Assessment of Neurologic Gunction_gerontologic
Transcript of Assessment of Neurologic Gunction_gerontologic
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ASSESSMENT OF
NEUROLOGIC GUNCTION
GERONTOLOGIC
CONSIDERATION
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STRUCTURAL AND
PHYSIOLOGIC
Loss of neuron occurs, leading to a
decrease in the number of synapse and
neurotransmitters. result slowed nerve
conduction and response time.
Brain weight is decreased and the
ventricle size increases to maintain cranial
nerve volume.
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Cerebral blood flow and metabolism arereduce slower mental function
Temperature regulation less efficient
PNS myelin is lost- decrease conductionvelocity in some nerves
Visual/auditory degenerates loss of
visual acuity and hearing Taste buds atrophy and nerve cells in the
olfactory bulb degenerate
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Nerve cells in the vestibular, cerebellum,proprioception pathways leading to balancedifficulties
Deep tendon reflex
can be decreased or insome absent
Hypothalamic is modified stage IV sleep isreduced
Autonomic nervous response
over slowing
Pupillary responses reduced or may notappear at all in the presence of cataracts.
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MOTOR ALTERATION
Reduced nerve input decreased strength
and agility, with increased reaction time.
Gait is slowed and wide based.
Changes making it difficult in maintaining
balance, predisposing the older person to
falls.
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SENSOR ALTERATION
Tactile sensation dulled due to adecrease in the number of sensoryreceptors.
Sensitivity to glare, decreased peripheralvision and a constricted visual field due todegeneration of visual pathways resulting in disorientation, especially atnight when there is a little or no light in theroom.
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Loss of hearing contribute to confusion,
anxiety, disorientation, misinterpretation of
the environment, feelings of inadequacy
and social isolation.
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TEMPERATURE REGULATION
AND PAIN PERCEPTION
May feel cold more readily than heat
require covering when in bed
Painful stimuli decreased
Two pain syndromes that are common in
the neurologic system in older adults are:
a. Diabetic neuropathiesb. Postherpetic neuropathies
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MENTAL STATUS
Change in mental status should never be
assumed to be a normal part of aging.
Delirium (mental confusion, usually with
delusions and hallucinations) is seen in
elderly who have underling CNS damage
or are experiencing an acute infection
such as infection, adverse medicationreaction or dehydration.
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NURSING IMPLICATION
Visual and hearing deficits requireadaptations in activities such aspreoperative teaching, diet therapy and
instructions about new medications. When using visual materials for teaching
or menu selection adequate lightingwithout glare, contrasting colors, and largeprint are used to offset visual difficultiescaused by
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