NR 601 Midterm Exam review
Week 1
Developmental changes
o Review Kennedy readings for age related changes
Physiological
Age related Change Functional Change Implications
Integumentary System
Loss of dermal and Loss of subcutaneous tissue Prone to skin breakdown and
epidermal thickness and thin epidermis. injury
Decreased vascularity see • Atrophy of sweat glands • Alteration in
resulting in decreased thermoregulatory response
sweat production
• Fluid requirements may
• Decreased body odor change seasonally
• Decreased heat loss • Loss of skin water
• Dryness • Increased risk of heat
stroke
Respiratory System
Decreased lung tissue Decreased vital capacity Reduced overall efficiency of
elasticity ventilatory exchange
Cilia atrophy Change in mucociliary Increased susceptibility to
transport infection
Decreased respiratory • Reduced ability to handle Increased risk of atelectasis
muscle strength secretions and reduced
effectiveness against
noxious foreign particles
• Partial inflation of lungs
at rest
,Cardiovascular System
Heart valves thicken and Reduced stroke volume, Decreased responsiveness to
become fibrotic cardiac output; may be stress
altered
Fibroelastic thickening of the Slower heart rate Increased prevalence of
sinoatrial node; decreased arrhythmias
number of pacemaker cells
Decreased baroreceptor Decreased sensitivity to Prone to loss of balance,
sensitivity (stretch changes in blood pressure which increases the risk for
receptors) falls
GI
Liver becomes smaller Decreased storage capacity
Decreased muscle tone Altered motility Increases risk of constipation,
functional bowel syndrome,
esophageal spasm,
diverticular disease
Decreased basal metabolic May need fewer calories
rate (rate at which fuel is
converted into energy)
NE CONDE)
Lab results
Lab Test Normal Changes with age Comments
UA
Protein 0-5mg/100ml Rises slightly May be due to kidney
changes with age,
urinary tract infection,
renal pathology
Specific Gravity 1.005-1.020 Lower max in elderly Decline in nephrons
, 1.016-1.022 impairs ability to
concentrate urine
Hematology
ESR Men: 0-20 Significant increase Neither sensitive nor
specific in aged
Women: 0-30
Iron Binding 50-160mcg/dl Slight decrease
230-410mcg/dl Decrease
Hemoglobin Men: 13-18g/100ml Men: 10-17g Anemia common in the
elderly
Women: 12-16g Women: None noted
Hematocrit Men: 45-52% Slight decreased Decline in
hematopoiesis
Women 37-48% speculated
Leukocytes 4,300–10,800/mm3 Drop to 3,100– Decrease may be due
9,000/mm3 to 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 50–200 levels fall immunization
B cells/mm3 encouraged
Platelet 150,000–350,000/ No change in
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 protein 6.0–8.4 g No change Decreases may indicate
malnutrition, infection,
liver disease
Blood urea nitrogen Men: 10–25 Increases Increases significantly
significantly up to 69 up to 69 mg
Women: 8–20 mg mg
Creatinine 0.6–1.5 mg Increases to 1.9 mg Related to lean body
mass decrease
Creatinine clearance 104–124 mL/min Decreases Used for prescribing
10%/decade after medications for drugs
age 40 years excreted by kidney
Glucose tolerance 62–110 mg/dL after Slight increase of 10 Diabetes increasingly
fasting; >120 mg/dL/decade after prevalent; drugs may
mg/dL after 2 hours 30 years of age cause glucose
postprandial intolerance
Alkaline 13–39 IU/L Increase by 8–10 Elevations >20%
phosphatase IU/L usually due to disease;
elevations may be
found with bone
abnormalities, drugs
(e.g., narcotics), and
eating a fatty meal
Week 1
Developmental changes
o Review Kennedy readings for age related changes
Physiological
Age related Change Functional Change Implications
Integumentary System
Loss of dermal and Loss of subcutaneous tissue Prone to skin breakdown and
epidermal thickness and thin epidermis. injury
Decreased vascularity see • Atrophy of sweat glands • Alteration in
resulting in decreased thermoregulatory response
sweat production
• Fluid requirements may
• Decreased body odor change seasonally
• Decreased heat loss • Loss of skin water
• Dryness • Increased risk of heat
stroke
Respiratory System
Decreased lung tissue Decreased vital capacity Reduced overall efficiency of
elasticity ventilatory exchange
Cilia atrophy Change in mucociliary Increased susceptibility to
transport infection
Decreased respiratory • Reduced ability to handle Increased risk of atelectasis
muscle strength secretions and reduced
effectiveness against
noxious foreign particles
• Partial inflation of lungs
at rest
,Cardiovascular System
Heart valves thicken and Reduced stroke volume, Decreased responsiveness to
become fibrotic cardiac output; may be stress
altered
Fibroelastic thickening of the Slower heart rate Increased prevalence of
sinoatrial node; decreased arrhythmias
number of pacemaker cells
Decreased baroreceptor Decreased sensitivity to Prone to loss of balance,
sensitivity (stretch changes in blood pressure which increases the risk for
receptors) falls
GI
Liver becomes smaller Decreased storage capacity
Decreased muscle tone Altered motility Increases risk of constipation,
functional bowel syndrome,
esophageal spasm,
diverticular disease
Decreased basal metabolic May need fewer calories
rate (rate at which fuel is
converted into energy)
NE CONDE)
Lab results
Lab Test Normal Changes with age Comments
UA
Protein 0-5mg/100ml Rises slightly May be due to kidney
changes with age,
urinary tract infection,
renal pathology
Specific Gravity 1.005-1.020 Lower max in elderly Decline in nephrons
, 1.016-1.022 impairs ability to
concentrate urine
Hematology
ESR Men: 0-20 Significant increase Neither sensitive nor
specific in aged
Women: 0-30
Iron Binding 50-160mcg/dl Slight decrease
230-410mcg/dl Decrease
Hemoglobin Men: 13-18g/100ml Men: 10-17g Anemia common in the
elderly
Women: 12-16g Women: None noted
Hematocrit Men: 45-52% Slight decreased Decline in
hematopoiesis
Women 37-48% speculated
Leukocytes 4,300–10,800/mm3 Drop to 3,100– Decrease may be due
9,000/mm3 to 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 50–200 levels fall immunization
B cells/mm3 encouraged
Platelet 150,000–350,000/ No change in
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 protein 6.0–8.4 g No change Decreases may indicate
malnutrition, infection,
liver disease
Blood urea nitrogen Men: 10–25 Increases Increases significantly
significantly up to 69 up to 69 mg
Women: 8–20 mg mg
Creatinine 0.6–1.5 mg Increases to 1.9 mg Related to lean body
mass decrease
Creatinine clearance 104–124 mL/min Decreases Used for prescribing
10%/decade after medications for drugs
age 40 years excreted by kidney
Glucose tolerance 62–110 mg/dL after Slight increase of 10 Diabetes increasingly
fasting; >120 mg/dL/decade after prevalent; drugs may
mg/dL after 2 hours 30 years of age cause glucose
postprandial intolerance
Alkaline 13–39 IU/L Increase by 8–10 Elevations >20%
phosphatase IU/L usually due to disease;
elevations may be
found with bone
abnormalities, drugs
(e.g., narcotics), and
eating a fatty meal
