January 2006, Volume 36 Number 1 , p 66 - 67
LITWACK, KIM RN, CFNP, PhD, FAAN
FOUR OUT OF TEN patients facing surgery are older than 65. Are you prepared to provide perioperative care that meets their age-related needs? In this article, I'll explain how to use a systems approach to assess for age-related physiologic changes and plan your care accordingly.
With aging, all major vessels lose significant elasticity. This progressive stiffening with age contributes to increased systolic blood pressure, adding to atherosclerotic changes caused by lifestyle, genetic factors, or coexisting disease. Atherosclerosis reduces organ perfusion, decreases the compliance of blood vessels, and increases afterload, all of which increase myocardial work. With age also comes:
* left ventricular hypertrophy. The left ventricle works harder to eject blood into a more rigid aorta. * progressive valvular incompetence. The leaflets of heart valves, and especially of aortic valves, become thicker ...