Exam 1 Study Guide
Older adult
Age related changes: The older patient may have compromised thermoregulation to where the
body temp may be lower than normal & therefor fibril response to infection may not occur.
Factors that affect physical aging: Culture, Environment, lifestyle, and Genetics
Skin Changes: Dermal thinning, loss of moisture, decreased perspiration, wrinkles, skin tears,
slower healing, pruritis (itching), inability to respond to heat/cold
Musculoskeletal Changes: Muscle atrophy, Joint stiffening, and bone demineralization.
Pulmonary changes: Chest wall becomes rigid, Thoracic muscles weaken, and ciliary activity
decreases.
Cardiovascular changes: Decreased cardiac output and stroke volume, Pooling of blood in
extremities, shortness of breath on exertion, cardiac valves stiffen (Murmurs)
Other changes: Decreased sense of touch, impaired hand to eye coordination, difficulty hearing,
Presbyopia (far-sightedness), and diminished sense of smell, Liver function decreases (older
adults usually require lower dose medications), Metabolism slows, kidney excretion decreases.
Definitions:
Capacity- (Determined by physician) ability to make an informed decision)
Competency- (Determined by a judge) The degree of mental soundness necessary to 1.
Make a decision about specific issue, and 2. Carry out the decision.
Depression
A mood disorder that causes a persistent feeling of overwhelming sadness and loss of
interest. It affects how a person feels, thinks, and behaves and can lead to a variety of
emotional and physical problem.
Consequences: Worsening medical conditions, Risk for physical illness, alcoholism and
drug use, increased pain and disability, delayed recover from illness, and suicide.
, Medications: SSRI’S (Selective serotonin reuptake inhibitors: increase serotonin levels)
such as - Citalopram (Celexa), Fluoxetine (Prozac)… (These meds are also used for OCD,
Anxiety, and panic disorders.)
Side effects: Anxiety, Nausea, Vomiting, Diarrhea, dry mouth, weight changes, and cause
erectile dysfunction, and Serotonin syndrome.
*Serotonin Syndrome Symptoms: Seizures, tremors, elevated HR, and fever*
Secondary medications: Tricyclic Antidepressants (Increase Norepinephrine and
serotonin)
Medications: Amitriptyline (Elavil), and Doxepin.
Side effects: Suicidal thoughts, orthostatic BP, dry mouth, and erectile dysfunction.
Other treatments for depression include Psychotherapy and Reflective/reminiscent
therapy.
Quick takeaways on depression:
Onset: sudden or gradual
Duration: weeks to years
State of consciousness: Self-absorbed
Behavior: Apathetic, feeling of worthlessness, vague somatic complaints.
Ability to follow instructions: Able to but doesn’t want to.
Mental ability: selective memory loss.
Ability to cure: Reversible
Dementia
An umbrella term that describes a collection of symptoms that are caused by disorders
affecting the brain… NOT ONE SPECIFIC DISEASE. Dementia affects thinking, behavior,
and the ability to perform everyday tasks. (Alzheimer’s is more common)
o Alzheimer’s: (40-70%) Life expectancy is 2-20 years, resulting in death secondary
to causes manifested by immobility and organ failure, not from the disease itself.
The actual diagnosis of Alzheimer’s is made only at autopsy. There is an early and
late stage to this disease. In the early stage you should try to orient the patient.
Towards the late stage the ability to care for oneself can be so limited that they
become bedridden, in the late stages you shouldn’t try to orient the patient
however you can redirect the conversation.
o Vascular dementias: (15-25%) when you don’t get enough blood to your
temporal lobe and your brain cells start to die off causing memory issues. Can be
sudden or gradual.
Older adult
Age related changes: The older patient may have compromised thermoregulation to where the
body temp may be lower than normal & therefor fibril response to infection may not occur.
Factors that affect physical aging: Culture, Environment, lifestyle, and Genetics
Skin Changes: Dermal thinning, loss of moisture, decreased perspiration, wrinkles, skin tears,
slower healing, pruritis (itching), inability to respond to heat/cold
Musculoskeletal Changes: Muscle atrophy, Joint stiffening, and bone demineralization.
Pulmonary changes: Chest wall becomes rigid, Thoracic muscles weaken, and ciliary activity
decreases.
Cardiovascular changes: Decreased cardiac output and stroke volume, Pooling of blood in
extremities, shortness of breath on exertion, cardiac valves stiffen (Murmurs)
Other changes: Decreased sense of touch, impaired hand to eye coordination, difficulty hearing,
Presbyopia (far-sightedness), and diminished sense of smell, Liver function decreases (older
adults usually require lower dose medications), Metabolism slows, kidney excretion decreases.
Definitions:
Capacity- (Determined by physician) ability to make an informed decision)
Competency- (Determined by a judge) The degree of mental soundness necessary to 1.
Make a decision about specific issue, and 2. Carry out the decision.
Depression
A mood disorder that causes a persistent feeling of overwhelming sadness and loss of
interest. It affects how a person feels, thinks, and behaves and can lead to a variety of
emotional and physical problem.
Consequences: Worsening medical conditions, Risk for physical illness, alcoholism and
drug use, increased pain and disability, delayed recover from illness, and suicide.
, Medications: SSRI’S (Selective serotonin reuptake inhibitors: increase serotonin levels)
such as - Citalopram (Celexa), Fluoxetine (Prozac)… (These meds are also used for OCD,
Anxiety, and panic disorders.)
Side effects: Anxiety, Nausea, Vomiting, Diarrhea, dry mouth, weight changes, and cause
erectile dysfunction, and Serotonin syndrome.
*Serotonin Syndrome Symptoms: Seizures, tremors, elevated HR, and fever*
Secondary medications: Tricyclic Antidepressants (Increase Norepinephrine and
serotonin)
Medications: Amitriptyline (Elavil), and Doxepin.
Side effects: Suicidal thoughts, orthostatic BP, dry mouth, and erectile dysfunction.
Other treatments for depression include Psychotherapy and Reflective/reminiscent
therapy.
Quick takeaways on depression:
Onset: sudden or gradual
Duration: weeks to years
State of consciousness: Self-absorbed
Behavior: Apathetic, feeling of worthlessness, vague somatic complaints.
Ability to follow instructions: Able to but doesn’t want to.
Mental ability: selective memory loss.
Ability to cure: Reversible
Dementia
An umbrella term that describes a collection of symptoms that are caused by disorders
affecting the brain… NOT ONE SPECIFIC DISEASE. Dementia affects thinking, behavior,
and the ability to perform everyday tasks. (Alzheimer’s is more common)
o Alzheimer’s: (40-70%) Life expectancy is 2-20 years, resulting in death secondary
to causes manifested by immobility and organ failure, not from the disease itself.
The actual diagnosis of Alzheimer’s is made only at autopsy. There is an early and
late stage to this disease. In the early stage you should try to orient the patient.
Towards the late stage the ability to care for oneself can be so limited that they
become bedridden, in the late stages you shouldn’t try to orient the patient
however you can redirect the conversation.
o Vascular dementias: (15-25%) when you don’t get enough blood to your
temporal lobe and your brain cells start to die off causing memory issues. Can be
sudden or gradual.
