N212 GERO LECTURE Chapter 15 - Infection

Chapter 15 - Infection Learning Objectives  Describe alterations in the immune system related to aging.  Describe nutritional factors that influence immune status.  Describe psychosocial factors that influence immune status.  Describe the effect of lifestyle factors on immune status.  Describe the effect of medications and drugs on immune status.  Identify strategies to prevent nosocomial or community-acquired infections.  Incorporate nutritional, psychosocial, and lifestyle factors into a nursing care plan. Introduction  Infection is one of the 10 most common causes of death in older adults  The presentation of infections in older adults is often masked, which can lead to delayed treatment  The immune system functioning is important for maintaining health, so a clear understanding of age-related changes is crucial The Chain of Infection  For infection to occur, there must be a reservoir of an infectious disease, a portal of entry, and a susceptible host  Zoonoses: infectious diseases passed from other animal species to humans  Nosocomial infections: acquired in the hospital  Community acquired: acquired outside the health care facility Age-Related Changes in the Immune System  As age increases, so does production of auto antibodies causing an increase in autoimmune disease  Atrophy of the thymus  Skin becomes more fragile and prone to breakdown or abrasion  Illness seen in older adults may be a direct consequence of changes in both cell-mediated and antibody-mediated immune response Factors Affecting Immunocompetence  Nutritional factors  Critically important to immune function  Protein-energy (caloric) malnutrition  Iron and trace element deficiency  Decreased zinc levels lead to an increase in the number of infections and an increase in the needed healing time  Psychosocial factors  Chronic and acute stress, depression, bereavement, and social relationships  Nutritional and dietary status is critical to immune function  One third of individuals older than age 65 have nutritional deficiencies  Risks associated with the development of a nosocomial infection include poor nutrition, unintentional weight loss, low serum albumin levels, decreased fluid intake, poor oral hygiene, and altered mental status  Factors contributing to inadequate nutrition include altered taste, social isolation, physical inability to prepare food, altered absorption, and poverty  Deprivation of protein an