Question

Mrs. S has recently been admitted to an assisted living community. At 75 – year-old retired nurse, she is able to function and independently perform most activities of daily living; however, she has experienced some minor injuries as a result of bumping into furniture in her room. Once, she tripped then walking from her dark bedroom to the brightly lighted bathroom during the night. Mrs. S is frustrated and claims she never had this problem in her home.

1. What can be done to prevent vision and hearing losses with aging?

2. Interview and make assessment of an older adult and identify if there will be possible impairment problem regarding sensory.

3. Explain your findings and give at least 4 nursing diagnosis, 10 nursing interventions with rationale.

Answer 1

answer 1 :

The steps that can be taken to prevent vision and hearing loss with aging are listed below:

Prevention of vision loss with aging :

The common problems seen with aging and eye are cataracts,diabetic retinopathy ,hypertensive retinopathy, glaucoma,presbyopias,eye dryness and eye trauma.These conditions are treatable if detected and treated early and avoidable by maintaing good general and eye health.

1.The cause of the vision loss due to diabetes is either due to cataract or glaucoma or retinopathy.Maintaining normal blood sugar levels by monitored treatment and early diabetes detection can prevent vision loss.

2.Uncontrolled high blood pressure causes increase risk of glaucoma and hypertensive retinopathy.Regular use of antihypertensives and low sodium diet can prevent hypertensive retinopathy.

3.Comprehensive eye examination including fundoscopy and intraocular pressure monitoring is of vital importance as an individual crosses the age of 35 ,especially in the diagnosis of glaucoma and retinopathy.Early detected glaucoma is treatable and can be controlled with medications,This helps to prevent vision loss.  

4.Pressure trauma to the eye,damage by UV radiation or foreign body can be prevented by using sun googles,suitable eye glasses and use of eye lubricants in cases of dry eyes.

5.Comprehensive health checkups including blood sugar examination,blood pressure measurements should be done at regular intervals after the age of 50 and necessary treatment should be undertaken to keep the sugar levels and blood pressure readings within normal range .

6.Use of a diet which is rich in fresh fruits and vegetables and antioxidant rich helps in the process of repair of the damaged cells, keeping  good general health and helps to prevent vision loss.

7. A diet rich in green leafy vegetables like spinach ,kale, carrots provide the necessary nutrition such as carotenoids  and Vitamin A which are essential for maintenance of vision.

8.Smoking must be stopped in order to prevent the harmful effects of smoking on the blood vessels and vision loss due to blood vessel damages.

9.Sunlight exposure must be restricted and protective goggles should be used In bright sunlight which protect eyes from the harmful effects of the ultraviolet radiation.These measures help to prevent the sunlight associated eye damage and vision loss.

10.Family history of glaucoma should prompt early check up of the intraocular pressure(early stages of glaucoma are often asymptomatic) and follow up at regular intervals so that the medications can be started early and glaucoma related blindness or vision loss can be prevented

All the above listed preventive measures  must be specifically focused upon as an individual ages to prevent the vision loss.

Prevention of hearing loss with aging

Inorder to prevent the loss of hearing loss with aging ,one must be careful with respect to the following points

1.Treat  any ear infection with ear discharge promptly and completely. Untreated infections can progress to ear damage and cause hearing loss in the long term.

2.Avoid the consumption of ototoxic drugs:long-term consumption of ototoxic drugs can cause hearing loss and hence no drugs should be consumed without physician monitoring.Some of the commonly used ototoxic drugs are painkiller like aspirin, diuretics like furesamide, antibiotics like gentamicin and vancomycin.All these must be taken only under physician supervision.

3.Barotrauma protection:Elderly individual must avoid high intensity sounds and take measures to protect his ears from barotrauma.Using sound dampeners or cotton balls are the simplest interventions which can prevent the high intensity sounds from causing ear damage and hearing loss.

4.Special precautions must be taken while cleaning wax from ears.Use of dirty or non sterile earbuds or pins must be avoided.These can predispose to ear trauma and ear  infection causing hearing loss.

5.Chronic diseases like hypertension, atherosclerosis, elevated levels of cholesterol and diabetes mellitus all can predispose to hearing loss by causing sensorineural changes in the ears and affecting the blood supply. Hence  these  chronic conditions must be diagnosed and treated at the earliest and general health precautions must be taken to maintain good health

6.Use of ear protectors especially while being around loud noises like drill machines,power Tools,vacuum pump or blowers is important to prevent hearing loss.

7.Listening to music at just about 50% of its volume has been recommended in order to protect the ears and prevent hearing loss.

8.Chronic Sinusitis can also affect hearing by causing fluid buildup in the middle ear and this must be treated in order to prevent hearing loss caused by chronic untreated sinus infection.

9.Smoking is an important cause of vessel wall damage and associated hearing loss and smoking must be avoided or totally stopped to prevent hearing loss with aging process.

All the above listed preventive measures  must be specifically focused upon as an individual ages to prevent the hearing loss.

Aging and sense of smell:

There is decrease in the perception of smell  with aging due to the damage to the nerve endings which become less sensitive .Also there is  decrease in the mucus in the nasal cavity which does not allow the odours to be retained for long so that they can be interpreted by the nerve endings These changes are generally seen after the age of 65 years and hence the sense of smell decreases with aging.