COMBINED (P.G.

) INSTITUTE OF MEDICAL SCIENCES &

RESEARCH, DEHRADUN

SUBJECT: ADVANCE NURSING PRACTICE

LESSON PLAN
ON
TOPIC: “AGE RELATED PROBLEMS-GERIATRICS”

SUBMITTED TO SUBMITTED BY
Mohamad Dildar
M.Sc. Nursing 1st Year
Title of the course – M.Sc Nursing 1st year

Topic – Age related problems- Geriatrics

Name of the subject teacher –

Duration –45 minutes

Date and time –

Place – College of Nursing

Group of students – 2nd year B.Sc. Nursing

Method of teaching – Lecture cum Discussion

AV aids – Blackboard, chart, PowerPoint.

Previous knowledge of the students – students may have some knowledge about age related
problems- Geriatrics
Objectives

General objective-

After this teaching learning activity, the students will be able to understand about age related problems of geriatrics
and can apply this knowledge in providing care to geriatrics patients in hospital and community settings.

Specific objectives-

The students will be able to-

 explain about aging.

 describe about physiological changes in geriatrics.
 describe about psychosocial concerns in geriatrics.
 describe about mental health changes in geriatrics.
 role of nurse in care for geriatric clients.
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1. 2min explain Introduction

about Aging is the biopsychosocial process of change that occurs in a
aging person between birth and death.
Gerontology is the study of the aging process.
Elderly (geriatrics) starts from the age of 65 years old

1.Physiological Changes
A. Integumentary system
1. Loss of pigment in hair and skin
2. Wrinkling of the skin
3. Thinning of the epidermis and easy bruising and tearing of the skin.
4. Decreased skin turgor, elasticity, and subcutaneous fat.
5. Increased nail thickness and decreased nail growth.
6. Decreased perspiration The teacher Powerpoint What are
describe explains Physiologic
7. Dry, itchy, scaly skin ,
2. about about the Problems in
7min 8. Seborrheic dermatitis and keratosis formation blackboard
physiolo- geriatics ?
(overgrowth and thickening of the skin) topic and
logical
changes learners
in listen
B. Neurological system
geriatrics 1. Slowed reflexes carefully.
2. Slight tremors and difficulty with fine motor movement
3. Loss of balance
4. Increased incidence of awakening after sleep onset.
5. Increased susceptibility to hypothermia and hyperthermia
6. Short-term memory decline possible
7. Long-term memory usually maintained
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.
C. Musculoskeletal system
1. Decreased muscle mass and strength and atrophy of muscles
2. Decreased mobility, range of motion, flexibility, coordination, and
stability
3. Change of gait, with shortened step and wider base
4. Posture and stature changes causing a decrease in height.
5. Increased brittleness of the bones
6. Deterioration of joint capsule components
7. Kyphosis of the dorsal spine (increased convexity in the curvature
of the spine)

D. Cardiovascular system
1. Diminished energy and endurance, with lowered tolerance to
exercise
2. Decreased compliance of the heart muscle, with heart valves
becoming thicker and more rigid
3. Decreased cardiac output and decreased efficiency
of blood return to the heart
4. Decreased compensatory response, so less able to
respond to increased demands on the cardiovascular
system
5. Decreased resting heart rate
6. Weak peripheral pulses
7. Increased blood pressure but susceptibility to
postural hypotension
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E. Respiratory system
1. Decreased stretch and compliance of the chest wall
2. Decreased strength and function of respiratory muscles
3. Decreased size and number of alveoli
4. Respiratory rate usually unchanged
5. Decreased depth of respirations and oxygen intake
6. Decreased ability to cough and expectorate sputum

F. Haematological system
1. Haemoglobin and haematocrit levels average toward the low end of
normal
2. Prone to increased blood clotting
3. Decreased protein available for protein-bound medications

G. Immune system
1. Tendency for lymphocyte counts to be low with altered
immunoglobulin production
2. Decreased resistance to infection and disease

I. Endocrine system
1. Decreased secretion of hormones, with specific changes related to
each hormone’s function
2. Decreased metabolic rate
3. Decreased glucose tolerance, with resistance to insulin in
peripheral tissues
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H. Gastrointestinal system
1. Decreased need for calories because of lowered basal metabolic
rate
2. Decreased appetite, thirst, and oral intake
3. Decreased lean body weight
4. Decreased stomach emptying time
5. Increased tendency toward constipation
6. Increased susceptibility for dehydration
7. Tooth loss
8. Difficulty in chewing and swallowing food

J. Renal system
1. Decreased kidney size, function, and ability to concentrate urine
2. Decreased glomerular filtration rate
3. Decreased capacity of the bladder
4. Increased residual urine and increased incidence of infection and
possibly incontinence
5. Impaired medication excretion

K. Reproductive system
1. Decreased testosterone production and decreased size of the testes
2. Changes in the prostate gland, leading to urinary problems
3. Decreased secretion of hormones with the cessation of menses
4. Vaginal changes, including decreased muscle tone and lubrication
5. Impotence or sexual dysfunction for both sexes; sexual function
varies and depends on general
physical condition, mental health status, and medication
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L. Special senses The teacher Powerpoint

1. Decreased visual acuity explains ,
2. Decreased accommodation in eyes, requiring increased adjustment about the blackboard
time to changes in light
topic and
3. Decreased peripheral vision and increased sensitivity to glare
4. Presbyopia and cataract formation learners
5. Possible loss of hearing ability; low-pitched tones are heard more listen
easily carefully.
6. Inability to discern taste of food
7. Decreased sense of smell
8. Changes in touch sensation
9. Decreased pain awareness
3.
3mins Describe II. Psychosocial Concerns
about A. Adjustment to deterioration in physical and mental health and
Psycho- well-being
Social B. Threat to independent functioning and fear of becoming a burden
concerns to loved ones
in C. Adjustment to retirement and loss of income
geriatric D. Loss of skills and competencies developed early in life
patients E. Coping with changes in role function and social life
F. Diminished quantity and quality of relationships and coping with
loss
G. Dependence on governmental and social systems
H. Access to social support systems
I. Costs of health care and medications
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IV. Mental Health Concerns The teacher Powerpoint

1. Depression: explains ,
2. Grief about the blackboard
3. Isolation topic and
4. Suicide learners
listen
Role of nurse in care of geriatric client carefully.
 Consider individuality of the elderly patients. Don’t attempt to
alter the lifelong character and behavior.
 Be patient, kind, sympathetic while providing care. Handle
them gently and maintain privacy while providing care.
 Communicate effectively. Make sure they can hear you.
 Encourage independence as far as possible.
 Assist to achieve emotional stability. Support them during
their periods of anxiety. Give them time to express their
feelings. Praise even minimal achievements. Encourage
contact with others.
 Protect them from injuries, falls, and accidents with proper
instructions / arrangements
 The elders are highly prone to develop bedsores. So, provide
comfortable bed, and smooth and wrinkle free bed linen.
Ensure adequate hydration and nutrition. Encourage to do
active range of motion exercises. Maintain body alignment,
posture, and mobility.
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The teacher Powerpoint

 Help them to establish good sleeping pattern. Try to engage explains ,
them in certain activities during day time, so that they can about the blackboard
sleep well during night time. topic and
 Caution them about self use of drugs especially analgesics learners
and narcotics. Because of the poor eyesight and forgetfulness listen
they may not be able to understand the instructions or the carefully.
importance of drug treatment.

SUMMARY

Elderly patients have age specific, complex and multifaceted needs.

They are affected in unique ways by the combined effects of the
ageing process, the disease process and the environment, which
challenge their sense of self and influence their perception of quality
of life

CONCLUSION

it is the need of the hour to introduce specialization in Geriatric

Nursing or at least some short term course should be started in order
to provide quality care to this vulnerable population.

REPATIUALIZATION

 What are the physiological changes in geriatics?

 What are the psychosoclal changes in geriatics?
 References

 Basavanthappa BT. Communication and Educational Technology for Nurses. Jaypee; 2011.
 Neeraja KP. Textbook of communication and education technology for nurses. JP Medical Ltd; 2011. Page no.- 350-398
 Sudha R. Nursing Education: Principles and Concepts. Jaypee; 2013.
 PramilaaR . Nursing Communication and Eductional Technology,jaypee;2010.
 Suresh.K.Sharma. Communication and Educational Technology.

Journal /article Reference

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634218/