NR 601 Midterm Exam review
Week 1
Developmental changes
o Review Kennedy readings for age related changes
o Physiological
Physiological
Age related Change Functional Change Implications
Integumentary
System
Loss of dermal and Loss of subcutaneous Prone to skin breakdown
epidermal thickness tissue and thin and injury
epidermis.
Decreased vascularity • Atrophy of sweat • Alteration in
glands resulting in thermoregulatory
decreased sweat response
production
• Fluid requirements may
• Decreased body change seasonally
odor
• Loss of skin water
• Decreased heat loss
• Increased risk of heat
• Dryness stroke
Respiratory System
Decreased lung tissue Decreased vital Reduced overall efficiency
elasticity capacity of ventilatory exchange
Cilia atrophy Change in mucociliary Increased susceptibility to
transport infection
Decreased respiratory • Reduced ability to Increased risk of
,muscle strength handle secretions and atelectasis
reduced effectiveness
against noxious foreign
particles
• Partial inflation of
lungs at rest
Cardiovascular
System
Heart valves thicken Reduced stroke Decreased
and become fibrotic volume, cardiac responsiveness to stress
output; may be altered
Fibroelastic thickening Slower heart rate Increased prevalence of
of the sinoatrial node; arrhythmias
decreased number of
pacemaker cells
Decreased Decreased sensitivity Prone to loss of balance,
baroreceptor to changes in blood which increases the risk
sensitivity (stretch pressure for falls
receptors)
GI
Liver becomes smaller Decreased storage
capacity
Decreased muscle Altered motility Increases risk of
tone constipation, functional
bowel syndrome,
esophageal spasm,
diverticular disease
Decreased basal May need fewer calories
metabolic rate (rate at
which fuel is
,converted into
energy)
o Lab results
Lab results
Lab Test Normal Changes with Comments
age
UA
Protein 0-5mg/100ml Rises slightly May be due to kidney
changes with age,
urinary tract infection,
renal pathology
Specific 1.005-1.020 Lower max in Decline in nephrons
Gravity elderly 1.016- impairs ability to
1.022 concentrate urine
Hematolog
y
ESR Men: 0-20 Significant Neither sensitive nor
increase specific in aged
Women: 0-30
Iron Binding 50-160mcg/dl Slight decrease
230-410mcg/dl Decrease
Hemoglobin Men: 13- Men: 10-17g Anemia common in the
18g/100ml elderly
Women: None
Women: 12- noted
16g
Hematocrit Men: 45-52% Slight Decline in
, Women 37- decreased hematopoiesisLeu
48%
speculated
Leukocytes 4,300– Drop to 3,100– Decrease may be due to
10,800/mm3 9,000/mm3 drugs or sepsis and
should not be attributed
immediately to age
Lymphocytes 00–2,400 T T-cell and B-cell Infection risk higher;
cells/mm3 50– levels fall immunization
200 B encouraged
cells/mm3
Platelet 150,000– No change in
350,000/ number
Blood
Chemistry
Albumin 3.5–5.0 Decline Related to decrease in
liver size and enzymes;
protein-energy
malnutrition common
Globulin 2.3–3.5 Slight increase
Total serum 6.0–8.4 g No change Decreases may indicate
protein malnutrition, infection,
liver disease
Blood urea Men: 10–25 Increases Increases significantly up
nitrogen significantly up to 69 mg
Women: 8–20 to 69 mg
mg
Creatinine 0.6–1.5 mg Increases to 1.9 Related to lean body
mg mass decrease
Week 1
Developmental changes
o Review Kennedy readings for age related changes
o Physiological
Physiological
Age related Change Functional Change Implications
Integumentary
System
Loss of dermal and Loss of subcutaneous Prone to skin breakdown
epidermal thickness tissue and thin and injury
epidermis.
Decreased vascularity • Atrophy of sweat • Alteration in
glands resulting in thermoregulatory
decreased sweat response
production
• Fluid requirements may
• Decreased body change seasonally
odor
• Loss of skin water
• Decreased heat loss
• Increased risk of heat
• Dryness stroke
Respiratory System
Decreased lung tissue Decreased vital Reduced overall efficiency
elasticity capacity of ventilatory exchange
Cilia atrophy Change in mucociliary Increased susceptibility to
transport infection
Decreased respiratory • Reduced ability to Increased risk of
,muscle strength handle secretions and atelectasis
reduced effectiveness
against noxious foreign
particles
• Partial inflation of
lungs at rest
Cardiovascular
System
Heart valves thicken Reduced stroke Decreased
and become fibrotic volume, cardiac responsiveness to stress
output; may be altered
Fibroelastic thickening Slower heart rate Increased prevalence of
of the sinoatrial node; arrhythmias
decreased number of
pacemaker cells
Decreased Decreased sensitivity Prone to loss of balance,
baroreceptor to changes in blood which increases the risk
sensitivity (stretch pressure for falls
receptors)
GI
Liver becomes smaller Decreased storage
capacity
Decreased muscle Altered motility Increases risk of
tone constipation, functional
bowel syndrome,
esophageal spasm,
diverticular disease
Decreased basal May need fewer calories
metabolic rate (rate at
which fuel is
,converted into
energy)
o Lab results
Lab results
Lab Test Normal Changes with Comments
age
UA
Protein 0-5mg/100ml Rises slightly May be due to kidney
changes with age,
urinary tract infection,
renal pathology
Specific 1.005-1.020 Lower max in Decline in nephrons
Gravity elderly 1.016- impairs ability to
1.022 concentrate urine
Hematolog
y
ESR Men: 0-20 Significant Neither sensitive nor
increase specific in aged
Women: 0-30
Iron Binding 50-160mcg/dl Slight decrease
230-410mcg/dl Decrease
Hemoglobin Men: 13- Men: 10-17g Anemia common in the
18g/100ml elderly
Women: None
Women: 12- noted
16g
Hematocrit Men: 45-52% Slight Decline in
, Women 37- decreased hematopoiesisLeu
48%
speculated
Leukocytes 4,300– Drop to 3,100– Decrease may be due to
10,800/mm3 9,000/mm3 drugs or sepsis and
should not be attributed
immediately to age
Lymphocytes 00–2,400 T T-cell and B-cell Infection risk higher;
cells/mm3 50– levels fall immunization
200 B encouraged
cells/mm3
Platelet 150,000– No change in
350,000/ number
Blood
Chemistry
Albumin 3.5–5.0 Decline Related to decrease in
liver size and enzymes;
protein-energy
malnutrition common
Globulin 2.3–3.5 Slight increase
Total serum 6.0–8.4 g No change Decreases may indicate
protein malnutrition, infection,
liver disease
Blood urea Men: 10–25 Increases Increases significantly up
nitrogen significantly up to 69 mg
Women: 8–20 to 69 mg
mg
Creatinine 0.6–1.5 mg Increases to 1.9 Related to lean body
mg mass decrease
