Chester Clinic

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 „ Signs/Symptoms – 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. „ Factor's Precipitating – 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 Myocardial Infarction – Coronary arteries are blocked and part of the heart muscle dies.
„ Signs/Symptoms: – crushing chest pain that radiates to the jaw and left arm.
– N/V, irregular pulse/resp, diaphoresis, anxiety, weakness, drop in B/P, SOB, paleness, syncope.
„ 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.
„ Orthopneic Position „ Strict I and O „ Possible fluid restriction „ Maintain Oxygen Therapy „ monitor Vital Signs( apical pulse, pulse deficit) „ Pulse Oximetry „ 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 when inactive.
„ 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 „ Calm environment „ 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 Rheumatoid Arthritis 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.
„ Extremely painful „ Symptoms include joint deformity, redness, fluid How Arthritis is Treated „ Pain Medications „ Physical Therapy to maintain flexibility „ Exercise to strengthen muscles around joint.
„ Surgery to replace damaged joint with an artificial one.
„ 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 „ Stooped posture „ Loss of height, and fractures „ Treatment includes: Calcium supplement/HRT 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.
„ 11 S/S 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, „ Other S/S 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.

Source: http://academic.cuesta.org/fjohnson/PowerPoint_PDF/Common%20diseases%20of%20the%20elderly.pdf