NSG 334 Exam 2 Study Guide With Correct Solutions
What lab values may INCREASE with aging? - ANSWER Uric Acid (GOUT)
Amylase (potentially due to a possible decline in renal function)
BUN (kidneys aren't working well possibly due to dehydration)
LDL (in females after menopause)
Alkaline Phosphatase
Aspartate transaminase
What lab values may DECREASE with aging? - ANSWER Hemoglobin
Hematocrit
Albumin
Creatinine
Thyroxine (T4)
Triiodothyronine (T3)
PaO2
Why might hematocrit and hemoglobin levels be decreased in older adults? - ANSWER
Changes in iron and B12 absorption (possible anemia)
Also fluid status may be altered
ASSESS: Changes in individual, fluid status, nutrition, and causes of possible blood loss
(most commonly associated with GI Bleed)
Why might albumin be slightly decreased in older adults? - ANSWER Possible decreased
liver function
Impaired nutritional intake
Low albumin can be associated with a low calcium level
Levels <3.5 are associated with increased mortality
Levels <2.5 affects osmotic pressure and edema.
Meds may play a role
Why might creatinine decrease in an older adult? - ANSWER Changes in renal function
,Loss of muscle mass
What is the best way to assess renal function in an older adult? - ANSWER creatinine
clearance
Why might PaO2 decrease slightly in an older adult? - ANSWER Loss of elasticity of lung
tissue
Decreased number of alveoli
Decrease in diaphragmatic strength.
Why might Uric Acid increase in an older adult? - ANSWER Impaired renal function
History of GOUT
Calcitonin (secreted by thyroid) - ANSWER Lowers blood calcium levels
parathyroid hormone - ANSWER increases blood calcium levels
Sodium - ANSWER Affected by fluid status
Unchanged with aging BUT
Decreased renal function affects Na control
CAN BE THE CAUSE OF SUDDEN CONFUSION. Older adults are especially sensitive to
low sodium
Potassium - ANSWER Unchanged by aging
Most likely changed by medications and I/O.
Cardiac muscle sensitive to abnormal K
Calcium - ANSWER HIGHLY BOUND TO ALBUMIN
Unchanged in aging but distribution may change (may be lost in bone to preserve levels
in the blood)
Phosphorus - ANSWER May be slightly decreased in older adults
Most in bone
Absorbed in small intestine with presence of Vitamin D.
Excreted by kidneys, thus an increase may be indicative of renal disease.
Magnesium - ANSWER Decreases by 15% between third and egth decade of life as renal
function declines.
2/3 found in bones
, Important for muscle and nerve function
Significant role in enzymatic processes for energy production.
Is albumin or pre-albumin used to measure response to nutritional supplementation? -
ANSWER Pre-albumin is used because it has a half life of 2 days. Albumin has a half life
of 21 days. Therefore it is much easier to see changes in pre-albumin lab values in a
short period of time.
Amylase - ANSWER Enzyme that catabolizes carbs in large intestine
Produced by pancreas
Slightly increased in aging
Serum Iron, IBC, Ferritin - ANSWER Slightly decreased in aging
Cause iron deficiency anemia
Can be related to absorption with an HCl decrease in the stomach acid
Vitamin B12 - ANSWER Decreased in aging
Possible cause of chronic gastritis or decreased HCl affecting intrinsic factor
Can cause pernicious anemia
Thyroxine (T4) - ANSWER decreases progressively in aging
Triiodothyronine (T3) - ANSWER Decreases about 20% in aging
What lab values may INCREASE with aging? - ANSWER Uric Acid (GOUT)
Amylase (potentially due to a possible decline in renal function)
BUN (kidneys aren't working well possibly due to dehydration)
LDL (in females after menopause)
Alkaline Phosphatase
Aspartate transaminase
What lab values may DECREASE with aging? - ANSWER Hemoglobin
Hematocrit
Albumin
Creatinine
Thyroxine (T4)
Triiodothyronine (T3)
PaO2
Why might hematocrit and hemoglobin levels be decreased in older adults? - ANSWER
Changes in iron and B12 absorption (possible anemia)
Also fluid status may be altered
ASSESS: Changes in individual, fluid status, nutrition, and causes of possible blood loss
(most commonly associated with GI Bleed)
Why might albumin be slightly decreased in older adults? - ANSWER Possible decreased
liver function
Impaired nutritional intake
Low albumin can be associated with a low calcium level
Levels <3.5 are associated with increased mortality
Levels <2.5 affects osmotic pressure and edema.
Meds may play a role
Why might creatinine decrease in an older adult? - ANSWER Changes in renal function
,Loss of muscle mass
What is the best way to assess renal function in an older adult? - ANSWER creatinine
clearance
Why might PaO2 decrease slightly in an older adult? - ANSWER Loss of elasticity of lung
tissue
Decreased number of alveoli
Decrease in diaphragmatic strength.
Why might Uric Acid increase in an older adult? - ANSWER Impaired renal function
History of GOUT
Calcitonin (secreted by thyroid) - ANSWER Lowers blood calcium levels
parathyroid hormone - ANSWER increases blood calcium levels
Sodium - ANSWER Affected by fluid status
Unchanged with aging BUT
Decreased renal function affects Na control
CAN BE THE CAUSE OF SUDDEN CONFUSION. Older adults are especially sensitive to
low sodium
Potassium - ANSWER Unchanged by aging
Most likely changed by medications and I/O.
Cardiac muscle sensitive to abnormal K
Calcium - ANSWER HIGHLY BOUND TO ALBUMIN
Unchanged in aging but distribution may change (may be lost in bone to preserve levels
in the blood)
Phosphorus - ANSWER May be slightly decreased in older adults
Most in bone
Absorbed in small intestine with presence of Vitamin D.
Excreted by kidneys, thus an increase may be indicative of renal disease.
Magnesium - ANSWER Decreases by 15% between third and egth decade of life as renal
function declines.
2/3 found in bones
, Important for muscle and nerve function
Significant role in enzymatic processes for energy production.
Is albumin or pre-albumin used to measure response to nutritional supplementation? -
ANSWER Pre-albumin is used because it has a half life of 2 days. Albumin has a half life
of 21 days. Therefore it is much easier to see changes in pre-albumin lab values in a
short period of time.
Amylase - ANSWER Enzyme that catabolizes carbs in large intestine
Produced by pancreas
Slightly increased in aging
Serum Iron, IBC, Ferritin - ANSWER Slightly decreased in aging
Cause iron deficiency anemia
Can be related to absorption with an HCl decrease in the stomach acid
Vitamin B12 - ANSWER Decreased in aging
Possible cause of chronic gastritis or decreased HCl affecting intrinsic factor
Can cause pernicious anemia
Thyroxine (T4) - ANSWER decreases progressively in aging
Triiodothyronine (T3) - ANSWER Decreases about 20% in aging
