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ACE Nursing Education

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For a number of reasons, disease can present differently in an older adult than in a younger person. The older adult may not develop fever in response to infection, may experience increased falling as a symptom of urinary tract infection, or develop confusion as the only symptom of acute myocardial infarction. This article reviews presentation of common illnesses in the older adult, as well as critical indicators of underlying conditions. Click on the following link to go to the website, print and read the article. Then, print, answer and submit the following test to your manager or educator.

Lippincott's Nursing Center.com – resources for better care

Presentation of Illness in Older Adults
Elaine J. Amella PhD, APRN, BC
ANJ, October 2004, Vol 104 (10):40-51

Post Test

T/F 1. Disease may present differently in the person over 65 than it would in a younger person.

T/F 2. People over 65 often take more medications than younger people.

T/F 3. Older Adults may not produce fever in response to infection.

T/F 4. Confusion is normal in older adults.

T/F 5. One common cause of confusion in the elderly is medication.

T/F 6. Urinary tract infection can cause mental confusion in the older adult.

T/F 7. Older adults are less likely to become thirsty.

T/F 8. People with dementia do not feel pain.

T/F 9. New onset incontinence is to be expected with aging.

T/F 10. Decreased functional ability can be a sign of infection in the elderly.

T/F 11. Appendicitis has a 70% mortality rate in the older adult population.

The department of internal medicine is developing evidence based clinical protocols which will be available in EPIC (as order sets) for use when admitting patients with these diagnoses. Their AIM is to standardize care and decrease length of stay and readmission rates.

Currently available protocols are:
  • CAP - Community Acquired Pneumonia Orderset
  • Congestive Heart Failure (CHF)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Diabetic Ketoacidosis Adult, ICU
  • General Medicine Admission
  • Immunodeficiency Flow Panel
  • MICU/CCU Admission Order Set
  • Oral Analgesic Medicaitons
  • Parenteral Opioids
  • Sepsis, Adult ICU
  • 111 - Stroke Alert
  • 112 - Stroke Activation
  • 300086 - Stroke Floor Admission
  • 3000000001 -  Stroke Critical care without tPA
  • 300088 Stroke - Transfer from Critical care to floor
  • 3004002 - Stroke Discharge

All protocols can be found in the EPIC order set section.

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