Adult health and aging

• Illness


  Response of an individual to a disease
• Disease


  Any altercation in a body system organ structure or function
• Acute


  • Onset: Abrupt
  • Duration: Short
  • Examples: Flu & Stomach Virus
• Chronic


  • Onset: Slow
  • Duration: 6 Months <
  • Examples: Hypertension or Diabetes
• Remission


  No symptoms; Cancer
• Exacerbation

  Symptoms (re)appear; COPD
• Challenges with chronic illnesses


  • Acceptance of the illness
  • Use of medications effectively (why/which drug their taking medication)
  • Modifying lifestyle (diet)
  • Effective coping strategies
  • Maintaining a feeling of being in control (Powerlessness is in NANDA)
  • Interacting effectively with the healthcare system on an ongoing basis (Transportation, Insurance coverage?)
• Levels of prevention


  • Primary: Vaccines, healthy diet, exercise, non smoking, Legislation (seat belts)
  • Secondary: Screenings, Labs, blood draws, (Must be diagnosis by provider)
  • Tertiary: Rehabilitation/Therapy
• Frequency of exams


  • Dentist: Every 6 months
  • Eye Exam: Once a year
  • Physical: Once a year
  • Tetanus: Every 10 years
  • Flu: Once a year
  • Self-Exams: Monthly
• Young adult crisis

  Intimacy vs. Isolation
• Characteristics that may be happening during young adulthood include balding and gray hairs
• Health promotions for young adults


  • Chlamydia: all sexually active women 24 and under
  • HPV Vaccine: unvaccinated women and men through 26: 2 doses for age 9-14, 3 doses for ages 15-26
  • Cervical Cancer Screening (Pap): start at age 21 and screen every 3 years until 29 then continue every 3 years or every 5 when combined with HPV testing
• Reasons why some adults don't want their children getting these vaccines include considering them inappropriate and not wanting to talk about sex with their 9-14 year old
• Middle adult crisis

  Generativity vs. Stagnation
• Older adult


  65 & up
• Older adult crisis


  Integrity vs. Despair
• Common occurrences in older adults

  • Losing loved ones
• Reasons why medications are lower for older adults


  • Metabolism: Liver shrinks; Decrease metabolism
  • Absorption: GI motility slows; Decreases Cell Absorption
  • Circulation: Vascular nerve control less stable/medications may alter circulation
  • Distribution: Body mass decrease; total body water declines; plasma protein levels decrease
  • Drug - Receptor Interaction: Brain receptors become more sensitive
  • Excretion: Number of functional nephrons/ renal blood flow/ glomerular filtration rate declines
• Challenges older adults face with taking medications


  • Vision: not seeing the bottle correctly
  • Memory: remember taking it; taking too much/little
  • OTC Drugs: Can double up on meds for same reason (2 liver medication)
  • Meds Prescribed for Others
  • Finances: can't afford/limited income
  • Lack of understanding: don't understand why they're taking the medication
  • Side Effects: Constipation; causing more medications for side effects
• Polypharmacy

  Taking medication at the same time/multiple medication
• Medication reconciliation


  All medications
• Types of abuse for older adults


  • Physical
  • Neglect
  • Psychologic
  • Sexual
  • Financial
  • Violation of Persona Rights (Decision Making)
  • Abandonment (Desertion)
• Vaccinations for middle/older adults


  • Shingles: 50 and older
  • Pneumococcal: 65 and older
  • Flu Shot
• Shingles


  Chicken Pox is dormant and is triggered
• Screenings for middle/older adults


  • Mammograms
  • Colorectal
  • Occult
  • Colonoscopy
  • Pap smear
• Mammograms


  40-74 years old; Every 1-2 years
• Occult stool test


  Annually; DNA test= 3 years
• Colonoscopy


  10 Years
• Pap smear

  21- 65; 3 years w/o HPV screening & 5 years with
• Leading causes of death in young adults (25-34)


  • Poisoning; Drugs
  • Suicides
  • Traffic Accidents
• Preventions for leading causes of death in young adults

  • Drug education/Legislation
  • Mental Health screenings, drug testing, Hepatitis C
  • Rehabilitation, Support groups
• Leading causes of death in middle adults (45-54)

  • Covid-19
  • Poisoning; Drugs
  • Coronary Heart Disease
• Preventions for leading causes of death in middle adults

  • Vaccines, Hand-washing, Social Distancing
  • Testing
  • Pulmonary Rehabilitation
  • Healthy Diet, Exercise, Smoking cessation
  • BP Screening, Cardiac & Cholesterol Screening, EKG's
  • Cardiac & Pulmonary rehabilitation, Support Groups
• Leading causes of death in older adults (55-74)


  • Covid-19
  • Coronary Heart Disease
  • Lung Disease
• Preventions for #2 cause of death in older adults

  • Healthy Diet, Exercise, Smoking cessation
  • BP Screening, Cardiac & Cholesterol Screening, EKG's
  • Cardiac & Pulmonary rehabilitation, Support Groups
• Nurse's role for care management

  • Support
  • Education
  • Assessment
  • Referral
• Types of care management in death & dying


  • Advanced Directives/ Living Will
  • Do Not Resuscitate (DNR) order by provider
  • Medical Power of Attorney
  • Organ Donation
• Hospice


  Goal is facilitating a peaceful & dignified death; projected to <6 months; not seeing curative treatment
• Palliative Care


  Goal is on improved quality of life and facing problems associated with life threatening illness
• Changes associated with death & dying in respiration & cardiovascular system


  • Respirations: Cheyne-Stokes, Death Rattle: mainly in throat with secretions
  • Cardiovascular: increased HR initially then later slowing & weakening pulse; decreased BP