Gerontology Nursing

By: Nini A. (BSC, MSC)

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 Gerontologic/geriatric nursing:
• Is the field of nursing that specializes in the
care of the elderly.
• Gerontology: the study of the aging process,
draws from the biologic, psychological, and
sociologic sciences.

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 Cont..
• Geriatrics: the study of old age that includes
the physiology, pathology, diagnosis, and
management of the disorders and diseases of
older adults
• Aging, the normal process of time-related
change, begins with birth and continues
throughout life.

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 Normal Age-Related Changes
• Intrinsic aging (from within the person) refers to those
changes caused by the normal aging process that are
genetically programmed and essentially universal within a
species.
• Universality is the major criterion used to distinguish
normal from abnormal aging.
• Extrinsic aging results from influences outside the person.
• Illness and disease, air pollution, and sunlight are
examples of extrinsic factors that may hasten the aging
process and that can be eliminated or reduced through
effective health care interventions.

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 Physiologic changes during aging
Cardiovascular System
• Decreased cardiac output;
• Diminished ability to respond to stress;
• Heart rate and stroke volume do not increase with maximum demand;
• Slower heart recovery rate;
• Increased blood pressure
Respiratory System
• Increase in residual lung volume;
• Decrease in vital capacity;
• Decreased gas exchange and diffusing capacity;
• Decreased cough efficiency

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 Cont..
Integumentary System
• Decreased protection against trauma and sun
exposure;
• Decreased protection against temperature
extremes;
• Diminished secretion of natural oils and
perspiration

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 Cont..
Reproductive System
• Female: Vaginal narrowing and decreased elasticity;
decreased vaginal secretions
• Male: Decreased size of penis and testes
• Male and female: Slower sexual response
Musculoskeletal System
• Loss of bone density;
• Loss of muscle strength and size;
• Degenerated joint cartilage
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 Cont..
Genitourinary System
• Male: Benign prostatic hyperplasia
• Female: Relaxed perineal muscles, detrusor
instability (urge incontinence), urethral
dysfunction (stress urinary incontinence)

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 Cont..
Gastrointestinal System
• Decreased salivation;
• Difficulty swallowing food;
• Delayed esophageal and gastric emptying;
• Reduced gastrointestinal motility

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 Cont..
Nervous System
• Reduced speed in nerve conduction;
• Increased confusion with physical illness and
loss of environmental cues;
• Reduced cerebral circulation (becomes faint,
loses balance)

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 Cont..
Special Senses
Vision:
• Diminished ability to focus on close objects;
• Inability to tolerate glare;
• Difficulty adjusting to changes of light intensity;
• Decreased ability to distinguish colors
Hearing:
• Decreased ability to hear high frequency sounds
Taste and smell:
• Decreased ability to taste and smell
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 Older adults care
 The elderly person entering the acute care setting is at increased
risk for complications, infections, and functional decline.
 To avoid complications in the older adult, it is important to
carefully and frequently;
o Assess vital signs,
o Assess mental status,
o Assess Fluid balance, and skin integrity;
o Identify and treat complications;
o Promote independent self-care and mobility;
o Assist with frequent position changes and deep-breathing
exercises;
o Assess possible medication reactions;
and assist with ADLs and toileting.

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 Physical Health Problems in Older Populations

• Impaired Mobility
• Dizziness
• Falls and Falling

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Post operative complications of older adults

The most common postoperative

complications in the older adults include ;
 Ileus,
 Nutritional deficiencies,
 Respiratory complications—including
pulmonary embolism
 Urinary retention. 

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 Pharmacological consideration of aging
• Medications have improved the health and well-
being of older people by alleviating symptoms of
discomfort, treating chronic illnesses, and curing
infectious processes.
• Problems commonly occur, however, because of
medication interactions, multiple medication effects,
multiple medication use, and noncompliance.
• Combinations of prescription medications and some
over-the-counter medications further complicate the
problem.
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 The following must be considered while administering medications to older people:

• Medications removed from the body primarily

by renal excretion remain in the body for a
longer time in people with decreased renal
function.
• Often dosages must be reduced, because over
dosage and medication toxicity at usual
therapeutic dosages are common.
• Unusual responses to medications may
manifest as toxic reactions and complications.
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 Cont..
• As a result of a slowing metabolism, medication
levels may increase in the tissues and plasma, leading
to prolonged medication action.
• If, for any reason, a patient is not dependable about
taking medication, the nurse must be sure that the
pill or capsule is actually swallowed and not retained
between the cheeks and the gums or teeth.
• The possibility of interactions between medications is
further magnified if the older person is also taking
one or more over-the-counter medications.

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For self-administration of medication the following steps should be taken by
the nurse

 Explain the action, side effects, and dosage of each

medication.
 Write out the medication schedule.
 Encourage the use of standard containers without safety
lids (if there are no children in the household).
 Destroy old, unused medications.
 Review the medication schedule periodically.
 Discourage the use of over-the-counter medications and
herbal agents without consulting a health professional.

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Reading assignment??
• Risk factors of post op complications of old
adults
• Common clinical features of older adults

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 Thank you!

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