teeth occurs

  22. LEARNING OBJECTIVE THREE • Eyes • Presbyopia • Xanthelasma • Pingueculae • Cataracts

  23. LEARNING OBJECTIVE THREE • Ears • Presbycusis • Accumulation of earwax

  24. LEARNING OBJECTIVE THREE • Respiratory • Pulmonary tissue stiffens • Breathing becomes harder • Gas exchange diminishes

  25. LEARNING OBJECTIVE THREE • Cardiovascular • Stiffening aorta • Hypertension

  26. LEARNING OBJECTIVE THREE • Gastrointestinal • Intensity of propulsion decreases • Gastritis and peptic ulcers • Constipation • Dependence on laxative use • Diverticulae • Hemorrhoids • Rectal prolapse

  27. LEARNING OBJECTIVE THREE • Nutrition and Fluid Intake • Calculation of body mass index (BMI) • Dehydration

  28. Figure 27.2 Adding fiber to the diet.

  29. LEARNING OBJECTIVE THREE • Genitourinary • Glomerular filtering decreased • Incontinence • Sexual activities

  30. LEARNING OBJECTIVE THREE • Endocrine • Fatigue

  31. LEARNING OBJECTIVE THREE • Musculoskeletal • Loss of muscle mass • Joint wear and tear

  32. LEARNING OBJECTIVE THREE • Neurological • Reduction in reaction time, learning, and short - term memory

  33. LEARNING OBJECTIVE FOUR

  34. LEARNING OBJECTIVE FOUR • Physical Assessment of the Older Adult • Techniques • Inspection • Palpation • Percussion • Auscultation

  35. LEARNING OBJECTIVE FOUR • Specific Areas of the Older Adult Assessment • General survey • Integumentary • Head and neck • Eyes • Ears • Respiratory system

  36. LEARNING OBJECTIVE FOUR • Specific Areas of the Older Adult Assessment • Breasts • Cardiovascular system • Abdomen • Genitourinary system • Musculoskeletal system • Neurological system

  37. LEARNING OBJECTIVE FOUR • General Survey • Evaluation of nutritional status • Measurement of vital signs

  38. LEARNING OBJECTIVE FOUR • Integumentary System • Inspection and palpation of the skin, hair, and nails • Measurement of skin lesions

  39. LEARNING OBJECTIVE FOUR • Head and Neck • Inspection of the nose, nares, and oral cavity • Evaluation of smell • Palpation and auscultation of carotid arteries • Inspection and palpation of neck veins • Evaluation of neck range of motion

  40. LEARNING OBJECTIVE FOUR • Eyes • Inspection of the structures • Measurement of visual acuity and peripheral fields of vision • Inspection of the fundus using an ophthalmoscope • Palpation of the eyeball

  41. LEARNING OBJECTIVE FOUR • Ears • Inspection of the structures • Evaluation of hearing

  42. LEARNING OBJECTIVE FOUR • Respiratory System • Inspection of the thorax • Percussion and auscultation of lung fields

  43. LEARNING OBJECTIVE FOUR • Breasts • Inspection and palpation of the structures

  44. LEARNING OBJECTIVE FOUR • Cardiovascular System • Auscultation of heart sounds • Measurement of apical pulse

  45. LEARNING OBJECTIVE FOUR • Abdomen • Inspection • Auscultation • Percussion • Palpation of the structures

  46. LEARNING OBJECTIVE FOUR • Genitourinary System • Inspection of the structures • Rectal examination

  47. LEARNING OBJECTIVE FOUR • Musculoskeletal System • Inspection of the joints, including range of motion • Inspection of the muscles • Inspection and palpation of the feet

  48. LEARNING OBJECTIVE FOUR • Neurological System • Evaluation of mental status • Cranial nerve testing • Evaluation of balance and coordination • Inspection for tremors • Evaluation of motor and sensory function • Evaluation of reflexes • Evaluation of sleep

  49. LEARNING OBJECTIVE FIVE

  50. LEARNING OBJECTIVE FIVE • Common Problems in the Older Adult • Skin lesions • Insulin resistance syndrome • Diabetes mellitus • Drug and alcohol abuse

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