Aging Amps
This is why older adults have a higher systolic BP even if the diastolic stays the same.
What is decreased arterial compliance/stiffening (Arteriosclerosis)?
This common physical finding in elderly shins indicates right-sided heart failure.
What is dependent edema?
The most common reason for lower extremity amputation in the elderly.
What is diabetes-related peripheral vascular disease?
Order: Furosemide 20mg IV. Have: 40mg/4mL. The nurse will administer this many mLs.
What is 2 mLs?
D/H x Q = x
20mg/40mg x 4mL = 2mL
Order: Atenolol 12.5mg. Have: 25mg tablets. The nurse will administer this many tablets.
What is 0.5 tab?
D/H x Q = x
12.5mg/25mg x tab = 0.5 tab
The physiological reason why an elderly heart takes longer to return to baseline after stress.
What is a decreased beta-adrenergic response (takes longer to speed up and slow down)?
A common, non-pathological heart sound in the very old caused by a stiff atrium.
What is S4 heart sound (Atrial Gallop)?
This "silent" vascular condition is often found in elderly during routine screening for a pulsating mass.
What is Abdominal Aortic Aneurysm (AAA)?
Order: Heparin 3,500 units. Have: 5,000 units/mL. The nurse will administer this many mLs.
What is 0.7 mLs?
D/H x Q = x
3,500 U/5,000 U x 1 mL = 0.7 mL
Order: Digoxin 0.0625mg. Have: 0.125mg tablets. The nurse will administer this many tablets.
What is 0.5 tab?
D/H x Q = x
0.0625 mg/ 0.125 mg x tab = 0.5 tab
Aging causes a decrease in these receptors, making the heart less responsive to Beta-agonists.
What are beta-receptors?
This is why orthostatic hypotension is more prevalent in the elderly (physiological cause).
What is a blunted baroreceptor reflex (vessels don't constrict fast enough when standing)?
Elderly patients with this condition must be taught "foot care" as strictly as diabetics.
What is Peripheral Arterial Disease (PAD)?
Order: Bumetanide 0.5mg. Have: 0.25mg/mL. The nurse will administer this many mLs.
What is 2 mLs?
D/H x Q = x
0.5 mg/0.25 mg x 1 mL = 2 mL
Order: Isosorbide 10mg. Have: 20mg tablets. The nurse will administer this many tablets.
What is 0.5 tab?
D/H x Q = x
10 mg/ 20 mg x tab = 0.5 tab
This age-related change in the SA Node increases the risk of arrhythmias.
What is fibrosis and loss of pacemaker cells (leads to Sick Sinus Syndrome)?
This diagnostic test is preferred for the elderly who cannot walk on a treadmill for a stress test.
What is a Pharmacologic Stress Test (using Lexiscan or Dobutamine)?
A painful, chronic condition where legs must be elevated to reduce heavy, aching pain.
What is Chronic Venous Insufficiency?
Order: Famotidine 20mg. Have: 10mg/mL. The nurse will administer this many mLs.
What is 2 mLs?
D/H x Q = x
20 mg/10 mg x 1 mL = 2 mL
Order: Spironolactone 12.5mg. Have: 25mg tablets. The nurse will administer this many tablets.
What is 0.5 tab?
D/H x Q = x
12.5 mg/ 25mg x tab = 0.5 tab
The effect of age-related myocardial fibrosis on cardiac compliance.
What is decreased compliance (the heart becomes "stiffer" and harder to fill)?
This symptom of MI is often absent in the elderly; they may present with "confusion" instead.
What is chest pain (the elderly often have "silent MIs" or "atypical" symptoms like SOB or delirium)?
The term "thick, brittle, opaque" nails is often seen in elderly patients with peripheral arterial disease.
What are trophic changes (Hypertrophic nails)?
Order: Methylprednisolone 40mg. Have: 125mg/2mL. The nurse will administer this many mLs.
What is 0.64 mLs?
D/H x Q = x
40 mg/125 mg x 2 mL = 0.64 mL
Order: Warfarin 1.25mg. Have: 2.5mg tablets. The nurse will administer this many tablets.
What is 0.5 tab
D/H x Q = x
1.25 mg / 2.5 mg x tab = 0.5 tab