NR 601 Midterm Exam review November 2019
Week 1
Developmental changes
o Review Kennedy readings for age related changes
Physiological
Age related Change  | Functional Change  | Implications
Integumentary System
Loss of dermal and
epidermal thickness | Loss of subcutaneous tissue
and thin epidermis. | Prone to skin breakdown and
injury
Decreased vascularity see  | • Atrophy of sweat glands
resulting in decreased
sweat production
• Decreased body odor
• Decreased heat loss
• Dryness | • Alteration in
thermoregulatory response
• Fluid requirements may
change seasonally
• Loss of skin water
• Increased risk of heat
stroke
Respiratory System
Decreased lung tissue
elasticity | Decreased vital capacity  | Reduced overall efficiency of
ventilatory exchange
Cilia atrophy  | Change in mucociliary
transport | Increased susceptibility to
infection
Decreased respiratory
muscle strength | • Reduced ability to handle
secretions and reduced
effectiveness against
noxious foreign particles
• Partial inflation of lungs
at rest | Increased risk of atelectasis
Cardiovascular System
Heart valves thicken and
become fibrotic | Reduced stroke volume,
cardiac output; may be
altered | Decreased responsiveness to
stress
Fibroelastic thickening of the
sinoatrial node; decreased
number of pacemaker cells | Slower heart rate  | Increased prevalence of
arrhythmias
Decreased baroreceptor
sensitivity (stretch
receptors) | Decreased sensitivity to
changes in blood pressure | Prone to loss of balance,
which increases the risk for
falls
GI
Liver becomes smaller  | Decreased storage capacity
Decreased muscle tone  | Altered motility  | Increases risk of constipation,
functional bowel syndrome,
esophageal spasm,
diverticular disease
Decreased basal metabolic
rate (rate at which fuel is
converted into energy) | May need fewer caloriesNE CONDE)
Lab results
Lab Test  | Normal  | Changes with age  | Comments
UA
Protein  | 0-5mg/100ml  | Rises slightly  | May be due to kidney
changes with age,
urinary tract infection,
renal pathology
Specific Gravity  | 1.005-1.020  | Lower max in elderly
1.016-1.022 | Decline in nephrons
impairs ability to
concentrate urine
Hematology
ESR  | Men: 0-20
Women: 0-30 | Significant increase  | Neither sensitive nor
specific in aged