Health Assessment of Elderly Client.pptx

Assessment of Elderly
Patients
1

Objectives
2
After the completion of this unit students will be able to:
1. Describe the variations in history taking for an elderly
client.
2. Differentiate health assessment variations for elderly
clients.
3. Identify any differing examination techniques or skills
for elderly client

Demonstration
Assessment of elderly patients
https://www.youtube.com/watch?v=jnaQIjOz2Dw

Elderly Population
4
 Elderly population have difficulty in carrying out
activities of daily living (ADLs)
 ADLs include bathing, dressing, toileting,
transferring, and feeding.
 They also have difficulties with instrumental
activities of daily living (IADLs).
 IADLs include ability to use the telephone,
shopping, food preparation, housekeeping, laundry,
using transportation, managing money

Common Medical Problems
 Arthritis
 Hypertension
 Heart disease
 Diabetes
 Visual impairments
 Hearing impairments
 Varicose Veins
 Dementia
5

Nursing Problems
 Impaired physical mobility
 Self care deficit
 Altered home management
 Decreased nutrition
 Incontinence
 Social Isolation
 Altered sensory perception
 High risk for fall / injury
 Confusion
6

Geriatric Syndrome
7
(Functional decline, morbidity and mortality)
 Mental status impairment (3Ds-Depression,
Dementia, Delirium)
 Functional impairment (ADL, Fall)
 Poor nutrition
 Incontinence
 Sleep problems
 Inappropriate medication use

Altered Clinical Presentation
8
In Elderly client
 Classic symptoms of disease is missing
E.g. Myocardial infarction may present with mental
confusion
 Presence of one condition may mask another
E.g. Symptoms of COPD and Ischemic Heart
Disease

Accumulated life history
9
 Treat older adults with respect for their
intelligence, wisdom, and accumulated life
history.
 Older adults may have long life history
 To direct the interview say “ This is valuable
information that I would like to hear about at
some later point in time, but right now I need to
focus on your problem of dizziness”

Interviewing Principles - Old Client
10
 Process may be longer and slower.
 Physical or cognitive alterations (memory loss,
slow response, hearing/vision impairment).
 Ask simple direct questions and avoid shouting.
 Face the patient to allow lip reading
 Allow the person to recall
 Avoid giving impression, this is not valued

Examination Principles
11
 Assess degree of help needed for movement
 Give extra time to understand the
instructions
 Keep the person warm
 Alternative positions if impaired mobility
 Guard whenever required
 Inspect areas at risk of skin breakdown

Examination Findings
12
 Skin:
 Wrinkling & sagging of skin
 Hypo pigmentation spots - Pseudoscar
 Hyper pigmentation - Senile lentigens
 Telangiectasias – dilated vessels
 Spider & cherry angiomas
 Senile purpura - easy bruising
 Dry skin – Xerosis / aesthiosis
 Seborrheic keratosis - raised warty benign
 Actinic keratosis - pink, dry scaly lesions
 Basal cell carcinoma-pearl nodule rolled borders

Wrinkling &
sagging of
skin
13
Hypopigmentation Hyperpigmentation
Dilated vessels Cherry Angioma Senile Purpura

Xerosis/dry skin
14
Seborrheic keratosis
Actinic keratosis
Basal Cell Carcinoma

15
 Nails & Hair:
 Thin / less / gray scalp, axilla & pubic hair
 Eyebrow, nostril & ear hair coarser, darker
 Nails may be thick / thin & split
 Eyes:
 Sunken eyes & ectropion
 Dry eye syndrome
 Cataract & Glaucoma
 Arcus senilis - grayish halo arc at limbus
 Presbyopia - poor accommodation and vision
 Fundoscopy – yellow retina

Sunken eyes
16
Arcus senilis
Presbyopia
yellow retina

17
 Nose:
 Smell sensation less, dry mucosa
 Ears:
 Pinna size increase, cerumen dries, pruritis &
impaction – Conductive loss
 Presbycusis (S/N loss) - use of aids
 TM – translucent & rigid

18
 Mouth:
 Taste ability intact, dry mouth - xerostomia
 Less salivation - oral candidiasis
 Dental caries / periodontal disease
 Abdomen
 Muscle wasting or fatty, obese

xerostomia
19
oral candidiasis
Periodontal disease
Presbycusis
Translucent & Rigid Tympanic
membrane

20
 Respiratory:
 Calcification ribs - less compliant chest wall
 Spinal changes - AP diameter increase
 Cardiac & Peripheral Vascular System:
 Maximum heart rate & cardiac output
decreases
 Athero / Arteriosclerosis - Systolic
HTN
 Orthostatic Hypotension
 Fibrosis of aortic valve – Systolic
murmur

21
 Musculoskeletal System:
 Height, mass & strength decrease - kyphosis
 Osteoarthritis & Osteoporosis
 Heberden’s and Bouchard’s nodes
 Nervous system:
 Deep Tendon Reflex difficult to elicit, Tremors
 Vibratory sense decrease, Posture imbalance
 Delirium - Attention & sensory deficit
 Dementia - confusion, cognitive memory deficit

22
 Male reproductive:
 Testosterone & testes size decrease
 Sperm motility & seminal fluid decrease
 Prostate enlargement
 Female reproductive:
 Estrogen decreases & intercourse b/c painful
 Vagina atrophies, uterus, ovaries & cervix size
decreases
 Breast/Genitalia:
 Breast size less, Gland atrophies – pendulous

HUMOR: THE PERKS OF BEING
OVER 50 (by James Kelly)
 Kidnappers are not very interested in you.
 In a hostage situation, you are likely to be released first.
 People call at 8 PM and ask, "Did I wake you?"
 There's nothing left to learn the hard way.
 Things you buy now won't wear out.
 You can live without sex, but not without glasses.
 You have a party and the neighbours don't even realize it.
 You no longer think of speed limits as a challenge.
 Your investment in health insurance is finally beginning to pay
off.
 Your joints are more accurate in predicting rain than the
National Weather Service.
 Your secrets are safe with your friends, because they
can't
remember them either.
 Your supply of brain cells is finally down to a
size. 22

Elderly Clients Needs Nursing Care
23

Health Assessment of Elderly Client.pptx

More Related Content

Similar to Health Assessment of Elderly Client.pptx (20)

Recently uploaded (20)

Health Assessment of Elderly Client.pptx

Editor's Notes