As humans age they go through many physical changes, this document will include age related changes for the cardiovascular system, respiratory changes, and the reproductive system. Also, nursing interventions, like how to asses changes, safety measures and education related to changes that happen as humans age.
As humans age they face many cardiovascular changes, many of these changes are due to a lack of cardiac reserve. These changes become apparent to the person when the ageing person is active or stressed, because activity and stress causes an increase in the metabolic demand on the body (Ignatavicius, Cardiovascular changes are as followed, cardiac value, left ventricle, conduction system, aorta and other large arteries and baroreceptors.
As humans age there becomes changes in their cardiac valves. The mitral and aortic valves have calcification and mucoid degeneration. Calcification is a buildup of calcium in the values of the heart. This can cause aortic stenosis, which is narrowing of the aortic valve opening. Aortic stenosis which begins after 60, but people often don’t have symptoms until 70 or 80. (HEART>ORG)
There are many changes in the left ventricle that occurs. The size of the left ventricle changes. The left ventricle becomes less distensible and stiff. Also, there are fibrotic changes, this causes a decrease in the diastolic filling by approximately 50%.
Starting at the age of 60 there is a decrease in the number of pacemaker cells in the heart. This decrease can cause a slower heart rate in ageing adults. There is also an increase of fibrous tissue and fat in the sinoatrial node.
Aorta and other Arteries
Changes in the aorta and other large arteries can cause hypertension, and other age-related changes. The aorta thickens, these changes in the aorta causes an increase in the systolic blood pressure. Also, the aorta and other larger arties become less distensible, which causes an increase system vascular resistance. This can lead to left ventricular hypertrophy.
Baroreceptors become less sensitive as humans age. Baroreceptors are in the aorta and are stimulated when stretching in the arterial walls is present, this stretching is due to an increase in blood pressure. The baroreceptors as we age start to be less sensitive.
As humans age, there are some major changes that occur in the respiratory system. Due to environmental exposures, the respiratory system can be affected even greater. These environmental factors include, cigarette smoke, bacteria, fumes for industrial factories, and other irritants. Infection is also a major factor that affects the older adult population and cause an abundance of respiratory conditions. The following are affected by ageing; alveoli, lungs, Pharynx and Larynx, Pulmonary vasculature, Muscle Strength, Exercise tolerance, Chest wall, and Susceptibility to infection.
The lungs contain millions of alveoli, and this is where the lungs and the bloodstream exchange oxygen and carbon dioxide. As humans age their alveoli ages with them. The ability to cough decreases, the capacity of diffusion decreases, the alveolar surface and elastic recoil decreases, and the airway closes early.
The lungs and organs in the plural cavity. Lungs go through an ageing process with the human body. This can take a great toll on an ageing adult and how they function in their day to day life. There is an increase in residual volume in the lungs, there is a decrease in the vital capacity, elasticity and efficiency of the exchange of carbon dioxide and oxygen in the lungs.
Pharynx and Larynx
The pharynx also called the throat is used for both respiration and a digestion tract. The larynx is also called the voice box and is located at the base of the tongue. The pharynx and larynx are affected by ageing, also, the vocal cords become slack, muscle atrophy takes place, airways lose cartilage and there is a loss of elasticity on the laryngeal muscles.
Pulmonary vasculature (PV) is the circulatory part of the respiratory system. PV transports deoxygenated blood to the alveoli and oxygenated blood to the heart. This system works with the cardiovascular system. As humans age, that causes changes in the PV system, there is an increase for hypoxia, and there is a decrease in the pulmonary capillary blood volume.
Muscle strength goes through age related changes in the ageing populations. Something an elder person experiences due to ageing is a decrease in the intercostals and diaphragm. These muscles are used for breathing, by expanding and contracting the chest wall.
Exercise can be hard for older adults due to the ageing process. Respiratory problems can cause older adults to stray away from exercise, because older adults’ response to hypoxia starts to decrease. Hypoxia is a lack of oxygen to the body tissue, so this can make exercise difficult for older adults. Also, a retention of carbon dioxide, called hypercarbia.
The chest wall is a protection barrier for vital organs, like the lungs. Changes in the chest wall plays a part in effective breathing, and as humans age there is changes that happen in the chest wall. The anteroposterior diameter increases, this is known as pigeon chest. The thorax becomes shorter, kyphoscoliosis (humpback) can occur over time. There is a decrease in the elasticity of the chest, and mobility of the chest wall. Due to the prevalence of osteoporosis among the older population this can lead to chest wall abnormalities.
Susceptibility to Infection
Older adults are susceptible to infection in their respiratory system due to changes in their body as they age. There is an altercation in their alveolar macrophages, a decrease in the effectiveness of the older adults’ cilia and a decrease in immunoglobulin A.
Reproductive changes due to ageing effects both males and females, while some of the changes are the same, there are many factors that differ due to gender.
Women go through many reproductive changes as the age. Most of these changes are due to hormonal changes. Women as they age can go perimenopause, which changes the amount of their menstruation and the frequency. After perimenopause, comes menopause which is when menstruation stops and physical change to your reproductive tract becomes apparent. Women have changes to their pubic hair, it starts to grey and thins out. Women also experience the labia majora and clitoris decreasing in size. Also, the vaginal walls become dry, smooth and begin to thin. The uterus and ovaries also decrease in size, and there is a loss of elasticity and of the connective tissue and pelvic ligaments. Vaginal yeast infections increase due to age related changes. In the breast of a women, there is an increase in the fibrosis and flabbiness, this causes the breast to hang lower than the chest wall. Also, in the breast there is a decrease of nipple erection.
Men go through reproductive changes as they age, and these changes happen over a long span of time. Men also experience their pubic hair becoming thing and turning grey. There is a loss of rugae and an increase in the dropping of the scrotum. Also, men experience prostate enlargement, and this can increase the chance of urethral obstruction, this can cause benign prostatic hyperplasia. Ageing men can have trouble getting an erection, due to the ageing process.
Cardiovascular Nursing Implications
Nursing implications for the cardiovascular system is assessing different things related to the cardiovascular system, like vitals, infections and dyspnea. It is important to know what is in normal range and what is not as a nurse so you can identify things that are abnormal. Also, teaching a patient about how to maintain a healthy heart in important, like keeping their blood pressure under control, eat a healthy diet, limit alcohol and smoking use, manage stress, keep at a healthy weight and exercise the proper amount.
It is important to asses the heart rhythm, rate and sounds in order to identify heart murmurs. Also, asking your patient about dyspnea, which is difficulty breathing. A nurse should teach their patient about what dyspnea is, and the importance of regular checkups to auscultate the heart, to identify heart murmurs.
For the conduction system of the heart, an electrocardiogram is used, this will show a person’s heartbeat and can help identify problems in the heart, like a heart dysrhythmia or a heartbeat less than 60 beats/minute. It is important to educate on a healthy lifestyle, to help prevent heart dysrhythmias.
An electrocardiogram can also be used to help identify problems with the left ventricle. On an electrocardiogram it should be assess for widen QRS complex and a long QT interval. Also, assess the heartrate with activity and no activity of the patient, and assess for activity intolerance. These are important to assess because with changes to the ventricle changes in the heart can happen, and with activity the heart will be less able to meet the high oxygen demand. Education is important for a patient with left ventricle problems, on not overdoing exercise due to the heart not being able to meet the oxygen demand.
Aorta and other large arteries
For the aorta and other large arteries, you should assess blood pressure, and not an increase in the blood pressure. Education the patient checking their own blood pressure and if they are on medication for high blood pressure, to take the correct dosage and take it at the proper time, this is to prevent hypertension, because unmanaged hypertension can lead to organ damage.
Respiratory nursing implications
Nursing implications for the respiratory system due to ageing, is assessing and educating the patient to maintain a healthy respiratory system. It is important for the patient to report any respiratory distress and for patients to stay away from respiratory irritants, like smoking, environmental hazards, and bacteria.
An important thing for a nurse to asses in respiratory complication, especially in patient who are immobile and after surgery. This includes, auscultating respiratory sounds and checking the patient’s vital signs. A patient should be taught pulmonary hygiene, like coughing, deep breathing and turning. Also, how to use an incentive spirometer, especially if the patient is bedridden or after surgery. It is important to educate on the proper use of the incentive spirometer and pulmonary hygiene because these reduce the risk of infectious respiratory complications.
Nursing implications for the lungs has to do with auscultation and percussion of the lungs. Also, encourage the patient to live a healthy lifestyle. Education is an important step in a patient maintaining heathy lungs. Education on the importance of not smoking and not remining stationary, because this can increase the risk of infection in the lungs, like pneumonia.
Pharynx and larynx
A patient experiencing pharynx and larynx problems, may have a soft voice that is difficult to understand. A face to face conversation with this patient is important, because it can help identify if pharynx and larynx problems are present. Educating the patient on voice exercise, and to visit the doctor if they notice changes in their voice.
Due to the risk for hypoxia, from the changes that happens in the pulmonary vasculature, assessing patients for their cognition and consciousness levels is very important in identifying a lack of oxygen to the brain. Encouraging the patient to discuss any breathing problems they may be having with someone in their medical team.
Patients need to be educated on the importance of exercising but doing exercises that benefit the patient and des not cause respiratory harm. Also, making sure patient can do activities of daily living, without having respiratory distress is an important factor to look at. Also, assessing is the the elder patient can not complete activities of daily living, they can experience malnutrition, tissue breakdown and immobility.
Muscle strength and susceptibility to infections
With muscle strength it is important for the nurse to asses changes in the respiratory rate, due to a decrease in the respiratory muscles. A loss of muscle strength in older adults can cause, respiratory problems. Also, with susceptibility to infections, the nurse should maintain proper hand hygiene, and watch for signs of aspiration. Patients should be educated on pulmonary hygiene, like turning, coughing, and deep breathing. Also promoting a healthy lifestyle and education on exercise, this can help with preventing respiratory illnesses and maintaining proper function of the respiratory system.
As changes take place to the chest wall, it is important to asses if a patient is experiencing dyspnea, also if a patient has osteoporosis, that can lead to abnormalities. in the chest wall. A nurse should always look for fall risk, for patients with respiratory problems and osteoporosis.
Reproductive nurse implications
With the many changes that happen in the reproductive system as humans get older, nurses assess the ageing that takes place like, urinary retention, changes in hormone levels, and educating the patient on changes that they will see due to the ageing process. Safety measures that should be put into place is education on self-breast exams are and testicular examinations in order to note changes, to help identify any cancer in the early stages.
As females go through many reproductive changes due to ageing, educating a patient is crucial, so a female can identify normal age-related changes. This includes teaching females about self-breast exams and mammograms, education on water-soluble lubricants, due to the drying of the vaginal walls. Also, Kegel exercises to help strengthen pelvic muscles.
As males age, education is also crucial for the reproductive system. For example, educating the patient how to do a testicular self-examination. This is an important teaching tool because, the patient can help detect any changes that could be cancerous. Also, educating the importance of prostate cancer screening, this screening can help early diagnosis of prostate cancer, if done by the patient every two years, or yearly according to their physicians’ recommendations.
In this document I discussed age-related changes to the cardiovascular system, respiratory system and the reproductive system. Also nursing implications for all three body systems, and education, safety measures and how to assess those age-related changes.
- Ignatavicius, D. and Workman, L. (2018). Elsevier Adaptive Quizzing for Ignatavicius: Medical-Surgical Nursing (9th Edition), St. Louis: Elsevier. ISBN: 9780323556040