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    ROS Corazon Rodriguez

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    Vito Vito
    (+) Right sided weakness, altered consciousness, pale appearance, and tracheostomy tube indicate patient has basal ganglia bleeding affecting motor and sensory functions. (+) Uneven skin color, brittle nails, thin hair, dry skin, and stage 2/3 bedsores on left foot show physiological changes of aging and inability to turn on time. (+) Cardiovascular changes like decreased arterial elasticity and increased stiffness cause isolated systolic hypertension, diastolic dysfunction, and conduction defects often seen in elderly patients.

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    ROS Corazon Rodriguez

    Uploaded by

    Vito Vito
    37 views3 pages
    (+) Right sided weakness, altered consciousness, pale appearance, and tracheostomy tube indicate patient has basal ganglia bleeding affecting motor and sensory functions. (+) Uneven skin color, brittle nails, thin hair, dry skin, and stage 2/3 bedsores on left foot show physiological changes of aging and inability to turn on time. (+) Cardiovascular changes like decreased arterial elasticity and increased stiffness cause isolated systolic hypertension, diastolic dysfunction, and conduction defects often seen in elderly patients.

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    (+) Right sided weakness, altered consciousness, pale appearance, and tracheostomy tube indicate patient has basal ganglia bleeding affecting motor and sensory functions. (+) Uneven skin color, brittle nails, thin hair, dry skin, and stage 2/3 bedsores on left foot show physiological changes of aging and inability to turn on time. (+) Cardiovascular changes like decreased arterial elasticity and increased stiffness cause isolated systolic hypertension, diastolic dysfunction, and conduction defects often seen in elderly patients.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    37 views3 pages

    ROS Corazon Rodriguez

    Uploaded by

    Vito Vito
    (+) Right sided weakness, altered consciousness, pale appearance, and tracheostomy tube indicate patient has basal ganglia bleeding affecting motor and sensory functions. (+) Uneven skin color, brittle nails, thin hair, dry skin, and stage 2/3 bedsores on left foot show physiological changes of aging and inability to turn on time. (+) Cardiovascular changes like decreased arterial elasticity and increased stiffness cause isolated systolic hypertension, diastolic dysfunction, and conduction defects often seen in elderly patients.

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    of 3

    Review of System/Physical

    Date: September 2, 2016

    Time: 10:00 AM

    System

    A. General/Overall
    Health Status

    ROS

    Mode of
    Assessmen
    t

    No verbal
    cues

    Inspection and
    palpation

    Ideal

    There should be no sign of pain. Appearance is clean, no body


    odor, neatly dressed according to the environment. The patient
    should exhibit body symmetry. No obvious deformity and a well
    appearance.
    Physiological changes in elderly patients:
    The dermis decreases in thickness by about 20%. As it thins it
    loses vascularity, cellularity and sensitivity. Its ability to exchange
    or retain internal heat is diminished. The skin becomes thin, fragile
    and slow to heal. Sweat and sebaceous glands are reduced both
    in number and effectiveness. Sensory neurons are decreased by
    30% from the age of 10 years to 90 years old.
    Subcutaneous fat deposition is altered in the elderly. Muscle,
    blood vessels and bone become more visible beneath the skin
    due to thinning of subcutaneous fat on the extremities. Fat
    deposition occurs mainly on the abdomen and thighs.

    B. Integument (skin,
    hair, nail)

    No verbal
    cues

    Inspection and
    palpation

    The skin is uniform in color, unblemished and no presence of any


    foul odor. Skin should be dry with a minimum of perspiration. No
    breaks in the skin, scars, lesions, wounds, redness or irritation.
    Skin turgor, color, temperature and moisture of the skin are within
    the normal limit. Skin should be dry with minimum perspiration.
    Moles may be presence, but no changes in shape, color or size.
    Hair should be thick and silky; it should be evenly distributed and
    has a fair amount of body hair. There are also no signs of infection
    and infestation observed. The nails should be light brown and has
    the shape of convex curve. The nail surface should be smooth and
    is intact with the epidermis. When nail bed is pressed the nails
    should return to usual color in less than 4 seconds.
    Physiological changes in elderly patients:

    Ecchymoses may occur readily when skin is traumatized,


    often on the forearm, because the dermis thins with aging.

    Uneven tanning may be normal because melanocytes are


    progressively lost with aging.

    Longitudinal ridges on the nails and absence of the

    Observed

    (+) Right sided weakness


    (+)Altered Consciousness
    (-) Verbal cues
    (+) O2 Therapy 10.5 L/min via
    T-Piece
    (+) Left Heparin lock
    (+) asymmetrical face
    (+)Frail Looking
    (+) Pale
    (+) Tracheostomy tube

    (+) Uneven Skin color


    distribution
    (+) brittle nails
    (+) Toe nails (yellow)
    (+) Long toe nails
    (+) thin gray hair
    (+) Foul Odor
    (+) Dry skin
    (+) Warm skin temperature
    (+) Stage 2/3 bedsores on left
    posterior foot , scattered
    formation in 2-5 mm diameter
    (+) Poor Skin Turgor
    (+) Moles in about 2mm
    - Neck
    - Chest
    - Shoulder

    Significance

    Due to Basal Ganglia


    bleeding it affects the
    patients control of motor,
    sensory, sleep, conscious
    level, regulation of
    neurotransmitters and other
    functions of CNS resulting to
    Altered Consciousness, no
    verbal cues and right sided
    weakness significant to
    patient.

    Presence of Bedsores in the


    Left posterior of foot is due to
    inability to turn patient in
    ordered time. Patient prefers
    to bend her legs which led to
    sores on her foot.
    Other observed changes is
    normal physiologic changes
    of the elderly

    Cardiovascular Changes
    The changes in the cardiovascular system associated with aging are a decrease in elasticity and an increase in stiffness of the arterial system. This results in increased afterload on the left
    ventricle, an increase in systolic blood pressure, and left ventricular hypertrophy, as well as other changes in the left ventricular wall that prolong relaxation of the left ventricle in diastole. There is a
    dropout of atrial pacemaker cells resulting in a decrease in intrinsic heart rate. With fibrosis of the cardiac skeleton there is calcification at the base of the aortic valve and damage to the His bundle
    as it perforates the right fibrous trigone. Finally there is decreased responsiveness to beta adrenergic receptor stimulation, a decreased reactivity to baroreceptors and chemoreceptors, and an
    increase in circulating catecholamines. These changes set the stage for isolated systolic hypertension, diastolic dysfunction and heart failure, atrioventricular conduction defects, and aortic valve
    calcification, all diseases seen in the elderly.

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