Masalah Pada Usila Agus 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 temperature 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 appropriately 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 dermatologist 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 dowagers 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 appropriate to the

patients age and ability. Educate the client regarding weight-bearing exercises. Encourage the client to conduct a home safety check to avoid falls. The physician may recommend calcium supplements, dietary consultations, or estrogen replacement. The physician may limit phosphorus 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, arteriosclerosis) reflected as cerebrovascular 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 ophthalmologist.

Provide adequate lighting and use large-print books . Provide adequate retina lighting.

Ears
Loss of auditory hair cells (organ of Corti)

Ossicle becomes fixed

Manifestasi
Hearing loss in upper frequencies, 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 arteriosclerosis,

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 temperature 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 ambulatory 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 respiratory 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 incontinence 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 strengthening 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 distinguish 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 frequent 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 appropriate and to guard against communicable 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 itching and painful intercourse; osteoporosis Rectocele, cystocele, stress incontinence

Pendidikan
The physician may prescribe supplemental

estrogen. The physician may prescribe supplemental estrogen. Suggest exercises for strengthening the pelvic floor.

Male Reproductive System

Decreased penile and testicle size

Atherosclerosis and arteriosclerosis

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 nutrition to avoid atherosclerosis. Encourage the client to have yearly checks for BPH, and provide instruction regarding testicular selfexamination.