Spring 2021
UPNS 338/430 Gerontology
Exam 1 Blueprint .
# of Questions Topic
8 Changes of Aging- Assessment and Prevention
5 Pharmacology Considerations
1 Chronic Disease
11 Respiratory
5 Safety- Falls Risks
5 Musculoskeletal
Please remember that some of the questions may be a combination of multiple topics (i.e., assessment
of the aging adult and safety considerations).
Changes of Aging- Assessment and Prevention (8)
Tips for approaching a geriatric patient
Priority complaint is your priority
PROMOTE STRENGTH AND SUPPORT THEIR WEAKNESS!!!
Keys to Assessment
hard of hearing “HOH”
Don’t forget to ask questions about sexual health even if it may be awkward
Cardiovascular System
Stiffening or hardening of blood vessels and arteries
o Causes heart to work harder to pump blood through them causing heart muscles to
change to adjust to increased workload
Usually diagnosed with cardiomyopathy (large heart) which is a normal change
From that congestive heart failure can form which is a complication of a normal
change
Thus, hardening of arteries and vessels causes heart to work harder to pump causing the heart
muscles to change to adjust to increased workload which causes someone to be diagnosed with
a cardiomyopathy as a normal change in the older adult
o If they develop congestive heart failure, it is a complication of these normal changes
Heart rate at rest will stay the same and not increase as much during activities
o When I walk up a hill fast, my heart rate will increase
o if an older adult walks up a hill fast, we won’t see a change in heart rate like we normally
would which can become concerning
Even at rest and they become tachycardia, so we want to check TEMPERATURE
It is uncommon for older adults to have a fever unless they have an
extreme infection or problem
, Spring 2021
UPNS 338/430 Gerontology
Exam 1 Blueprint
Pay close attention to temperature if they come in with confusion or UTI which
can lead to confusion and an infection/fever
These changes increase the risk of high blood pressure (hypertension)
o We allow older adults higher thresholds for blood pressure
Health promotion
o Physical activity
o Healthy diet sodium restriction; 2 mg or less in diet
If they live alone and typically eat canned or frozen foods that are high in
sodium, we need to do an assessment for alternatives
o Don’t smoke
Musculoskeletal System
Bones tend to shrink in size and density making them susceptible to fracture
o A greater risk for osteoporosis and osteopenia
Postmenopausal women are at highest risk or anyone previously receiving
radiation and chemotherapy
Decrease heigh over time
o Their muscles become slightly weaker so shoulders can droop
Stature even drastically changes
If head is over heels, they are at risk for falling
Health promotion
o Vitamin D helps with the absorption of calcium
Adequate calcium
At least 1,200 mg of calcium/day
Dairy products, broccoli, kale, salmon, tofu
Adequate vitamin D
800 IU/day
Sunlight, salmon, eggs, vitamin D-fortified milk and supplements
Physical activity
Weight-bearing exercises
o Walking, joking, tennis, climbing stairs, and weight training
Supports muscles which helps bones
Gastrointestinal System
Structural changes in large intestine can result in constipation
o if drier or dehydrated, they are going to have slowed which happens in the emptying of
the stomach, colon, and large intestine this can cause constipation
be active, fiber, and fluids
o use of diuretics and iron or medical conditions like diabetes and HF that affect the fluid
in the body
Health Promotion
, Spring 2021
UPNS 338/430 Gerontology
Exam 1 Blueprint
o Healthy diet high-fiber foods such as fruits, vegetables, and whole grains
Limit high-fat meals, dairy products and sweets
Drink plenty of water
o Physical activity
o Don’t ignore bowel movement holding bowel movement can cause constipation
Encourage them to go at least every 2 hours
Genitourinary System
Less elastic as you age leading to more frequent urination
o Kidneys decrease in size
Decrease in GFR (which is normal)
If you have a decrease in GFR, the concern in BUN Cr
Weakening of bladder muscles and pelvic floor muscles make it difficult for you to empty or
completely lose control (incontinence)
o Incontinence is never normal, but the risk for is because of weakening pelvic muscles
o Enlarged or inflamed prostate can also cause difficulty emptying or incontinence
Medications that can cause toxicity if there is a decrease in excretion
o Digoxin assess if they are seeing halos
Check heart rate we want to know if it is above 60 bpm before admin
On auscultation with digoxin toxicity, the pulse will be lower than 60 bpm so we
would hold next dose
o Vancomycin
Health Promotion
o Toilet regularly
o Maintain healthy weight
o Avoid bladder irritants caffeine, acidic foods, alcohol, and carbonated beverages
Ask about caffeine
o Avoid constipation fiber
Neurocognitive System
Brain undergoes changes as you age that affect memory/thinking skills
o Naturally goes through changes
o Normal for patient to have momentary lapses in memory like losing keys
o It is not normal if they forget things, they should remember such as setting dinner out
they just cooked
Health promotion
o Treat cardiovascular disease
High BP, hyperlipidemia and diabetes these may increase risk of cognitive
disease
o Vitamins for neurological health
B-complex vitamins
UPNS 338/430 Gerontology
Exam 1 Blueprint .
# of Questions Topic
8 Changes of Aging- Assessment and Prevention
5 Pharmacology Considerations
1 Chronic Disease
11 Respiratory
5 Safety- Falls Risks
5 Musculoskeletal
Please remember that some of the questions may be a combination of multiple topics (i.e., assessment
of the aging adult and safety considerations).
Changes of Aging- Assessment and Prevention (8)
Tips for approaching a geriatric patient
Priority complaint is your priority
PROMOTE STRENGTH AND SUPPORT THEIR WEAKNESS!!!
Keys to Assessment
hard of hearing “HOH”
Don’t forget to ask questions about sexual health even if it may be awkward
Cardiovascular System
Stiffening or hardening of blood vessels and arteries
o Causes heart to work harder to pump blood through them causing heart muscles to
change to adjust to increased workload
Usually diagnosed with cardiomyopathy (large heart) which is a normal change
From that congestive heart failure can form which is a complication of a normal
change
Thus, hardening of arteries and vessels causes heart to work harder to pump causing the heart
muscles to change to adjust to increased workload which causes someone to be diagnosed with
a cardiomyopathy as a normal change in the older adult
o If they develop congestive heart failure, it is a complication of these normal changes
Heart rate at rest will stay the same and not increase as much during activities
o When I walk up a hill fast, my heart rate will increase
o if an older adult walks up a hill fast, we won’t see a change in heart rate like we normally
would which can become concerning
Even at rest and they become tachycardia, so we want to check TEMPERATURE
It is uncommon for older adults to have a fever unless they have an
extreme infection or problem
, Spring 2021
UPNS 338/430 Gerontology
Exam 1 Blueprint
Pay close attention to temperature if they come in with confusion or UTI which
can lead to confusion and an infection/fever
These changes increase the risk of high blood pressure (hypertension)
o We allow older adults higher thresholds for blood pressure
Health promotion
o Physical activity
o Healthy diet sodium restriction; 2 mg or less in diet
If they live alone and typically eat canned or frozen foods that are high in
sodium, we need to do an assessment for alternatives
o Don’t smoke
Musculoskeletal System
Bones tend to shrink in size and density making them susceptible to fracture
o A greater risk for osteoporosis and osteopenia
Postmenopausal women are at highest risk or anyone previously receiving
radiation and chemotherapy
Decrease heigh over time
o Their muscles become slightly weaker so shoulders can droop
Stature even drastically changes
If head is over heels, they are at risk for falling
Health promotion
o Vitamin D helps with the absorption of calcium
Adequate calcium
At least 1,200 mg of calcium/day
Dairy products, broccoli, kale, salmon, tofu
Adequate vitamin D
800 IU/day
Sunlight, salmon, eggs, vitamin D-fortified milk and supplements
Physical activity
Weight-bearing exercises
o Walking, joking, tennis, climbing stairs, and weight training
Supports muscles which helps bones
Gastrointestinal System
Structural changes in large intestine can result in constipation
o if drier or dehydrated, they are going to have slowed which happens in the emptying of
the stomach, colon, and large intestine this can cause constipation
be active, fiber, and fluids
o use of diuretics and iron or medical conditions like diabetes and HF that affect the fluid
in the body
Health Promotion
, Spring 2021
UPNS 338/430 Gerontology
Exam 1 Blueprint
o Healthy diet high-fiber foods such as fruits, vegetables, and whole grains
Limit high-fat meals, dairy products and sweets
Drink plenty of water
o Physical activity
o Don’t ignore bowel movement holding bowel movement can cause constipation
Encourage them to go at least every 2 hours
Genitourinary System
Less elastic as you age leading to more frequent urination
o Kidneys decrease in size
Decrease in GFR (which is normal)
If you have a decrease in GFR, the concern in BUN Cr
Weakening of bladder muscles and pelvic floor muscles make it difficult for you to empty or
completely lose control (incontinence)
o Incontinence is never normal, but the risk for is because of weakening pelvic muscles
o Enlarged or inflamed prostate can also cause difficulty emptying or incontinence
Medications that can cause toxicity if there is a decrease in excretion
o Digoxin assess if they are seeing halos
Check heart rate we want to know if it is above 60 bpm before admin
On auscultation with digoxin toxicity, the pulse will be lower than 60 bpm so we
would hold next dose
o Vancomycin
Health Promotion
o Toilet regularly
o Maintain healthy weight
o Avoid bladder irritants caffeine, acidic foods, alcohol, and carbonated beverages
Ask about caffeine
o Avoid constipation fiber
Neurocognitive System
Brain undergoes changes as you age that affect memory/thinking skills
o Naturally goes through changes
o Normal for patient to have momentary lapses in memory like losing keys
o It is not normal if they forget things, they should remember such as setting dinner out
they just cooked
Health promotion
o Treat cardiovascular disease
High BP, hyperlipidemia and diabetes these may increase risk of cognitive
disease
o Vitamins for neurological health
B-complex vitamins
