NR 601 LATEST EXAM -
GUARANTEED PASS 100%
Developmental changes Physiological - correct answer ✔✔1. Reduced physiological reserve of
most body systems, particularly cardiac, respiratory, and renal.
2. There are reduced homeostatic mechanisms that fail to adjust regulatory systems such as
temperature control and fluid and electrolyte balance.
3. There are changes in the sympathetic response, which contribute to orthostasis and falls, as
well as lack of hypoglycemic response.
4. There is impaired immunological function: infection 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: fasting or activity status.
Pharmacologically: medication, tobacco, or alcohol use.
Physiological aging - correct answer ✔✔Age related Change
Functional Change
Implications
Integumentary System
Loss of dermal and epidermal thickness
Loss of subcutaneous tissue and thin epidermis.
Prone to skin breakdown and injury
,Decreased vascularity
• Atrophy of sweat glands resulting in decreased sweat production
• Decreased body odor
• Decreased heat loss
• Dryness
• Alteration in thermoregulatory response
• Fluid requirements may change seasonally
• Loss of skin water
• Increased risk of heat stroke
Respiratory System
Decreased lung tissue elasticity
Decreased vital capacity
Reduced overall efficiency of ventilatory exchange
Cilia atrophy
Change in mucociliary transport
Increased susceptibility to infection
Decreased respiratory muscle strength
• Reduced ability to handle secretions and reduced effectiveness against noxious foreign
particles
• Partial inflation of lungs at rest
Increased risk of atelectasis
Cardiovascular System
,Heart valves thicken and become fibrotic
Reduced stroke volume, cardiac output; may be altered
Decreased responsiveness to stress
Fibroelastic thickening of the sinoatrial node; decreased number of pacemaker cells
Slower heart rate
Increased prevalence of arrhythmias
Decreased baroreceptor sensitivity (stretch receptors)
Decreased sensitivity 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 motility
Increases risk of constipation, functional bowel syndrome, esophageal spasm, diverticular
disease
Decreased basal metabolic rate (rate at which fuel is converted into energy)
May need fewer calories
Geriatric syndrome - correct answer ✔✔SPICES
Sleep Disturbances
Problems with eating or feeding
Incontinence
Confusion
, Evidence of falls
Skin breakdown
They are starting to experience bladder control problems, sleep problems, delirium, dementia,
falls, gait and balance, depression, visual acuity, and weight loss.
Early implementation of preventive therapies and safety measurement are important.
Prevention is best provided using an interdisciplinary team approach. Early detection and
correction of problems such as sensory deficits, confusion, and gait and balance issues can
increase independence and longevity among this group. The focus of all healthcare should be
on maintaining function, dignity, and individual control to promote health and quality of life.
Associated with substantial morbidity and poor outcomes. They are multifactorial and although
each is distinct, they share several risk factors. For example, older age, cognitive impairment,
functional impairment, and mobility impairments are risk factors for falls, functional decline,
delirium, and pressure ulcers.
Lab results Dunphy table 77.2 - correct answer ✔✔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 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 infection risk higher
50-200 Bcells Immunizations encouraged
Platelets 150,000-350,000 no change
Blood chemistry
GUARANTEED PASS 100%
Developmental changes Physiological - correct answer ✔✔1. Reduced physiological reserve of
most body systems, particularly cardiac, respiratory, and renal.
2. There are reduced homeostatic mechanisms that fail to adjust regulatory systems such as
temperature control and fluid and electrolyte balance.
3. There are changes in the sympathetic response, which contribute to orthostasis and falls, as
well as lack of hypoglycemic response.
4. There is impaired immunological function: infection 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: fasting or activity status.
Pharmacologically: medication, tobacco, or alcohol use.
Physiological aging - correct answer ✔✔Age related Change
Functional Change
Implications
Integumentary System
Loss of dermal and epidermal thickness
Loss of subcutaneous tissue and thin epidermis.
Prone to skin breakdown and injury
,Decreased vascularity
• Atrophy of sweat glands resulting in decreased sweat production
• Decreased body odor
• Decreased heat loss
• Dryness
• Alteration in thermoregulatory response
• Fluid requirements may change seasonally
• Loss of skin water
• Increased risk of heat stroke
Respiratory System
Decreased lung tissue elasticity
Decreased vital capacity
Reduced overall efficiency of ventilatory exchange
Cilia atrophy
Change in mucociliary transport
Increased susceptibility to infection
Decreased respiratory muscle strength
• Reduced ability to handle secretions and reduced effectiveness against noxious foreign
particles
• Partial inflation of lungs at rest
Increased risk of atelectasis
Cardiovascular System
,Heart valves thicken and become fibrotic
Reduced stroke volume, cardiac output; may be altered
Decreased responsiveness to stress
Fibroelastic thickening of the sinoatrial node; decreased number of pacemaker cells
Slower heart rate
Increased prevalence of arrhythmias
Decreased baroreceptor sensitivity (stretch receptors)
Decreased sensitivity 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 motility
Increases risk of constipation, functional bowel syndrome, esophageal spasm, diverticular
disease
Decreased basal metabolic rate (rate at which fuel is converted into energy)
May need fewer calories
Geriatric syndrome - correct answer ✔✔SPICES
Sleep Disturbances
Problems with eating or feeding
Incontinence
Confusion
, Evidence of falls
Skin breakdown
They are starting to experience bladder control problems, sleep problems, delirium, dementia,
falls, gait and balance, depression, visual acuity, and weight loss.
Early implementation of preventive therapies and safety measurement are important.
Prevention is best provided using an interdisciplinary team approach. Early detection and
correction of problems such as sensory deficits, confusion, and gait and balance issues can
increase independence and longevity among this group. The focus of all healthcare should be
on maintaining function, dignity, and individual control to promote health and quality of life.
Associated with substantial morbidity and poor outcomes. They are multifactorial and although
each is distinct, they share several risk factors. For example, older age, cognitive impairment,
functional impairment, and mobility impairments are risk factors for falls, functional decline,
delirium, and pressure ulcers.
Lab results Dunphy table 77.2 - correct answer ✔✔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 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 infection risk higher
50-200 Bcells Immunizations encouraged
Platelets 150,000-350,000 no change
Blood chemistry
