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Significant Physiological Changes

Special Care Needs


Loss of pigment; Thinning of epidermis; Easy bruising; Decreased skin turgor, elasticity, SQ fat; Increased nail thickness/decreased nail growth; Decreased perspiration; Dry, itching, scaly skin; Seborrheic dermatitis/keratosis formation


Slowed reflexes; Slight tremors/difficulty with fine motor movement; Loss of balance; Sleep pattern disturbances; Short term memory decline


Decreased muscle mass/strength; Decreased mobility/ROM/flexibility/

coordination/stability; Change of gait; Increased brittleness of bones; Kyphosis


Diminished energy; Decreased cardiac output; Decreased resting heart rate; Diminished peripheral pulses; Increased blood pressure/susceptibility to postural hypotension; stiffening/thickening of valves and vessels


Decreased respiratory function secondary to anatomical changes in respiratory muscles/alveoli; Increased rate respirations; Decreased depth respirations/oxygen intake; Decreased ability cough/expectorate


Decreased need for calories; Decreased appetite/thirst/oral intake; Decreased body weight; Digestive disturbances; Decreased absorption of CHO/proteins/fats/vitamins; Increased tendency constipation/dehydration; Dysphagia; teeth changes


Decreased secretion of hormones; Decreased metabolic rate; Decreased glucose tolerance/resistance to insulin


Decreased kidney size/function/ability to concentrate urine; Decreased GFR; Decreased capacity of bladder; Increased residual urine/incontinence; Increased incidence UTI; Impaired medication excretion


Decreased testosterone production/size of testes in males; Changes in prostate gland in males; Decreased secretion of female hormones/menopause; Vaginal changes in females; Sexual dysfunction both se


ALS (Lou Gehrig’s)

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Myasthenia Gravis

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What is


Auto-Immune or not?

A PNS disorder, acute inflammatory demyelinating polyneuropathy, rapidly progressing flaccid paralysis.


Rapidly progressing fatal CNS disease that affects voluntary muscle control, leads to death of the cells resulting in the brain losing the ability to initiate and control muscle movement

Affects the diaphragm and chest wall resulting in respiratory failure and need for placement of an artificial airway and ventilator support, does not impair the senses or ability to think.

Neuromuscular junction disorder that results in the body’s immune system attacking healthy cells


What are the risk factors/Causes it?

Cause: infection by virus or bacteria usually respiratory or GI

No known cause but environment and genetic plays a role

No known risk factor

How do you Diagnose?

Lumbar puncture to obtain CSF (findings include elevated protein)

Electro myography reveals slowed nerve conduction velocity soon after the patient develop paralysis

Both upper and lower motor neuron damage that cannot be attributed to other causes

Serological test

Electro myography

Edrophonium (Tensilon)- Anticholinesterase

IVP, (Diarrhea, Bradycardia)

Antidote: Atropine

What are the signs and symptoms?

How do you treat?

Nursing Considerations

Cardiac Rhythms


What is it?

What causes it?

S/S and Diagnose


Normal Sinus Rhythm

Sinus Bradycardia

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Rate less than 60 bpm

Normal P wave preceding each QRS complex

Regular atrial and ventricle rhythms

Normal in a well-conditioned heart, example, athletes

Increased intracranial pressure, increased vagal tone due to straining during defecation,

Administer atropine for symptoms of low cardiac output


Sinus Tachycardia

Rate more than 100 bpm

Atrial and ventricular rhythms are regular

Normal P wave preceding each QRS complex

Beta-adrenergic blockers or calcium channel blockers for symptomatic patients


Atrial and ventricular rhythm is regular

QRS complex premature, usually followed by a complete compensatory pause

QRS complexes are wide and distorted, usually less than 0.14 second

Premature QRS complexes occurring singly, in pairs, or in threes, alternating with normal beats, focus from one or more sites.

Heart failure; old or acute myocardial ischemia, infraction or contusion

Caffeine, tobacco, or alcohol use.

Psychological stress, anxiety, pain

Potassium chloride IV if PVS induced by hypokalemia.

Magnesium sulfate IV if PVC induced by hypomagnesemia.


Premature, abnormal-looking P waves that differ in configuration from normal P waves

QRS complexes after P waves except in very early or blocked PACs

May prelude supraventricular tachycardia.

Stimulates, hyperthyroidism, COPD, infection and other heart diseases.

Usually n

Older Adult



What Is Cancer? | American Association for Cancer Research (AACR)

Cardiovascular changes

Cardiac conduction is affected by the decrease in the number of pacemaker cells in the SA node with age. By age 60, the number in the pacemaker is decreased SA node. In advancing age, there is an increase in elastic and collagenous tissue in all parts of the conduction system. Fat accumulates around the SA node, sometimes it produces a partial or complete separation of the node from the atrial musculature. Cardiac output is unaffected by age.

What is This?

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignant tumors. Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually do not grow back, whereas cancerous tumors sometimes do.

Respiratory changes

Alveoli lose their shape and become baggy. The diaphragm over time become weaker, decreasing the ability to inhale and exhale, this happens when exercising. Ribcage bones become thinner and the shape changes, which makes it less able to expand and contract with breathing.

What are the risk factors/Causes it?

The most common risk factors for cancer include aging, tobacco, sun exposure, radiation exposure, chemicals and other substances, some viruses and bacteria, certain hormones, family history of cancer, alcohol, poor diet, lack of physical activity or being overweight.

Gastro changes

Alterations in taste and smell, gastric motility, intestinal overgrowth and changes in gastro hormone release are the basis of the physiological anorexia of aging. Alterations in swallowing lead to silent aspiration. Changes in gastro function can lead to constipation and fecal incontinence. Changes in probiotics can lead to diarrhea and altered immune system. In the liver, aging is associated with delayed drug metabolism.

How do you Diagnose?

The doctor does a biopsy to diagnose cancer. A biopsy is a procedure in which the doctor removes a sample of tissue. A pathologist looks at the tissue under

Multiple Sclerosis

Parkinson’s Disease

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Bell’s Palsy

What is


Auto-Immune or not?

A neurologic disease resulting in impaired and worsening function of voluntary muscles. Affecting nerve cells in the brain and spinal cord.


Progressively debilitating disease affecting motor function. Overstimulation of the basal ganglia by acetylcholine, dopamine is decreased

Not Auto Immune

Muscle weakness on one side of the face.

Inflammation of the cranial nerve # 7

Recovery 3 weeks- 9 months (some patient may have residual affects)

What are the risk factors/Causes it?

Caused by a genetic, immune mediated attack or infection that destroys myelin.

Risks: Age between 20-40, females, family history, association with interleukin 7 and interleukin 2 receptor genes, viruses and infectious agents, living in a cold climate, physical injury, emotional stress, pregnancy, fatigue, overexertion

Risks: Onset findings age 40-70, males, genetic predisposition, environmental toxins, chemical solvents, chronic use of antipsychotic medications.

Complications: pneumonia, aspiration, dementia

Causes: reactivation of herpes, acute demyelination like Guillain Barre, viruses

Risks: Age, pregnancy, patients with diabetes or hypothyroidism

How do you Diagnose?

There is no single test to diagnose MS. A thorough physical and neurologic examination that includes MRI imaging and blood test, combined with a careful study of an individual’s medical history.

What are the signs and symptoms?

Decrease in cognitive function

Blurred vision

Incontinence and urinary urgency

Muscle spasms



How do you treat?


Plasma exchange

Interferon beta medications

Fingolimod (Gilenya)

Nursing Considerations