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Caring for the elderly client


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Non insulin dependent mellitus
(NIDDM)type II
-more common in older than insulin dependent
-not enough insulin to meet Carbohydrate metabolism
-hyperglycemia, hypersmolar, non-ketotic coma
-uncurable, but can control with diet, wght, exercise, drugs (insulin shots)
Review of systems
-uncover symptoms associated with current health prob
-identify chronic conditions
-teach PT to manage over time
-bone mass decrease
-easily get fractures
-maintain safety
-prevention with calcium and Vitamen D
Chronic conditions
-6 months or more
-disrupt biological,socail + physical functions
-often not diagnosed until has a neg impact on PT
-goal is not to cure, but to make comfortable
-die respectfully

Osteoarthritis/Degenerative Joint Disease (DJD)
-most major chronic
-old age
-destruction of cartilage cause by over production
-Primary DJD is most common
-treat:control pain, NSAIDS
The amount of chronic disease or health care prob an adult over 65 has
at least 3
Monitoring a client taking HTN meds
prevention of a PT not taking HTN meds because no physical signs of illness and the side effects (constipation, drowsiness, cough, depression)
Acute conditions
-6 months or less
-develope rapidly
-can be caused by chronic prob
-more immediate/technologocal treatments
-goal is to cure
PT with PVD are taught to perform these
-elevate legs
-avoid tight clothes
-avoid extreme temps
-no cross legs
-cotton socks
Chronic illness's found in older adults
-Cardiovascular cond.(coronary hrt/artery disease, congestive hrt failure)
-Peripheral vascular disease (PVD)
-Neurological cond.(cerebral vascular accident/CVA, Parkinson's, Sensory loss)
postural hypotension
change in BP and HR after a change in position
Macular degeneration
loss of central vision
-can decrease with vitamen B and Zinc
Hypertension (HTN)
-BP over 160/90 is high at any age
-HTN increases with age
-Physiological changes: stiff aorta, change in kidney and endocrine system
-Teach PT to take meds and reinforce good health
Transient Ischemia Attack (TIA)
little stroke, can recover from, letting body know a big one is coming
Coronary Hrt Disease (CHD) or Coronary Artery Disease (CAD)
-hrt mucle not getting enough bld supply
-leading cause of death in US
-often, a MI is 1st sign of CHD or CAD
-controlled with surgery and meds
Left-Hemisphere CVA
-Rght side effected
-language prob
-physical functions
-frightened, cautious
-repeat behaviors
lack of bld supply
eyeball changes shape resulting in farsightedness
Congestive Hrt Failure (CHF)
-bulid up of bld and fluid becuase of ineffective pumping of cardiac muscle
-causes: HTN,ishchemia,
-goal is to reduce work load on the hrt
-nurse resp for: assessing edema, wieght, diet, BP changes with position
CVA/strokes classification
-type (embolism or hemorrhage)
-location of assult
-rate of developement
-brain hemisphere
Peripheral vascular disease (PVD)
-abnormalality of peripheral veins and arteries cause by aging and arteriosclerosis
-depletion of O2 and retention of waste products
-signs: hair loss on extremeties, skin ulcers, thin/dry skin, brown skin
-major cause of blindness
-increase pressure in the eye, puts pressure on optic nerve causing loss of peripheral vision
-control with meds
Parkinson's Disease
-most in men
-mid 40's usually 60-80yrs
-chronic, progressive
-rigidity, unstable posture, and tremors
-Goal is to maintian functioning as long as can
-primary meds: Levodopa
clouding of lens of the eye, makes vision blurry and night driving difficult
-can be removed with surgery
Right-Hemisphere CVA
-lft side paralysis
-lft side wkness
-impairs, judgements, short attention span, easily ditracted, impulsive
Sensory Loss
-vision and hearing changes
-presbyopia, cataracts, glaucoma, macular degeneration
Cerebral Vascular Accident (CVA)
-3rd leading cause of death
-risks:old age, HTN, diabetes, mellitus, TIA, hrt disease
-signs: numbness, weakness, tingles, headaches, LOC change, nausea/vomiting
Chronic obstrucitive pulmonary disease (COPD) or " " Lung " (COLD)
-cause by exposure to irratants(tobacco..)
-chronic bronchitis, asthma, emphysema
-4th leading cause of death
-signs:cough,SOB,barrel chest
-nurse care: prevent infections, adequete hydration

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