Aging Adult and Urinary Elimination Lecture Notes

Practice flashcards covering physical, cognitive, and psychosocial changes in middle and older adulthood, along with urinary elimination concepts and terms.

Middle Adulthood Age Range

The period of life from age $40$ to $65$.

Fatty Tissue Redistribution (Middle Adult)

Males tend to develop abdominal fat, while females thicken through the middle.

Presbyopia

A diminishment of visual acuity, especially for near vision, common in middle adulthood.

Presbycusis

A diminishment of hearing acuity, especially for high-pitched sounds, common in middle adulthood.

Perimenopausal Bone Changes

Loss of calcium from the bones, particularly in females undergoing menopause.

Cardiac Output (Middle Adult)

Output begins to decrease during these years.

Muscle Mass (Middle Adult)

There is a gradual decrease in mass, strength, and agility.

Cognitive Motivation (Middle Adult)

Adults are more motivated to learn when they can apply the knowledge to their present life.

The Sandwich Generation

Middle-aged adults who are between adult children and dependent older parents.

Moral Development (Middle Adult)

Occurs at the conventional or postconventional level, where the rights of others take precedence.

Spiritual Development (Middle Adult)

Adults become less rigid in beliefs, recognize paradoxes, and appreciate symbolism.

Malignant Neoplasms

One of the common health problems in middle adulthood.

Physical Exam Frequency (Middle Adult)

Recommended every year.

Breast Cancer Screening

Recommended every year starting at age $45-50$.

Cervical Cancer Screening

Recommended every $3$ years for those aged $30-65$.

Prostate Exam

Recommended every year starting at age $50$.

Colorectal Cancer Testing

A colonoscopy is recommended every $5-10$ years starting at age $45$.

Bone Density Testing

Conducted during menopause for women and starting at age $50$ for men.

Pneumococcal Vaccine

Recommended for adults age $65$ and up.

Zoster Vaccine

Recommended starting at age $50$ and up.

Older Adulthood Age Range

Chronological age of $65$ and up.

Definition of Age 65 as 'Old'

Arbitrarily set in the $1930s$ for Social Security payments based on the labor market.

Institutionalization Myth

The reality is that only $1$ percent of adults $65-74$, $2$ percent of adults $75-84$, and $8$ percent of adults $85+$ live in long-term care facilities.

Self-Rated Health (Older Adults)

$81$ percent of adults $65-74$ and $68$ percent of adults $85+$ rate their health as good, very good, or excellent.

Aging and Intelligence

Neither intelligence nor personality normally change because of aging; only response time may be prolonged.

Sexual Activity in Older Adults

The ability to perform and enjoy sexual activity lasts well into the $90s$ in healthy adults.

Incontinence in Older Adults

It is not a part of aging; it generally has a root cause and requires medical attention.

Aging Organ Systems

All organ systems undergo some degree of decline, and the body becomes less efficient.

Common Chronic Disorders (Older Adults)

Included are HTN, OA, Heart Disease, Cancer, DM, COPD, Asthma, and Stroke.

Integumentary Changes (Older Adults)

Wrinkling, sagging, balding, thick nails, moles, and purpura.

Musculoskeletal Changes (Older Adults)

Included are atrophy, brittle bones, kyphosis, stiff joints, and becoming shorter.

Neurological Changes (Older Adults)

Delayed verbal response, slow reflexes, slow temperature regulation, balance issues, and less sleep.

Special Senses and Nutrition

Changes in taste and smell can lead to nutrition issues.

Cardiopulmonary Changes (Older Adults)

Included are stiffer vessels, atherosclerosis, weaker pulses, and aspiration risk.

Gastrointestinal Changes (Older Adults)

Nutrient absorption slows, leading to constipation, indigestion, and dry mouth.

Dentition (Older Adults)

Tooth decay may lead to a need for dentures.

Genitourinary Changes (Older Adults)

Included are GFR decrease, nocturia, retention, and incontinence.

Ageism

Prejudice or discrimination on the grounds of a person's age, such as suggesting those over $70$ should not have partners.

Aspiration Risk (Page 15)

A cardiopulmonary change seen in older adults.

Dementia

Various organic disorders that progressively affect cognitive function; it is chronic and develops gradually.

Delirium

An acute syndrome of brain failure that can last hours to weeks from a specific cause.

Delirium Causes

Included are drugs (anesthesia), nutrition, dehydration, sleep deprivation, and immobility.

Dementia Causes

Can result from stroke, HTN, or Alzheimer's Disease.

Age-Related Fragile Blood Vessels

Can cause bruising on forearms in the dermis.

AMS (Altered Mental Status)

In acute cases, this can indicate infection, polypharmacy, or other issues.

Reminiscence

A technique used by nurses to help patients adapt to aging by asking about their past, such as childhood celebrations.

Elder Abuse Definition

An intentional act or failure to act by a caregiver that increases harm to an older adult.

Reporting Elder Abuse

Must be reported to Adult Protective Services.

Elder Abuse Sources

Can be physical, sexual, emotional, financial, or neglect.

SPICES (S)

Sleep disorder.

SPICES (P)

Problems with eating or feeding.

SPICES (I)

Incontinence.

SPICES (C)

Confusion.

SPICES (E)

Evidence of falls.

SPICES (Second S)

Skin breakdown (bleeding).

Aspiration/Dehydration (SPICES)

Associated with the 'P' (Problems eating).

Frailty Prevention Priority

A priority for a frail patient is the prevention of falls.

Kidneys Primary Function

To maintain composition and volume of body fluids through selective reabsorption and secretion of water and electrolytes.

Nephrons

The units that make up the kidneys and remove end products of metabolism from blood.

Metabolic End Products

Included are urea, creatinine, and uric acid.

Urine

The waste product excreted by the kidneys.

Bladder

A smooth muscle sac that serves as a temporary reservoir for urine.

Stretch Receptors

Nerves in the bladder wall stimulated by bladder pressure to create the desire to void.

Urethra

Transports urine from the bladder to the exit.

Female Urethra Length

Approximately $1.6\,inches$.

Male Urethra Length

Approximately $8\,inches$.

Autonomic Bladder

A bladder no longer controlled by the brain due to injury or disease, voiding by reflex only.

Voiding

An involuntary reflex act, though voluntary control can be learned after infancy.

Urinary Incontinence

Any involuntary escape of urine.

Shy Bladder

Difficulty relaxing the restraining muscle sufficiently to void.

Anuria

$24\text{-hour}$ urine output is less than $50\,mL$.

Dysuria

Painful or difficult urination.

Frequency (Urinary)

Increased incidence of voiding.

Glycosuria

The presence of glucose in the urine.

Nocturia

Awakening at night to urinate.

Oliguria

$24\text{-hour}$ urine output is less than $400\,mL$.

Polyuria

Excessive output of urine, also known as diuresis.

Proteinuria

Protein in the urine.

Pyuria

Pus in the urine.

Urgency

A strong desire to void.

Urinary Stagnation

Leads to bacterial growth and increases the risk for UTI.

Urinary Retention Causes

Included are medications, BPH (Benign Prostatic Hyperplasia), and vaginal prolapse.

Kidney Aging Effect

Diminished ability to concentrate urine, leading to nocturia.

Bladder Aging Effect

Decreased muscle tone leading to decreased ability to hold urine and increased frequency.

Bladder Contractility (Aging)

Decreased contractility can cause retention and stasis, leading to UTIs.

Functional Incontinence (Aging)

Results from neuromuscular problems affecting voluntary control and the ability to reach the toilet in time.

Immobility and Bladder Tone

Prolonged immobility decreases bladder and sphincter tone.

Foley Catheter and Tone

Decreases bladder tone because the bladder muscle is not being used.

Diuretics Effect

Cause increased urine production, which may result in urge incontinence.

Renal Failure

Condition where the kidney fails to remove metabolic end products and cannot regulate fluids, electrolytes, or pH balance.

Renal Failure Threshold

Kidney function drops below $15\%$.

Acute Kidney Injury (AKI)

A sudden decline in kidney function from causes like severe dehydration, shock, sepsis, or obstruction.

Chronic Kidney Disease (CKD)

A slow loss of kidney function over months causing irreparable damage, potentially leading to ESRD.

Nephrotoxicity

The quality of being toxic to the kidneys, caused by certain medications.

Nephrotoxic Medication Examples

Included are ASA (Aspirin), Ibuprofen, and Gentamicin.

Analgesics/Tranquilizers and Urination

Suppress the CNS, diminishing the effectiveness of urination reflexes.

Cholinergic Medications

Stimulate contraction of the detrusor muscle, producing urination.

Clean-catch/Midstream Specimen

Specific assessment technique for collecting a urine sample.

Pyelonephritis

An upper UTI involving the kidney or ureter.

Cystitis

A lower UTI involving the bladder.