NR 601 MID TERM EXAM STUDY GUIDE Fundamental Considerations
- Recognize that presenting features of disease/illness may be different and having
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greater awareness of the impact of chronic illness on the patient.
- Perspective is different than with younger adults.
Physiological Changes with Aging
- The clinician must be aware that all the systems interact an, in doing so, can increase
the older person’s vulnerability to illness/disease.
- During the clinical decision-making process, the clinician knowledgeable about
physiological changes with aging will be less likely to undertreat a treatable condition. -
Example- Use the diagnostic process to differentiate the more benign seborrheic
keratosis from actinic keratosis.
- Be informed; do not attribute a finding to the aging process alone. The elder may
conclude there is no point in changing behavior, because the process is inevitable.
- Three primary points:
1) There is a reduced physiological reserve of most body systems, particularly cardiac,
respiratory, and renal.
2) There are reduced homeostatic mechanisms that fail to adjust regulatory systems
such as temperature control and fluid and electrolyte balance.
3) There is impaired immunological function: infection risk is greater, and autoimmune
diseases are more prevalent.
Laboratory Values in Older Adults
- Many factors can influence lab value interpretation in the elderly, including the
physiological changes with aging, the prevalence of chronic disease, changes in
nutritional and fluid intake, lifestyle (including activity), and the medications taken.
- Reference ranges therefore may be preferable. Reference ranges or intervals, such as
age, sex, or race can be defined demographically. For example, the reference range for
older adults might be the intervals within which 95% of persons over age 70 fall.
- Further defined physiologically (fasting or activity status) or pharmacologically
(medication, tobacco or ETOH use).
- Biochemical individuality is of particular importance in detecting asymptomatic
abnormalities in older adults. Significant homeostatic disturbances in the same
individual may be detected through serial laboratory tests, even though all individual
test results may lie within normal limits of the reference interval for the entire group [Show Less]