Developmental changes Physiological -correct answers1. Reduced physiological reserve of most
body systems, par cularly cardiac, respiratory, and renal.
2. There are reduced homeosta c mechanisms that fail to adjust regulatory systems such as
temperature control and fluid and electrolyte balance.
3. There are changes in the sympathe c response, which contribute to orthostasis and falls, as
well as lack of hypoglycemic response.
4. There is impaired immunological func on: infec on risk is greater and autoimmune diseases
are more prevalent.
Laboratory: Reference ranges for older adults might be the intervals within which 9%% of
persons over 70 fall.
Causes: Physiologically: fas ng or ac vity status.
Pharmacologically: medica on, tobacco, or alcohol use.
Physiological aging -correct answersAge related Change
Func onal Change
Implica ons
Integumentary System
Loss of dermal and epidermal thickness
Loss of subcutaneous ssue and thin epidermis.
Prone to skin breakdown and injury
,Decreased vascularity
• Atrophy of sweat glands resul ng in decreased sweat produc on
• Decreased body odor
• Decreased heat loss
• Dryness
• Altera on in thermoregulatory response
• Fluid requirements may change seasonally
• Loss of skin water
• Increased risk of heat stroke
Respiratory System
Decreased lung ssue elas city
Decreased vital capacity
Reduced overall efficiency of ven latory exchange
Cilia atrophy
Change in mucociliary transport
Increased suscep bility to infec on
Decreased respiratory muscle strength
• Reduced ability to handle secre ons and reduced effec veness against noxious foreign
par cles
• Par al infla on of lungs at rest
Increased risk of atelectasis
Cardiovascular System
,Heart valves thicken and become fibro c
Reduced stroke volume, cardiac output; may be altered
Decreased responsiveness to stress
Fibroelas c thickening of the sinoatrial node; decreased number of pacemaker cells
Slower heart rate
Increased prevalence of arrhythmias
Decreased baroreceptor sensi vity (stretch receptors)
Decreased sensi vity to changes in blood pressure
Prone to loss of balance, which increases the risk for falls
GI
Liver becomes smaller
Decreased storage capacity
Decreased muscle tone
Altered mo lity
Increases risk of cons pa on, func onal bowel syndrome, esophageal spasm, diver cular
disease
Decreased basal metabolic rate (rate at which fuel is converted into energy)
May need fewer calories
Lab results Dunphy table 77.2 -correct answersUA 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 sensi ve nor specific
Iron binding 50-160 230-410 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 infec on risk higher
50-200 Bcells Immuniza ons 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 malnutri on common.
Globulin 2.3-3.5 Slight increase
Total serum
Protein 6.0-8.4 no change Decrease may indicate malnutri on
Infec on, liver disease
BUN M: 10-25 Increases significantly Decline in GFR
W: 8-20 up to 69 Decreased cardiac output
Crea nine 0.6-1.5 increases to 1.9 RT lean body mass
Crea nine Decreases 10% Used for prescribing meds
Clearance 104-124 a er 40 yrs old for drugs excreted by kidney
GT 62-110 (a er fas ng) Slight increase 10 Diabetes increase in prevalent
<120 (2h PP) a er 30 yrs drugs may cause intolerance
Alk Phos 13-39 increase by 8-10 Eleva on >20% usually due to disease
Eleva ons may be found with bone
Abnormali es, drugs (narco cs), and
body systems, par cularly cardiac, respiratory, and renal.
2. There are reduced homeosta c mechanisms that fail to adjust regulatory systems such as
temperature control and fluid and electrolyte balance.
3. There are changes in the sympathe c response, which contribute to orthostasis and falls, as
well as lack of hypoglycemic response.
4. There is impaired immunological func on: infec on risk is greater and autoimmune diseases
are more prevalent.
Laboratory: Reference ranges for older adults might be the intervals within which 9%% of
persons over 70 fall.
Causes: Physiologically: fas ng or ac vity status.
Pharmacologically: medica on, tobacco, or alcohol use.
Physiological aging -correct answersAge related Change
Func onal Change
Implica ons
Integumentary System
Loss of dermal and epidermal thickness
Loss of subcutaneous ssue and thin epidermis.
Prone to skin breakdown and injury
,Decreased vascularity
• Atrophy of sweat glands resul ng in decreased sweat produc on
• Decreased body odor
• Decreased heat loss
• Dryness
• Altera on in thermoregulatory response
• Fluid requirements may change seasonally
• Loss of skin water
• Increased risk of heat stroke
Respiratory System
Decreased lung ssue elas city
Decreased vital capacity
Reduced overall efficiency of ven latory exchange
Cilia atrophy
Change in mucociliary transport
Increased suscep bility to infec on
Decreased respiratory muscle strength
• Reduced ability to handle secre ons and reduced effec veness against noxious foreign
par cles
• Par al infla on of lungs at rest
Increased risk of atelectasis
Cardiovascular System
,Heart valves thicken and become fibro c
Reduced stroke volume, cardiac output; may be altered
Decreased responsiveness to stress
Fibroelas c thickening of the sinoatrial node; decreased number of pacemaker cells
Slower heart rate
Increased prevalence of arrhythmias
Decreased baroreceptor sensi vity (stretch receptors)
Decreased sensi vity to changes in blood pressure
Prone to loss of balance, which increases the risk for falls
GI
Liver becomes smaller
Decreased storage capacity
Decreased muscle tone
Altered mo lity
Increases risk of cons pa on, func onal bowel syndrome, esophageal spasm, diver cular
disease
Decreased basal metabolic rate (rate at which fuel is converted into energy)
May need fewer calories
Lab results Dunphy table 77.2 -correct answersUA 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 sensi ve nor specific
Iron binding 50-160 230-410 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 infec on risk higher
50-200 Bcells Immuniza ons 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 malnutri on common.
Globulin 2.3-3.5 Slight increase
Total serum
Protein 6.0-8.4 no change Decrease may indicate malnutri on
Infec on, liver disease
BUN M: 10-25 Increases significantly Decline in GFR
W: 8-20 up to 69 Decreased cardiac output
Crea nine 0.6-1.5 increases to 1.9 RT lean body mass
Crea nine Decreases 10% Used for prescribing meds
Clearance 104-124 a er 40 yrs old for drugs excreted by kidney
GT 62-110 (a er fas ng) Slight increase 10 Diabetes increase in prevalent
<120 (2h PP) a er 30 yrs drugs may cause intolerance
Alk Phos 13-39 increase by 8-10 Eleva on >20% usually due to disease
Eleva ons may be found with bone
Abnormali es, drugs (narco cs), and
