Review slides, as needed.

1. Chapter 9

2.  Homeostasis – body harmony
 Metabolism – Physical and Chemical
processes
 Must be working at steady level
 Changes are signs and symptoms
 Change in temp – indicates infection
 Body systems – all work together and have
own structure and function

3.  Organs – Make up body systems – specific
function
 Tissues – Make up organs
 Cells – Make up tissues – building blocks

4.  Anterior/ – front
 Posterior/Dorsal – Back
 Superior – toward head
 Inferior – away from head
 Medial – toward midline
 Lateral – to the side, away from body
 Proximal – closer to torso
 Distal – away from torso

5.  Function – Protective covering
 Protects internal organs from injury
 Prevents bacteria from entering body
 Prevents water loss, essential to life
 Made up of glands and tissues
 Function – Sense Organ
 Heat, pain, cold, touch, pressure

6.  Thinner skin
 Less elastic
 Feels colder
 Hair thinner, gray
 Wrinkles, “liver” spots
 Nails more brittle
 Dry, itchy more often, due to decreased
circulation

7.  Help with bathing
 Apply lotions
 Be gentle – skin fragile
 Gently brush hair
 Keep them warm
 Keep bed linens wrinkle-free
 Be careful when giving nail care - diabetic
 Encourage them to drink fluids

8. Signs of Skin breakdown:
 Reddened skin
 Cuts, abrasions, skin tears
 Swelling
 Scalp or hair changes
 Skin that appears different from normal or
that has changed

9.  Bones, joints, tendons, ligaments, cartilage
 Gives body structure and function
 Skeleton protects internal organs
 Types of joints
 Ball and socket joint – movement in all directions
 Hip and shoulder
 Hinge joints – movement in one direction
 Elbow, knee

10.  Attached to bones, cause body movement
 Voluntary – arm and leg – skeletal
 Involuntary – diaphragm – breathing
 Exercise – important for maintaining health
 Improves circulation, muscle tone
 Immobility – Can’t move
 Caused by disease process sometimes
 Contributes to muscle atrophy (shrinking)
 Loss of strength, constipation, blood clots
 Contractures – shortening of muscles, inflexible,
freezes in position

11.  Weak muscles, loss of tone (shape)
 Slower body movements
 Joints stiffen
 Height is lost – lumbar/thoracic vertebra
 Brittle bones (osteoporosis) loss of bone
density – holes in bones

12.  Fall prevention – to prevent fractures
 ROM – to keep joints mobile
 Encourage self-participation in ADLs
 Encourage walking, if able

13.  Changes with ADL participation
 Changes with ROM
 Swelling of joints
 Pain in joints

14.  Control and message center of the body
 Senses and interprets information
 Made up of brain, spinal cord, and nerves
 Brain
 3 main sections
 Cerebrum, cerebellum, and brainstem
 Cerebrum – right and left sides of brain
 R - Controls movement & function left side of body
 L – Controls movement & function right side of body.
 Cerebellum – Balance & voluntary muscle movement
 Spinal Cord – houses nerve pathways

15.  Slower reflexes – does not react as quickly
 Decreased sensation – not able to fully sense
hot and cold accurately
 Possible memory loss – short term – “where
did I put those car keys???”

16.  Help resident make lists for reminders.
 Put a calendar on the wall for them.
 Give time for decision-making or responses
to questions.
 Never rush them.

17.  fatigue, pain that is unusual
 Shaking (hands, head, body)
 Trembling (in fingers, hands, elsewhere)
 Difference in speech (slurred, not making
sense)
 Unable to move one side of body (sudden)
 Any other symptoms related to stroke

18. Normal changes of aging are:
Decline in:
 Vision and hearing
 Smell (things smell different than normal)
 Taste (can’t taste something that is otherwise
normal…salt, sugar, usually need more of)
 Touch – diminished sensation (hot, cold)

19. Any reported change in:
 Vision
 Hearing
 Dizziness
 c/o pain in a different location

20.  Heart
 Acts like a pump
 Blood vessels
 Carries blood throughout body
 Blood
 Carries oxygen and nutrients to all areas of body

21. 2 phases of the heart beat:
 Systole (sis-toe-lee) – contraction phase
 Diastole (dye-as-toe-lee) – relaxation phase
 Blood pressure measures pressure against vessel
walls during these two phases

22.  Heart pumps less efficiently – less squeezing
 Decreased circulation – blood moves slower
 Narrowed blood vessels- plague build-up adds
to slower blood movement

23.  Encourage exercise and movement – take for
a walk, if on care plan
 ROM – can do in bed or wheelchair
 Allow time for completion of activities –
don’t ever rush!
 Keep Warm – this improves the circulation of
blood.

24.  Change in pulse rate
 Faster or slower
 c/o weakness or fatigue
 Change in ability to perform own ADLs
 Swelling in extremities
 Blue anything – lack of oxygen
 Chest pain – heart attack
 SOB – heart attack
 Severe headache – could be stroke

25.  Organs – Lungs and Trachea
 Inspiration and expiration (one full breath)
 1. Breathe in…
 2. Breathe out…
 Oxygen and carbon dioxide
 a. we breathe in oxygen
 b. we breathe out carbon dioxide (waste product)
 This whole process is called:
“Ventilation and Perfusion”

26.  Adjust position as needed – HOB up
 This helps when residents are short of breath.
 After surgery or with pneumonia:
encourage deep breathing and coughing to
expel mucous buildup.
 Observe and report…
 Change in RR
 Coughing, wheezing, other sounds
 Pale, blue, or gray look
 Chest pain
 Discolored sputum

27.  Organs – kidneys, ureters, bladder, urethra
 See page 137 & 138
 Function:
 Filters blood and excretes waste products
through urine
 Normal changes of aging…
 Filtering capability diminishes
 Bladder muscle tone weakens
 Frequent urination – more trips to the BR
 Frequent UTIs

28.  Encourage fluid intake, if applicable
 Answer call light promptly
 Keep residents clean and dry, if incontinent

29.  Weight loss or gain- fluid retention
 Swelling – cause by fluid retention
 Color, odor, consistency or urine, if unusual
 c/o pain, burning with urination
 Inadequate fluid intake – could lead to
dehydration
 c/o abdominal pain
 c/o frequency – increase BR trips

30.  Organs
 See page 139
 Main functions
 Digestion – food in
 Elimination – waste out

31.  Answer call light promptly
 Encourage fluids and nutritious foods
 Dentures in and fitting
 Observe swallowing precautions

32.  Problems with
 Dentures, swallowing, mouth pain
 Incontinence
 Poor appetite
 BMs, unusual or no
 N,V,D
 c/o heartburn

33.  Glands – regulation of hormones
 Pancreas – insulin
 Thyroid – thyroid hormones
 Diabetes
 Blood sugar levels
 Capillary blood glucose – finger stick
 Observe and report…
 c/o headache
 Weakness
 Blurred vision
 other…see pg 141 – signs related to high/low
blood sugar

34.  Body’s attempt to fight off invading
organisms
 Skin, mucous membranes, nose hair
 Inflammatory response includes:
 Swelling, redness, increased temperature
 This response begins when there is an invading
organism inside the body.

35.  Wash hands frequently
 Encourage personal hygiene
 Take accurate VS
 Keep resident’s area clean
 Report abnormal VS or other to RN or LPN