NURS 5333 Module 3 Guided Questions (w Ans)

Module 3 Guided Questions Lesson 1: Geriatrics for the PCP 1. What are the physiologic changes of aging? What kinds of problems are caused by these changes?  Vision: Presbyopia is caused by loss of elasticity of the lenses. Close vision is markedly affected. Onset is during early to mid-40s. Can be remedied with “reading glasses” or bifocal lenses. Cornea less sensitive to touch. Arcus senilis, cataracts, and glaucoma are more common. Annual eye exams, assess ability to read (driving, Rx bottles) Arcus Senilis- check lipids  Hearing: Presbycusis (Sensorineural Hearing Loss) Screen with audioscope or whisper test. Refer to audiology if failed. Higher risk for cerumen impaction. Be aware of temp. hearing loss inducing meds: ASA, Lasix  Mouth: Receding gums and xerostomia (dry mouth) Decreased sensitivity of taste buds results in decreased appetite. Dentures- do they fit? Leukoplakia- check bottom lip, cheilitis, glossitis  Neck: probably is not supple, masses are likely cancer. Check thyroid and TSH level, check carotids  Chest: BP  r/t  vascular resistance. Baroreceptors less sensitive to changes in position. Decreased sensitivity of the autonomic nervous system. Blunted BP response. Decrease in maximum heart rate. Higher risk of orthostatic hypotension. S4 heart sound a “normal finding” in the elderly if not associated with heart disease. The left ventricle hypertrophies with aging (up to 10% of thickness). ↓ Cough reflex, ↓ mobility= risk for PNA  Extremities: Edema- does it resolve at night? Discoloration of lower extremities r/t chronic edema. Assess pulses, Heberden nodes, foot abnormalities  risk of fa