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Health & Physical Assessment in Nursing First Edition. Donita D’Amico and Coleen Barbarito. Chapter 27 Assessing the Older Adult. LEARNING OBJECTIVE ONE. LEARNING OBJECTIVE ONE. Focus Areas for Older Adult Outlined in the Healthy People 2010 Diabetes Injury and violence prevention

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health physical assessment in nursing first edition
Health & Physical Assessment in NursingFirst Edition

Donita D’AmicoandColeen Barbarito

Chapter 27

Assessing the Older Adult

learning objective one3
LEARNING OBJECTIVE ONE
  • Focus Areas for Older Adult Outlined in the Healthy People 2010
    • Diabetes
    • Injury and violence prevention
    • Mental health/mental disorders
    • Immunization
learning objective one4
LEARNING OBJECTIVE ONE
  • Key Objectives for Diabetes
    • Increase the number of individuals with diabetes who receive education
    • Decrease the number of cases of newly diagnosed diabetes
    • Reduce the number of diabetes-related deaths
    • Increase the number of individuals who have eye, dental, and foot examinations
learning objective one5
LEARNING OBJECTIVE ONE
  • Key Objectives for Injury and Violence Prevention
    • Reduce deaths from falls
    • Reduce hip fractures among older adults
    • Reduce disability from unintentional injury
learning objective one6
LEARNING OBJECTIVE ONE
  • Key Objectives for Mental Health/Mental Disorders
    • Increase the number of persons seen in primary healthcare who receive mental health screening and assessment
learning objective one7
LEARNING OBJECTIVE ONE
  • Key Objectives for Immunization
    • Increase the number of older adults who receive vaccination for influenza and pneumonia
learning objective two9
LEARNING OBJECTIVE TWO
  • Theories of Aging
    • Environmental influences
    • Cellular changes
    • Theories
      • Wear and tear
      • Cross-linkage
      • Free radical
      • Genetic
      • Apoptosis
learning objective two10
LEARNING OBJECTIVE TWO
  • Wear-and-Tear Theory - The Body Is Likened to a Machine That Wears Out
learning objective two11
LEARNING OBJECTIVE TWO
  • Cross-Linkage Theory - Strands of DNA That Should Remain Separate Are Linked Together
learning objective two12
LEARNING OBJECTIVE TWO
  • Free Radical Theory - Highly Reactive Molecules Interact with and Damage Cellular Components
learning objective two13
LEARNING OBJECTIVE TWO
  • Genetic Theories - Focus on Chromosomal Differences Between Persons
learning objective two14
LEARNING OBJECTIVE TWO
  • Apoptosis Theory - Regulation of Cells Through Growth Restriction
learning objective two15
LEARNING OBJECTIVE TWO
  • Miller (2004) and Biological Aging
    • Affects all living organisms
    • Natural, inevitable, irreversible, and progressive with time
    • Course of aging varies from individual to individual
learning objective two16
LEARNING OBJECTIVE TWO
  • Miller (2004) and Biological Aging
    • Rate of aging for different organs and tissues varies within individuals
    • Influenced by nonbiologic factors
    • Processes are different from pathologic processes
    • Increases vulnerability to disease
learning objective three18
LEARNING OBJECTIVE THREE
  • Impact of Aging on Organs and Body Systems
    • Integumentary
    • Mouth, nose, and throat
    • Eyes
    • Ears
    • Respiratory
    • Cardiovascular
learning objective three19
LEARNING OBJECTIVE THREE
  • Impact of Aging on Organs and Body Systems
    • Gastrointestinal
    • Nutrition and fluid intake
    • Genitourinary
    • Endocrine
    • Musculoskeletal
    • Neurological
learning objective three20
LEARNING OBJECTIVE THREE
  • Skin
    • Lentigo senilis
    • Wrinkles
    • Baldness
    • Decrease in sweat production
learning objective three21
LEARNING OBJECTIVE THREE
  • Mouth, Nose, and Throat
    • Smell and taste diminish
    • Cheilitis
    • Loss of teeth occurs
learning objective three22
LEARNING OBJECTIVE THREE
  • Eyes
    • Presbyopia
    • Xanthelasma
    • Pingueculae
    • Cataracts
learning objective three23
LEARNING OBJECTIVE THREE
  • Ears
    • Presbycusis
    • Accumulation of earwax
learning objective three24
LEARNING OBJECTIVE THREE
  • Respiratory
    • Pulmonary tissue stiffens
    • Breathing becomes harder
    • Gas exchange diminishes
learning objective three25
LEARNING OBJECTIVE THREE
  • Cardiovascular
    • Stiffening aorta
    • Hypertension
learning objective three26
LEARNING OBJECTIVE THREE
  • Gastrointestinal
    • Intensity of propulsion decreases
    • Gastritis and peptic ulcers
    • Constipation
    • Dependence on laxative use
    • Diverticulae
    • Hemorrhoids
    • Rectal prolapse
learning objective three27
LEARNING OBJECTIVE THREE
  • Nutrition and Fluid Intake
    • Calculation of body mass index (BMI)
    • Dehydration
learning objective three29
LEARNING OBJECTIVE THREE
  • Genitourinary
    • Glomerular filtering decreased
    • Incontinence
    • Sexual activities
learning objective three30
LEARNING OBJECTIVE THREE
  • Endocrine
    • Fatigue
learning objective three31
LEARNING OBJECTIVE THREE
  • Musculoskeletal
    • Loss of muscle mass
    • Joint wear and tear
learning objective three32
LEARNING OBJECTIVE THREE
  • Neurological
    • Reduction in reaction time, learning, and short - term memory
learning objective four34
LEARNING OBJECTIVE FOUR
  • Physical Assessment of the Older Adult
    • Techniques
      • Inspection
      • Palpation
      • Percussion
      • Auscultation
learning objective four35
LEARNING OBJECTIVE FOUR
  • Specific Areas of the Older Adult Assessment
    • General survey
    • Integumentary
    • Head and neck
    • Eyes
    • Ears
    • Respiratory system
learning objective four36
LEARNING OBJECTIVE FOUR
  • Specific Areas of the Older Adult Assessment
    • Breasts
    • Cardiovascular system
    • Abdomen
    • Genitourinary system
    • Musculoskeletal system
    • Neurological system
learning objective four37
LEARNING OBJECTIVE FOUR
  • General Survey
    • Evaluation of nutritional status
    • Measurement of vital signs
learning objective four38
LEARNING OBJECTIVE FOUR
  • Integumentary System
    • Inspection and palpation of the skin, hair, and nails
    • Measurement of skin lesions
learning objective four39
LEARNING OBJECTIVE FOUR
  • Head and Neck
    • Inspection of the nose, nares, and oral cavity
    • Evaluation of smell
    • Palpation and auscultation of carotid arteries
    • Inspection and palpation of neck veins
    • Evaluation of neck range of motion
learning objective four40
LEARNING OBJECTIVE FOUR
  • Eyes
    • Inspection of the structures
    • Measurement of visual acuity and peripheral fields of vision
    • Inspection of the fundus using an ophthalmoscope
    • Palpation of the eyeball
learning objective four41
LEARNING OBJECTIVE FOUR
  • Ears
    • Inspection of the structures
    • Evaluation of hearing
learning objective four42
LEARNING OBJECTIVE FOUR
  • Respiratory System
    • Inspection of the thorax
    • Percussion and auscultation of lung fields
learning objective four43
LEARNING OBJECTIVE FOUR
  • Breasts
    • Inspection and palpation of the structures
learning objective four44
LEARNING OBJECTIVE FOUR
  • Cardiovascular System
    • Auscultation of heart sounds
    • Measurement of apical pulse
learning objective four45
LEARNING OBJECTIVE FOUR
  • Abdomen
    • Inspection
    • Auscultation
    • Percussion
    • Palpation of the structures
learning objective four46
LEARNING OBJECTIVE FOUR
  • Genitourinary System
    • Inspection of the structures
    • Rectal examination
learning objective four47
LEARNING OBJECTIVE FOUR
  • Musculoskeletal System
    • Inspection of the joints, including range of motion
    • Inspection of the muscles
    • Inspection and palpation of the feet
learning objective four48
LEARNING OBJECTIVE FOUR
  • Neurological System
    • Evaluation of mental status
    • Cranial nerve testing
    • Evaluation of balance and coordination
    • Inspection for tremors
    • Evaluation of motor and sensory function
    • Evaluation of reflexes
    • Evaluation of sleep
learning objective five50
LEARNING OBJECTIVE FIVE
  • Common Problems in the Older Adult
    • Skin lesions
    • Insulin resistance syndrome
    • Diabetes mellitus
    • Drug and alcohol abuse
learning objective five51
LEARNING OBJECTIVE FIVE
  • Skin Lesions
    • Xanthelasma
    • Acrochordons
    • Actinic keratoses
    • Seborrheic keratoses
    • Cherry angiomas
    • Senile purpura
    • Cheilitis
learning objective five52
LEARNING OBJECTIVE FIVE
  • Insulin Resistance Syndrome
    • Obesity
    • Heart disease
    • Hypertension
    • Gout
    • Polycystic ovaries
    • Type 2 diabetes
learning objective five53
LEARNING OBJECTIVE FIVE
  • Diabetes Mellitus
    • Incidence
    • Prevalence
    • Diagnosis
learning objective five54
LEARNING OBJECTIVE FIVE
  • Drug and Alcohol Abuse
    • Nutritional assessment
    • Changes in personal appearance
learning objective six56
LEARNING OBJECTIVE SIX
  • Critical Thinking and the Nursing Process
learning objective six57
LEARNING OBJECTIVE SIX
  • Learning Needs and Teaching Plans