Chapter 4. Body Systems and Related Conditions

Homeostasis

the condition in which all of the body's systems are working at their best

Anterior (ventral)

front of the body

Posterior (dorsal)

back of body

Superior

toward the head

Inferior

away from the head

Medial

toward the midline

lateral

away from the midline

proximal

close to torso

distal

away from torso

integumentary system

Consists of the skin, mucous membranes, hair, and nail. largest system/organ in the body. prevent injury to internal organs.

three layers of skin

epidermis, dermis, subcutaneous

sebaceous glands

secrete sebum (oil) into the hair follicles where the hair shafts pass through the dermis. in elderly it secretes less oil which is why they are dry

Aging and the Integumentary System

-skin becomes dry, fragile, and loses elasticity. thinner gray hair, wrinkles and brown spots, nails harder and more brittle.

-report abnormalities: pale, white, red or purple areas.

-help by assisting with bathing, use lotions for dry skin, keep pt warm, encourage fluid intake

scabies

-a skin infection caused by an infestation of itch mites called sarcoptes scabiei

-contagious, spread through direct contact

atrophy

to waste away, decreasing in size, weakening of muscles

contracture

the permanent and often painful shortening of a muscle or tendon, usually due to lack of activity

musculoskeletal system

-206 bones, two bones meet at a joint

-joints make movement possible

-muscles provide movement and produce heat

-physical activity increase blood flow to organs

-muscles develop atrophy and contracture from inactivity

Aging and the Musculoskeletal System

-muscles weaken and lose tone, body movement slows, bones loose strength, become brittle & can easily break. Joins become stiff & painful. Gradual loss of height & strength

-abnormalities: changes in movement, pain, joint swelling, white/shiny/red/warm areas over joints

Inflammation

swelling

autoimmune illness

an illness in which the body's immune system attacks normal tissue in the body

autoimmune arthritis

rheumatoid arthritis

rheumatoid arthritis

a type of arthritis in which joints become red, swollen, and very painful; movement is restricted and deformities of the hands are common

Osteoarthritis

inflammation of the bones and joints, not autoimmune can affect hips etc

arthritis treatment

-anti-inflammatory medications (aspirin, ibuprofen)

-local applications of heat

-range of motion exercises (ROM)

-regular exercise or activity routines

-diet to reduce weight or maintain strength

Osteoporosis

a disease that causes bones to become porous and brittle, causing them to break easily. due to age, lack of hormones or Ca, alcohol consumption, lack of exercise. common in women after menopause

Menopause

the end of menstruation

osteoporosis symptoms

LBP, stooped posture, loss of height

Partial weight bearing (PWB)

a doctor's order stating that a person is able to support some body weight on one or both legs

Non-weight bearing (NWB)

a doctor's order stating that a person is unable to touch the floor or support any body weight on one or both legs.

full weight-bearing (FWB)

a doctor's order stating that a person has the ability to support full body weight on both legs

guidelines for the care of a new cast

-elevate extremity

-observe swelling, tightness, discoloration, sores, temp, bleeding, odor, etc.

-protect pt skin from edges of cast

-keep cast dry

-do not insert anything into cast

-use bed cradles as needed

Guidelines for hip replacement care

-Dress weaker side first

-have pt sit to do task

-no ROM on operative leg

-hip cant bend more than 90 degrees

-transfer resident carefully with strong side leading

-when on chair/toilet, operative knee/leg should be straightened

-strong leg stand first

guidelines for knee replacement care

- apply special stocking for blood clots

-perform ankle pumps

-encourage fluids

-ask for pain meds as needed

-report any abnormalities (redness, swelling, heat, calf tenderness)

Central Nervous System (CNS)

brain and spinal cord

Peripheral Nervous System (PNS)

nerves

nervous system functions

- control/message center of body

-coordinate all body functions

Aging and the Nervous System

•Slower processing time

•memory loss

•Decreased touch sensation

•Change in perception of pain

•Change in sleep patterns

•Altered balance and/or decreased coordination

-report: shaking, inability to move one side of body, difficulty speaking/slurring, vision/hearing changes, dizziness/loss of balance, memory loss/confusion

hemiplegia

paralysis of one side of the body

hemiparesis

slight paralysis or weakness affecting one side of the body

expressive aphasia

trouble communicating thoughts through speech or writing

receptive aphasia

inability to understand spoken or written words

Emotional Lability

laughing or crying without any reason or when it is inappropriate

Dysphagia

difficulty swallowing

Know this about stroke/CVA

- occurs when blood supply to part of brain is blocked or blood vessel leaks/ruptures within brain

-lack or o2 -> cells die

-weakness occurs on opposite affected side of brain

Parkinson's disease

a progressive disease that destroys brain cells and is identified by muscular tremors, slowing of movement, and partial facial paralysis

multiple sclerosis

progressive degenerative disease of the central nervous system characterized by inflammation, hardening, and loss of myelin throughout the spinal cord and brain, which produces weakness and other muscle symptoms. trouble walking, blurred vision, weakness, blindness, loss of function in arms/legs

paraplegia

loss of function of the lower half of the body

quadriplegia

loss of function of legs, trunk, and arms

know this about head/spinal cord injuries

-result from falls, sports, car accident

-can cause permanent brain damage etc.

circulatory system

- heart, blood vessels, blood

-four heart chambers (2 atria and 2 ventricles)

-remove waste from blood

Aging of circulatory system

-heart muscle weakens and pumps with less force.

-arteries narrow & are less elastic allowing less blood flow and poor circulation in many body parts.

-report: change in pulse, weakness, swelling or hands feet ankles, pale/blue, chest pain, weight gain, shortness of breath

Hypertension (HTN)

High blood pressure (typically >140/90)

Diuretics

medications that reduce fluid volume in the body

know this about hypertension (HTN)

-caused by hardening/narrow of blood vessels, pregnancy, renal disease, adrenal tumor

-symptoms are headache, blurred vision, dizziness

-sometimes no noticeable symptoms, silent killer so important to check bp

angina pectoris

chest pain, pressure, or discomfort

know this about myocardial infarction MI

-caused by block of blood flow to heart muscles -> tissue death

-lead to heart damage or death

guidelines for myocardial infarction

- encourage pt to follow exercise program and special diet

-meds to regulate HR and BP

-stress management for pt

know this about congestive heart failure

care for congestive heart failure

- meds to help control CHF

-answer call lights promptly

-encourage pt to follow diet

-allow for rest periods

- measure I & O and weight

-elastic stockings

-ROM exercises

-extra pillows help breathing

peripheral vascular disease (PVD)

-cause: fatty deposits in blood vessels that harden

-symptoms: cool arms/legs, swelling in hands/feet, pale/blue hands/feet, blue nail bed, leg and feet ulcers

-treatment: quit smoking, meds, exercise, surgery to cut out blocked areas

respiratory system

-inspiration is breathing in, expiration is breathing out

Aging and the respiratory system

Respiratory tissues & chest wall become more rigid

Vital capacity decreases to 35% by age 70.

Decreases in macrophage activity

Diminished ciliary action

Decrease in blood levels of O2

Result is an age-related susceptibility to pneumonia or report: change in RR, coughing, congestion, sore throat, blue lips, discolored sputum

chronic obstructive pulmonary disease (COPD)

permanent, destructive pulmonary disorder that is a combination of chronic bronchitis and emphysema

-all body systems are affected when lungs/brain don't get enough oxygen

-signs: chronic cough, shortness of breath, pale skin

urinary incontinence

the inability to control the bladder, which leads to an involuntary loss of urine

urinary system

kidneys, ureters, urinary bladder, urethra

Aging and the Urinary System

-decreased ability to filter blood via kidney

-weakened bladder muscle tone

-bladder may not empty completely -> infection

-report: pain/burning sensation, urine color changes, bladder swelling, pain in kidney/back

Urinary Tract Infection (UTI)

-being bedbound is a risk factor for increased incidence of UTIs

-more likely to occur in women

Aging and the Gastrointestinal System

-decreased saliva

-dulled taste sense

-absorption of vitamins decrease

-digestion is longer/less efficient

-constipation more frequent

report: nausea, vomit, constipation, bloody/black/hard stool

enema

a specific amount of water, with or without an additive, introduced into the colon to eliminate stool

suppository

a medication given rectally to cause a bowel movement

fecal impaction

-cause: hard stool that is stuck in the rectum, can't be expelled, result from unrelieved constipation

-treatment: nurse insert gloved finger to rectum to break mass into fragments to be passed through

-high fiber diet and lots of fluids and increase in activity plus meds can prevent this.

Hemorrhoids

-cause: enlarged veins in the rectum/anus due to increased pressure in lower rectum

-signs: rectal itching, burning, pain, bleeding

-Treatment: meds, compresses, sitz baths, surgery

diarrhea

cause: freqent elimination of liquid

treat with meds

gastroesophageal reflux disease (GERD)

a chronic condition in which the liquid contents of the stomach back up into the esophagus. can damage esophagus and cause bleeding/ulcers. scars from damage make swallowing difficult

-heartburn is the most common symptom

-treatment: meds, sitting up after meals, diet

stoma

an artificial opening in the body

ostomy

surgically created opening from inside body to outside

-necessary due to bowl disease and cancer

-colostomy is in intestine to allow stool to be eliminated

-needs to be cleaned and replaced whenever stool is eliminated

colostomy care

-wear gloves wash hands

-protective blanket

remove bag, wash area, skin cream, add clean bag and seal securely

-remove soiled linens and bag and dispose

-wash hands and report changes to nurse, document

endocrine system

glands, hormones play role in maintaining homeostasis

Aging and the Endocrine System

decrease in levels of hormones, less insulin production, less able to handle stress

-report: headache, weakness, blurred vision, dizziness, irritability.

Pre-diabetes

A condition in which a person's blood glucose levels are above normal but not high enough for a diagnosis of type 2 diabetes.

Gestational Diabetes

type of diabetes that appears in pregnant women who have never had diabetes before but who have high glucose levels during pregnancy

diabetes signs

- excessive thirst and hunger, sudden vision changes, tingling/numbness in hands, dry skin, sores that are slow to heal, more infections

-can cause changes in circulatory system, eye damage, insulin reaction, diabetic ketoacidosis

female aging reproductive system

-menopause, decrease in estrogen and decrease in Ca -> brittle bones

-dry/thin vaginal walls

male aging of reproductive system

-decrease in sperm production

-enlargement of the prostate gland

vaginitis

-causes: bacteria, fungus, hormone changes

-signs: changes in color, odor, discharge, itching

-treated with oral meds and creams

benign prostatic hypertrophy

noncancerous enlargement of the prostate gland

lymphatic system

-remove excess fluids and waste to help immune system fight infection

-lymph fluid then flows into bloodstream

Aging and the Lymphatic System

-increased risk of infection, longer illness recovery

-decreased number/size of lymph nodes

-decreased response to vaccines

-report: recurrent infections: swelling of lymph nodes, increased fatigue

HIV/AIDS

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

-HIV causes AIDS, attacks immune system and disables it

-AIDS in final stage of infection and CNS symptoms (dementia) appear.

-no cure for AIDS