老人生理健康評估與護理

• 1. Geriatric Nursing 1.1.2.2.1.1.2.2. Assessment of elderly- nutritional and Eliminated issues Hsiao Yu-Ling e mail yuling@tmu edu tw Assessment of elderly- nutritional and Eliminated issues Hsiao,Yu-Ling e mail yuling@tmu.edu.tw 141420 02-273616616329 () 1

2. Health-PerceptionHealth-Management Pattern Nutritional-Metabolic PatternNutritional Metabolic Pattern Elimination Pattern 2 3. 3 4. Nutritional-Metabolic Pattern (2003) 4 5. 22 (lean body mass) BMR 75-80 5 6. --- --- --- 6 7. Vit B 7 8. 8 9. 1/3 9 10. 10 11. 11 12. XX (achalasia)(motility disorders) disorders) 12 13. X (Substernal distress)distress) 13 14. B12 aspirineaspirine, tolbutamide, phenylbutazine, colchicine adrenal corticosteroidsadrenal corticosteroids 14 15. 15 16. 2 DB12 16 17. -- 17 18. - - 18 19. 19 20. 15~30 Vit C 20 21. 21 22. 22 23. phenothiaznes 23 24. , 24 25. (fi d ) ,(fixed stare) 25 26. CO CO2 amphetamine catecholamine , 1000mg/dl1000mg/dl 3500sm/l 26 27. /1/3 1991 27 28. 28 29. () () () ()( )()() ()( ) ) ( ) ( )() 29 30. ( h l )(Anthropometric evaluation) (Biochemical data) (Clinical evaluation)(Clinical evaluation) (Dietary intakes) 24 (Emotional status) (Functional assessment) 2003 30 2003 31. 31 32. 32 33. 33 34. 34 35. 35 36. (Diet history) (Standard(Standard Anthropometry /Biochemical measurements) 36 37. A A. () () 37 38. B. 4-5g/dl Total iron-binding capacity 205-410mg/dlTotal iron binding capacity 205 410mg/dl serumtransferrin Lymphocytes(TLC) urine urea nitrogen WMC Urinary creatinine creatinine height index 24hrs urine Hemoglobin hematocrit protein calorie intake Nitrogen balance obligatory Nitrogen loss Basel energy expenditure in K cal/day measure if allergyexpenditure in K cal/day measure if allergy- mediated immunity (skin testing) 38 39. positive socialization experiencespositive socialization experiences (TPN N l f di )(TPN Nasal feeding) 39 40. () 40 41. 41 42. ( b h k ) (seborrheic keratoses ) ,2-3 (sebaceous hyperplasia) (skin tageacrochordons) (cherry angioma) 42 43. (actinic keratoses solarkeratoses) (leukoplakia) (basal-cell vcarcinoma)(squamous-cell carcinoma) (malignant melanoma) 43 44. , (/) 44 45. para-aminobenzoic acid PABA ( )) (bathtub) (immersion)poorta- baty showerbaty,shower 45 46. BUN 46 47. 1 1. 2. 3 3. DM 47 48. 48 49. 49 50. 4 4. 5. 6. 7. 8 8. 9. 10. 50 51. Eli i i P Elimination Pattern 2004 51 52. 80-901/4 (1/2)(atherosclerosis)( / ) ( ) (GFR) GFR( )(GFR125ml/min)(GFR125ml/min 8097 ml/min1/3-2/3) 1080-90 BUN(70BUN 21 2mg/dl7 18 mg/dl)21.2mg/dl7-18 mg/dl) 52 53. 250-300ml300- 500ml 50 53 54. incontinence -- 54 55. 1 1. a. (1) (2) (3) (4)( ) b. c c. d. 55 56. (1) DysuriaDysuria (2) (2) 56 57. 2. a. b. c. d. e. 57 58. 3. 58 59. 1.() 2 2. 3. 4. 5. 6. 59 60. -- 60 61. 1.1. a. (1)(1) 61 62. (2) (3)(3) b. 62 63. 2. a. diverticulosisdiverticulosis b b. c. 3 3. 4. 4. 5. 63 64. 1 1. 2. 3. 64 65. 2004P.182 stress urinary incontinence urger urinary incontinenceurger urinary incontinence mixed incontinence overflow urinary incontinenceoverflow urinary incontinence functional incontinence efle in ontinen ereflex incontinence total incontinence 65 66. 1. 66 67. 2 2. (1) (1) (2) (3) (4) (5)(5) 67 68. 3. (1). (2).( ) (3). (4) (4). (5). ( ) (6). (7). 68 69. 69 70. 1 1. S2 4 S2~4 (S2~4) S2 4S2~4 2. 3. 70 71. 4. (1) (2) (3)( ) (4) (5) (6)(6) (7) 71 72. Nutritional-Metabolic Pattern Elimination Pattern ? Thank for your attention!Thank for your attention!Thank for your attention!Thank for your attention! 72