Microsoft powerpoint - common diseases of the elderly.ppt
Common Diseases of Elderly
serious inflammation of the lungs
A variety of causitive microbes
– Bacteria– Viruses– Protozoan
– Increased temperature and pulse– abnormal respirations– cough productive of thick, colored sputum
– TCDB, oxygen, monitor resp./temp.
– HOB up, tissue bag on rail, enc. fluids
symptoms include SOB, cyanosis
from prolonged impairment
in the exchange of gases.
decreased elasticity of lungs
The following conditions
can lead to COPD:– Tuberculosis– Frequent Pneumonia– Chronic Asthma– Chronic Bronchitis– Emphysema
Chronic obstruction of air flow to alveoli causes
– the air sacs to become nonfunctional– difficulty in expelling air from lungs
– air pollutants, cigarette smoke, auto exhaust,
insecticides, chronic conditions such as pneumonia,
bronchitis, asthma, and a genetic predisposition.
– pursed lip breathing, breathing exercises, positioning,
incentive spirometer, oxygen therapy, enc. fluids,
avoid crowds and air 35-40 degrees, maintaining
humidity if ordered, nebulizer.
Angina Pectoris- pain of effort
– Coronary arteries are unable to
meet heart's demand.
– heavy eating, stress, exertion
Signs and Symptoms
– dull pain increasing in intensity
usually under sternum
spreading to left arm and neck
– May be abdominal angina– Profuse perspiration– Pale or flushed face
Treatment/Prevention for Angina
C.N.A.'s Role- Prevention
– Avoid stress/sudden exertion– Encourage pt. not to smoke– Encourage frequent small
C.N.A.'s Role in Treatment
– Note time of onset
HOB up, loosen clothing
Assist pt. to take Nitroglycerin
May take one pill q 5 min X 3
Report to the nurse at once
Monitor Vital signs
Enc. pt. to wear oxygen
– Coronary arteries are blocked and part of
the heart muscle dies.
– crushing chest pain that radiates to the
jaw and left arm.
– N/V, irregular pulse/resp, diaphoresis,
anxiety, weakness, drop in B/P, SOB,
C.N.A.'s Role: Same as for Angina, +
– Assist with ADL's– Report to nurse recurrence and any
bleeding (clotting ability may be altered
may be R or L sided
h.f. backward- R sided- failure
of the right ventricle. Occurs
secondary to L sided failure.
Edema below heart.
h.f. forward - L sided- failure of
left ventricle. Heart failure
usually starts here. Edema
above heart, distended neck
veins, pulmonary congestion.
Cough, frothy sputum, SOB.
Strict I and O
Possible fluid restriction
Maintain Oxygen Therapy
monitor Vital Signs( apical
pulse, pulse deficit)
Assist with ADL's, commode
Etiology of disease
– from not enough dopamine in the brain .
Symptoms are progressive
(may be minor o
1) tremors- start in hands (pill rolling) or foot
eventually involves entire body. More evident
2) muscular rigidity- head bowed, body bent
forward, eventually falls., arms flexed, thumbs
turned into palms. Sometimes arched backwards
3) Akinesia- slowness in voluntary muscular
– shuffling gait, steps grow faster and faster– difficulty starting walking– difficulty stopping walking, – slurred and poorly enunciated speech
– facial muscles lose expressiveness
Treatment of Parkinson's
Surgery for younger
Drug therapy slows
down progression of
At risk for falls
At risk for choking
Assist with ADL's
Osteoarthritis- the dis-ease of aging
Affects > 1/3 of all people
Cartilage in joint worn away
Bone scrapes against bone
Can be extremely painful
Usually found in 1-2 joints
Most often in fingers
The pain /stiffness can
almost always be
Observe residents for pain
this shows kyphosis or hunchback
Doesn't just affect elderly.
Systemic disease- whole body
Lasts whole life
Attacks many joints
Damages cartilage, bone,
tendons, and ligaments.
Symptoms include joint
deformity, redness, fluid
How Arthritis is Treated
Physical Therapy to
Exercise to strengthen
muscles around joint.
Surgery to replace
damaged joint with an
Empathy is the purest
form of understanding.
Gout, a systemic disease from buildup of uric acid
Liver makes more u/a than kidneys can excrete.
Diet high in rich foods, lead, aspirin, diuretics,
levodopa (parkinson's drug, cyclosporine (anti-
rejection drug) increase risk. Develops quickly.
Swelling, inflammation, red, stiffness, and pain
in one joint at a time usually hallux, or ankle.
2.1 mill cases in US, men more common, ages
40-50, in women after menopause, child rare.
DX blood tests, or needle aspiration of joint.
TX. Prevention is best by avoiding scallops,
sardines, red meat, sweetbreads, gravy, cream
sauces, avoid ETOH, drink lots of H2O, exercise.
As last resort NSAIDS (can cause severe GI and
heart problems) Cortiosteroids, or colchicine and
probenecid (benemid) or colbenemid (combines
Loss of calcium from bones
Loss of height, and fractures
Weight bearing exercises
Fosamax- must sit for 30 min.
given before breakfast with 8
ounces of plain water. Avoid
caffeine, carbonation. Not usually
given with HRT.
Lupus - autoimmune disease affecting any system of
the body, self allergy, body attacks self
What is it:
Systemic Lupus Erythematosus a
chronic rheumatic disease affects joints,
muscles, heart, lungs, skin, blood-forming
organs, kidneys, and nervous system.
malar rash over cheeks and nose
(butterfly)discoid rash (scaly, disk shaped sores
on face, neck, and or chest, sensitivity to
sunlight, oral ulcers, arthritis, serositis
(inflammation of lining around heart, lungs, and
or abdomen causing pain and SOB, protein in
urine, CNS problems, anemia, risk of infection,
fatigue, fever, muscle aches, N/V/D,
swollen glands, lack of appetite, sensitivity to
cold, wt loss.
Cause is unknown
DX: difficult no single set of symptoms. PE, blood test can
detect a group of antibodies. (C3, C4, CH50, CH100,
sedimentation rate (ESR) or C-reactive protein (CRP) U/A,
Chest xrays, EKG.
TX: aspirin, NSAIDS, antimalarial drugs, corticosteroids,
immunosuppressants, exercise, diet, rest, sun protection.
Affects women 8-10 X as often as men, between ages 18-45,
more prevalent in African Americans, can occur in young
children and older people as well, hereditary factor.
Diabetes Mellitus Definitions/Facts
Type I or IDDM– failure of
pancreas to produce insulin. Mostly
in children and adolescence. Can
occur later in life.
Type II or NIDDM Insulin
resistance or inadequate insulin
secretion. Use to only be seen in
middle-aged obese people with
sedentary lifestyles. Children are
now affected. Most elderly have
Symptoms: polyuria, polyphagia,
polydipsia, and weight loss.
Tailoring Care for Elderly Residents c Diabetes
Dialysis for kidney failure will be
transported 2-3X per week.
Intricate circulation to
Will feel sick when leaving.
the kidneys predisposes Will feel exhausted when returning
patients to kidney
Foot care ICU:
I= inspect feet every day
C= soak feet qd, lotion(avoid toes
U = update nurse on any changes
poor fitting shoes, pain.
Skin Care report very dry skin, redness,
warmth, or mottling, itching.
Good oral hygiene report white patches
or sores on tongue or mouth.
More on Nursing Care for Diabetics
Diet must eat at regular intervals. Report
immediately if resident does not eat.
Exercise improves circulation and helps
control blood glucose by keeping energy
demands at a steady level.
Report a change in behavior or function.
Hyperglycemia increased thirst, increased
urination, increased hunger, hot, dry, flushed
skin, headache, confusion, sweet fruity
circulation to the
breath, weakness, N/V, low blood pressure,
eyes predisposes a
full bounding pulse, unconsciousness.
diabetic to loss of
Hypoglycemia hunger, weakness, dizziness,
headache, shakiness, cold, moist, clammy,
pale skin, rapid shallow resp, nervousness
and excitement, rapid pulse, unconscious.
fängt am Sonntag an Du sollst deinen Nächsten lieben wie dich selbst; ich bin der Herr. (3. Mose 19,18) s ist der 1. September 2001. In Israel beginnt das neue Schul-jahr. Die zwei heißesten Sommermonate, Juli und August, sind vorbei und damit die Sommerferien. Im südafrikanischen Durbanhetzen Araber gegen Israel, bezeichnen den jüdischen Staat als ras-sistisch und vergleichen seinen Umgang mit den Palästinensern mitdem Holocaust. Ich sitze im Schulhof einer israelischen Grund-schule und schaue der Begrüßungszeremonie für die Erstklässler zu.
Contents lists available at Journal of Psychiatric Research Similarities in serum oxidative stress markers and inﬂammatory cytokines in patients with overt schizophrenia at early and late stages of chronicity Mariana Pedrini ,, Raffael Massuda Gabriel R. Fries ,, Matheus A. de Bittencourt Pasquali , Carlos Eduardo Schnorr José Claudio F. Moreira Antonio L. Teixeira