NR 601 Midterm Exam guide

Developmental changes o Review Kennedy and Dunphy readings for age related changes o Physiological o Lab results- Dunphy Table 77.2 UA Normal Changes with age Comments Protein 0-5 rises slightly Due to kidney changes, UTI, renal SG 1.005-1.020 Lower 1.016-1.022 Decline in nephrons impairs ability to Concentrate urine Hematology ESR M: 0-20 W: 0-30 Sign increase Neither sensitive nor specific Iron binding Slight decrease HGB M: 13-18 W:12-16 M: 10-17 W: none Anemia is common in elderly HCT M: 45-52 W: 37-48 Slight decrease Decline in hematopoiesis Leukocytes 4,300-10,800 Drop to 3,100-9,000 Decrease may be due to drugs or sepsis Lymphocytes 500-2,400 Tcells Fall infection risk higher 50-200 Bcells Immunizations encouraged Platelets 150,000-350,000 no change Blood chemistry Albumin 3.5-5.0 Decline R/T decreased liver size and enzymes. Protein-energy malnutrition common. Globulin 2.3-3.5 Slight increase Total serum Protein 6.0-8.4 no change Decrease may indicate malnutrition Infection, liver disease BUN M: 10-25 Increases significantly Decline in GFR W: 8-20 up to 69 Decreased cardiac output Creatinine 0.6-1.5 increases to 1.9 RT lean body mass Creatinine Decreases 10% Used for prescribing meds Clearance 104-124 after 40 yrs old for drugs excreted by kidney GT 62-110 (after fasting) Slight increase 10 Diabetes increase in prevalent <120 (2h PP) after 30 yrs drugs may cause intolerance Alk Phos 13-39 increase by 8-10 Elevation >20% usually due to disease Elevations may be found with bone Abnormalities, drugs (narcotics), and Eating fatty meals.