NR 601 midterm Exam
Physiological age related changes - ANS-Skin: loss of dermal thickness, atrophy of
sebaceous glands, decreased vascularity, decr sweating, imp. thermoregulation, loss of
body hair
Resp: decr lung elasticity, thoracic wall calcification, cili atrophy, decr muscle strength
CV: thick, fibrose valves, degeneration of MV, thickening of SA node, bradycardia, S4,
lipid deposits
GI: smaller liver, more gallstones, decr taste, decr gastric acid,
GU: decr renal mass & GFR & Creat clear., decr ability to dilute urine
neuro/musc: decr myosin & bone mass, osteoclasts reabsorb bone
eye: decr tear production, imp. color vision, dry eye, glaucoma
ear: high frequency loss first
endo: less thermoregulation, poor perception in changes in temp., decr metabolic rate
Immune: decr t-cell,
lab change relating to age - ANS-- Spec gravity ( lower)
-TIBC (lower)
-HGB/HCT (lower)
-no change in PLT
- Alb (lower)
- BUN/Creat (higher)
- cholesterol (higher)
- Thyroxine (lower=3.3-8.6)
Altered presence of illness - ANS-- may fail to develop a fever from infection
- depression= agitation & psychotic features
- cardiac manifestations=thyroid disease
- Jaundice = gallbladder disease or malignancy
- delusions/hallucinations= dementia or medication side effects
- lack of cooperation in their care
-sepsis without leukocytosis or fever
Exercises for specific diagnosis - ANS--Osteoarthritis: Walking, aquatic activities, tai chi,
resistance exercises, cycling
-CAD/ CHF/COPD: Walking, cycle ergometry
- Type 2 DM: Resistive, aerobic, aquatic, recreational activities
, - Anxiety: Walking, biking, weight lifting- If able to do high-intensity exercise, this
benefits anxiety
- Depression: Walking, cycling, recreational activities Group participation
- Fibromyalgia: Aerobic, aquatic therapy, strengthening, tai chi, Pilates -
Chronic venous insufficiency: Walking, standing exercises
- Osteoporosis: Weight-bearing exercises, weight training
-Parkinson's disease: Walking, stationary bike, dancing, tai chi, Pilates, boxing
-Peripheral arterial disease: Lower extremity exercises, walking
- sleep disorders: Tai chi, walking, aquatherapy, biking
-Dementia: Walking, recreational activities
Barriers to physical activity - ANS-Lack of time
■ Perceived need for equipment
■ Perceived barrier to beginning exercise/physical activity
■ Disability or functional limitation
■ Unsafe neighborhood or weather conditions
■ No parks or walking trails
■ Depression
■ High body mass index (BMI)
■ Lack of motivation
■ Interpersonal loss or significant life event
■ Ignorance of what to do
Contraindications to physical activity - ANS--Unstable angina
■ Uncompensated heart failure
■ Severe anemia
■ Uncontrolled blood glucose
■ Unstable aortic aneurysm
■ Uncontrolled hypertension or tachycardia
■ Severe dehydration or heat stroke
■ Low oxygen saturation
Testing prior to exercise - ANS--health history
- medications
-present physical activity and functional level
- barriers to exercise
- physical examination.
- stress test before engaging in vigorous exercise (men >45, wom>55 & sedentary
Physiological age related changes - ANS-Skin: loss of dermal thickness, atrophy of
sebaceous glands, decreased vascularity, decr sweating, imp. thermoregulation, loss of
body hair
Resp: decr lung elasticity, thoracic wall calcification, cili atrophy, decr muscle strength
CV: thick, fibrose valves, degeneration of MV, thickening of SA node, bradycardia, S4,
lipid deposits
GI: smaller liver, more gallstones, decr taste, decr gastric acid,
GU: decr renal mass & GFR & Creat clear., decr ability to dilute urine
neuro/musc: decr myosin & bone mass, osteoclasts reabsorb bone
eye: decr tear production, imp. color vision, dry eye, glaucoma
ear: high frequency loss first
endo: less thermoregulation, poor perception in changes in temp., decr metabolic rate
Immune: decr t-cell,
lab change relating to age - ANS-- Spec gravity ( lower)
-TIBC (lower)
-HGB/HCT (lower)
-no change in PLT
- Alb (lower)
- BUN/Creat (higher)
- cholesterol (higher)
- Thyroxine (lower=3.3-8.6)
Altered presence of illness - ANS-- may fail to develop a fever from infection
- depression= agitation & psychotic features
- cardiac manifestations=thyroid disease
- Jaundice = gallbladder disease or malignancy
- delusions/hallucinations= dementia or medication side effects
- lack of cooperation in their care
-sepsis without leukocytosis or fever
Exercises for specific diagnosis - ANS--Osteoarthritis: Walking, aquatic activities, tai chi,
resistance exercises, cycling
-CAD/ CHF/COPD: Walking, cycle ergometry
- Type 2 DM: Resistive, aerobic, aquatic, recreational activities
, - Anxiety: Walking, biking, weight lifting- If able to do high-intensity exercise, this
benefits anxiety
- Depression: Walking, cycling, recreational activities Group participation
- Fibromyalgia: Aerobic, aquatic therapy, strengthening, tai chi, Pilates -
Chronic venous insufficiency: Walking, standing exercises
- Osteoporosis: Weight-bearing exercises, weight training
-Parkinson's disease: Walking, stationary bike, dancing, tai chi, Pilates, boxing
-Peripheral arterial disease: Lower extremity exercises, walking
- sleep disorders: Tai chi, walking, aquatherapy, biking
-Dementia: Walking, recreational activities
Barriers to physical activity - ANS-Lack of time
■ Perceived need for equipment
■ Perceived barrier to beginning exercise/physical activity
■ Disability or functional limitation
■ Unsafe neighborhood or weather conditions
■ No parks or walking trails
■ Depression
■ High body mass index (BMI)
■ Lack of motivation
■ Interpersonal loss or significant life event
■ Ignorance of what to do
Contraindications to physical activity - ANS--Unstable angina
■ Uncompensated heart failure
■ Severe anemia
■ Uncontrolled blood glucose
■ Unstable aortic aneurysm
■ Uncontrolled hypertension or tachycardia
■ Severe dehydration or heat stroke
■ Low oxygen saturation
Testing prior to exercise - ANS--health history
- medications
-present physical activity and functional level
- barriers to exercise
- physical examination.
- stress test before engaging in vigorous exercise (men >45, wom>55 & sedentary
