Masalah Pada UsilaAgus S UMS

Integumentary System

Loss of subcutaneous fat Loss of pigment Loss of elasticity Receding capillaries Slower reproduction of hair and skin cells Diminished oil and sweat production Erratic pigment and cell production

Manifestasi

Wrinkling, sagging, decreased ability to maintain hydration, less protection against tempera ture changes

Paler skin, graying hair, less protection against sun damage Increased incidence of trauma

Sallow skin, thicker nails Balding; thin, fine hair; slower healing

Dry, fragile skin; intolerance to heat Senile lentigines (liver spots) and keratoses (skin

thickening

pendidikan

Encourage the client to drink plenty of fluids and dress appro priately for climate changes.

Encourage the use of sunscreens with appropriate UV protection. Suggest using good lubricating lotions and bathing less often. Caution the client to guard against injuries.

Suggest ways to guard against injuries. Encourage the client to use good lubricating lotions

and bathe less often. Suggest ways to avoid becoming overheated.

Show the client how to conduct skin checks and consult a derma tologist with any concerns

Musculoskeletal System

Loss of muscle strength and size Loss of bone density Degenerative joint cartilage

Manifestasi

Loss of strength, flexibility, and endurance Vertebral compression with diminished height

and a dowager’s hump (abnormal spinal curvature); osteoporosis (abnormal bone porosity) with frequent fractures

Less clear margins with spurs of bone that restrict movement, degenerative joint disease (DJD), arthritis

Pendidikan

Suggest frequent exercise appro priate to the patient’s age and ability.

Educate the client regarding weight-bearing exercises. Encour age the client to conduct a home safety check to avoid falls. The physician may recommend cal cium supplements, dietary consul tations, or estrogen replacement. The physician may limit phos phorus intake

Nervous System

Slower nerve conduction Reduced cerebral circulation Referred circulatory problems

Manifestasi

Slower reaction time, slower learning, slower perception of pain with resulting increase in injuries

Loss of balance and vertigo (whirling sensation), frequent falls

Increase in cardiovascular diseases (atherosclerosis, arterio sclerosis) reflected as cerebro vascular accidents (CVA) (brain ischemia due to vessel occlusion), cerebral hypoxia, and transient ischemic attacks

Pendidikan

Allow extra time as needed and educate the client about possible hazards of delayed reaction times. Aim teaching at comprehension level. Encourage the client to con-duct home safety checks.

Have the client install bath rails, remove throw rugs, conduct a home safety check. Encourage the client to use ambulatory aids. Educate the client and family about the danger signs for cerebrovascular accidents and transient ischemic attacks

Mata

Less time spent in deep sleep Diminished adjustment of lens to

accommodation Lens cloud

Manifestasi

Less restful sleep, more frequent naps Presbyopia (farsightedness Cataracts (lens opacity) that dim Obtain a

referral to an ophthal‑ vision as less light reaches the mologist.

Provide adequate retina

Pendidikan

Allow the client rest periods as needed. Obtain a referral to an ophthal mologist.

Provide adequate light ing and use large-print books

. Provide adequate retinalighting.

Ears

Loss of auditory hair cells (organ of Corti) Ossicle becomes fixed

Manifestasi

Hearing loss in upper frequen cies, problems distinguishing Ch, S, Sh, and Z

Presbycusis (hearing loss), strains to hear, misses cues, inappropriate responses

Pendidikan

Obtain a referral to an otologist. Speak clearly, facing the client, in an area with few distractions.

Obtain a referral to an otologist. Speak clearly, facing the client, in an area with few distractions.

Other Senses

Diminished sense of smell Diminished sense of taste

Manifestasi

Loss of appetite, poor nutrition Loss of appetite, poor nutrition, may increase

use of salt or spices

Suggest dietary consultation. Suggest dietary consultation.

Encourage the use of spices rather than salt

Cardiovascular System

Atherosclerosis and arterio sclerosis, narrowing of vessels

Slower response time to demands for increased output Diminished function

Manifestasi

Loss of peripheral circulation, fatty plaques with resulting myocardial infarctions and CVAs, cold extremities, slower healing time, hypertension

Complaints of fatigue on exertion Pulmonary involvement with edema, dyspnea

Pendidikan

Encourage the client to exercise and to eat a balanced, low-fat, low-salt diet. Have the client dress appropriately for tempera ture changes and conduct a home safety check.

Help the client pace exercise and exertion. Educate the client regarding low-salt diets

and orthopneic position

Respiratory System

Stiffening costal cartilage Decreased gas exchange

Manifestasi

Decreased expansion and con-traction, barrel chest, decreased lung capacity

Fatigue and breathlessness on exertion, impaired healing due to insufficient oxygen, syncope (sudden drop in blood pressure)

Pendidikan

Educate the client about smoking hazards and emphysema. Encourage moderate exercise. Encourage the client to exercise, as appropriate, and to use ambu latory aids. Caution the client to guard against upper respiratory infections and to conduct a home safety check.

Encourage the client to drink adequate fluids to liquefy respi ratory secretions

Gastrointestinal System

Drying of secretions, including saliva Decreased enzyme activity Slower peristalsis

Manifestasi

Dry mouth, dysphagia (difficulty swallowing) Incomplete digestion, poor conversion of

nutrients with malnourishment Constipation, flatulence, indigestion Poor chewing function, choking on large

pieces, loss of appetite, poor nutrition Loss of teeth

Educate the client regarding oral hygiene and adequate fluid intake.

Encourage the client to eat small, frequent, well-balanced meals.

Suggest the client increase fluid and fiber intake. Have the client avoid laxative dependency. Refer the client to dentist and provide instruction regarding good oral hygiene. Suggest dietary counseling.

Urinary System

Decreased bladder capacity Decreased bladder muscle tone Fewer functioning nephrons

Manifestasi

Urinary frequency Urinary retention with resulting urinary tract

infections or incon tinence Less blood flowing through the kidneys to be

cleaned of wastes, creating possible lethal levels of medications or normal body wastes

Pendidikan

Encourage the client to respond to the initial urge to void. Suggest exercises for strengthen ing the pelvic floor. Urge the client to completely empty the bladder with each voiding.

Have the client increase fluid intake to maintain hydration

Endocrine System

Decreased enzyme activity

Manifestasi:

Menopause, glucose intolerance with non–insulin-dependent diabetes mellitus, slower metabolism

Pendidikan: The physician will supplement as needed.

Immune System

Diminished production and function of T cells and B cells

Diminished ability to distin guish self from other

Diminished defenses elsewhere (eg, gastrointestinal enzymes)

Manifestasi

Less resistance to illness Increase in autoimmune diseases Overload on compromised immune system

and more fre quent serious illnesses

Pendidikan

Encourage the client to obtain immunizations as age appropriate.

Educate the client regarding symptoms of autoimmunity. Encourage the client to obtain immunizations as age appropri ate and to guard against commu nicable diseases.

Female Reproductive System

Decreased egg production Decreased estrogen production Poor perineal muscle tone

Manifestasi

Menopause or climacteric “Hot flashes”; thinner, drier vaginal walls with

vaginal itch ing and painful intercourse; osteoporosis

Rectocele, cystocele, stress incontinence

Pendidikan

The physician may prescribe supplemental estrogen.

The physician may prescribe supplemental estrogen.

Suggest exercises for strengthen ing the pelvic floor.

Male Reproductive System

Decreased penile and testicle size Atherosclerosis and arterio sclerosis Benign prostatic hyperplasia (BPH)

Manifestasi

Loss of libido Impotence Urgency, frequency, nocturia, retention

Pendidikan

The physician may refer the client for counseling.

The physician may refer the client for counseling. Educate the client regarding good nutri tion to avoid atherosclerosis. Encourage the client to have yearly checks for BPH, and provide instruction regarding testicular self-examination.