C
With aging, narrowing of the arteries causes some increase in the systolic and diastolic BPs. Decreases occur in diastolic pressure, diastolic filling, and beta-adrenergic stimulation; increases occur in arterial pressure, systolic pressure, wave velocity, and left ventricular end diastolic pressure. Decreased cardiac output and cardiac reserve decrease the older adult's response to stress. Changes in libido may occur. Testosterone levels do not affect erections produced by erotic stimuli. There is a loss of skin elasticity. By the age of 60, gastric secretions decrease 70% - 80% of those of the average adult. A decrease in pepsin may hinder protein digestion. There may be a decrease in SUBQ fat and decreasing body warmth. Some swallowing difficulties occur because older people are susceptible to fluid loss and electrolyte imbalance. This results from decreased thirst sensation, difficulty swallowing, chronic disease, reduced kidney function, diminished cognition, or adverse drug reactions.
C
Chest pain, along with dyspnea, cough, hemoptysis, and apprehension, is a classic sign of a pulmonary embolism. Six days postoperatively is a prime time for symptoms of a pulmonary embolus to occur, because decreased mobility promotes the development of deep vein thrombosis. The lack of a productive cough does not require nursing intervention; a productive, not nonproductive, cough indicates a respiratory infection requiring intervention. An increase in temperature can result from the inflammatory process; the temperature-regulating mechanisms in older adults may be compromised slightly, and they may show a slight elevation in body temperature for a longer period of time after surgery than a younger client. Weight bearing is being done by the unaffected leg at this time, and fatigue is expected.
A, D, E
If unsure about any information, the client should be encouraged to ask for further instructions and more information. A client needs to be proactive and should check all aspects of the prescription with the pharmacist before leaving the pharmacy. A pharmacist may have permission to substitute a generic form of the drug or may change the number of pills that deliver the prescribed dose, both of which can confuse the client (e.g., one tablet may deliver 50 milligrams of a drug and be equal to two 25-milligram tablets). Because of the risk of drug interactions associated with polypharmacy and altered age-related physiological functioning that can cause drug toxicity, the client should inform the health team about all drugs (e.g., prescription, over-the-counter, recreational), herbal preparations, and amount of alcohol ingested to ensure safety. A client should stop taking a prescribed medication only after consultation with the health care provider. Unused and expired medications should not be discarded into the toilet because they can contaminate groundwater.
A
Clients with COPD often develop a barrel chest over time because of air being trapped, thus resulting in enlarged lungs and thoracic cavity. This also causes the lungs to have less flexibility. Cyanosis is a bluish discoloration, especially of the skin and mucous membranes, caused by excessive concentration of deoxyhemoglobin in the blood caused by deoxygenation. COPD sufferers can exhibit this, but barrel chest is the most obvious sign, as other respiratory/cardiovascular disorders can cause cyanosis as well. Hyperventilation is the act of breathing faster or deeper than normal, which causes excessive expulsion of circulating carbon dioxide. This causes the arterial concentration of carbon dioxide (PaCO 2) to fall below normal, raising blood pH, and results in alkalosis. COPD sufferers can experience hyperventilation, but barrel chest is the classic sign of COPD. Lordosis is an unusual inward curving of the spine in the lower part of the back. It can be considered medically significant; however, it is not associated with classic signs of COPD.