I fixed my computer, so here is question #28

#28 Discuss the age related changes of each system in the elderly and what problems could arise.

Integumentary
Due to decrease in sebaceous gland activity and tissue fluid, we see increased skin dryness. Due to decreased vascularitiy, we see increased skin pallor. Due to reduced thickness and vascularity of the dermis; loss of subcutaneous fat, we see an increased skin fragility. Due to loss of skin elasticity, increased dryness, and decreased subcutaneous fat, we see progressive wrinkling and sagging of the skin. Due to clustering of melanocytes, we see brown age spots on exposed body parts e.g. face, hands, and arms. Due to reduced number of unction of sweat glands, we see decreased perspiration. Due to progressive loss of pigment cells form the hair bulbs, we see thinning and graying of scalp, pubic, and axillary hair. Due to increased calcium deposition, we see slower nail growth and increased thickening with ridges.
Neuromuscular
Due to decrease in muscle fibers, we see decreased speed and power of skeletal muscle contractions. Due to diminished conduction speed of nerve fibers and decreased muscle tone, we see slowed reaction time. Due to atrophy of intervertebral discs, we see loss of height. Due to bone demineralization, we see osteoporosis. Due to deterioration of joint cartilage, we see joint stiffness. Due to decreased muscle reaction time and coordination, we see impaired balance.
Sensory/perceptual
Due to degeneration leading to lens opacity (cataracts), thickening, and inelasticity (presbyopia), we see loss of visual acuity. Due to changes in the ciliary muscles; rigid pupil sphincter; decrease in pupil size, we see increased sensitivity to glare and decreased ability to adjust to darkness. Due to fatty deposits, we see partial or complete glossy white circle around the periphery of the corneas. Due to changes in the structures and nerve tissues in the (presbycusis) inner ear; thickening of the eardrum, we see progressive loss of hearing. Due to decreased number of taste buds in the tongue because f tongue atrophy, we see decreased sense of taste, especially the sweet sensations at the tip of the tongue. Due to atrophy of the olfactory bulb at the base of the brain, we see a decreased sense of smell. Due to possible nerve conduction and neuron changes, we see an increased threshold for sensations of pain, touch, and temperature.
Pulmonary
Due to decreased elasticity and ciliary activity, we see decreased ability to expel foreign or accumulated matter. Due to weakened thoracic muscles; calcification of costal cartilage, making the rib cage more rigid; dilation from inelasticity of alveoli, we see decreased lung expansion, less effective exhalation, reduced vital capacity, and increased residual volume. Due to diminished delivery and diffusion of oxygen to the tissues to repay the normal oxygen debt because of exertion or changes in both respiratory and vascular tissues, we see difficult, short, heavy, rapid breathing (dyspnea) following intense exercise.
Cardiovascular
Due to increased rigidity and thickness of heart valves (hence decreased filling/emptying abilities); decreased contractile strength, we see reduced cardiac output and stroke volume, particularly during increased activity or unusual demands; may result in shortness of breath on exertion and pooling of blood in the extremities. Due to increased calcium deposits in the muscular layer, we see reduced elasticity and increased rigidity of arteries. Due to inelasticity of systemic arteries and increased peripheral resistance, we see increase in diastolic and systolic blood pressure. Due to reduced sensitivity of the blood pressure-regulating baroreceptors, we see orthostatic hypertension.
Gastrointestinal
Due to alterations in the swallowing mechanism, we see delayed swallowing time. Due to gradual decrease in digestive enzymes, reduction in gastric ph, and slower absorption rate, we see increased tendency for indigestion. Due to decreased muscle tone of the intestines; decreased peristalsis, we see increased tendency for constipation.
Urinary
Due to decreased number of functioning nephrons and arteriosclerosis changes in blood flow, we see reduced filtering ability of the kidney and impaired renal function. Due to decreased tubular function, we see less effective concentration of urine. Due to enlarged prostate gland in men; weakened muscles supporting the bladder or weakness of the urinary sphincter in women, we see urinary urgency and urinary frequency. Due to decreased bladder capacity and tone, we see a tendency for a nocturnal frequency and retention of residual urine.
Genitals
The exact mechanism is unclear; possible endocrine changes, we see prostate enlargement (benign) in men. Due to diminished secretion of female hormones and more alkaline vaginal pH, we see multiple changes in women (shrinkage and atrophy of the vulva, cervix, uterus, fallopian tubes, and ovaries; reduction in secretions; and changes in vaginal flora)

Pg404-5 Kozier, Fundamentals of nursing