Please respond to the following write ups in about 8-10 sentnces with atleast 2 APA refrences 

Work 1 

Three ways in which the changes common to aging can be delayed

There are multiple statements about how sedentary lifestyles contribute to increased health problems throughout life, particularly when it comes to aging and the elderly. Routine physical exercise increases cardiac output and ventilation, which slows tissue changes associated with senescence by improving nutrition and oxygenation to the cells (Hubert & VanMeter, 2018). Weight bearing exercise helps to decrease risk for osteoporosis, and exercise can limit changes associated with aging to the cardiovascular system as well (Hubert & VanMeter, 2018). The immune system is also affected with aging, putting patients at higher risk for repeat inflammation or infection. Regular physical activity can also prevent immunosenescence and improve the effectiveness of the annual influenza vaccine without negative side effects that patients have the potential of occurring with prescription medications (Sellami et al., 2018).

Maintaining a healthy diet is another way that the common changes of aging can be delayed. Dietary intakes affects multiple body systems when it comes to aging. Too much dietary intake of fats and cholesterol puts patients at higher risk for atherosclerosis. The risk for atherosclerosis already increases with age due to the thickening of arteries (Hubert & VanMeter, 2018). Calcium, Vitamin C and Vitamin D are all associated with musculoskeletal health. These nutrients should be consumed throughout life to maintain a healthy system, but in the geriatric population it becomes important due to the risk of osteoporosis from the natural aging process that results in loss of calcium from the system (Hubert & VanMeter, 2018).

Many people worry about their cognitive status when they age. In my family, every woman on the paternal side for the last three generations has died with some type of cognitive impairment related to aging, most commonly Alzheimer’s- which makes this topic all the more interesting for me. Social interaction and cognitive activities that involve problem solving like puzzles, reading, and card games, reduce senescence in the central nervous system (Hubert & VanMeter, 2018). In one study that looked at social interaction among elderly community residents, positive correlations were made between maintaining social interaction and preventing cognitive decline. The study also found that maintaining healthy relationships by going out and making time for leisure activities by using the recreation center prevented cognitive decline as well (Kimura et al., 2017)

Patient example for labs and diagnostic tests

Mrs. C.T., a 78 year old woman, states that she is having hip and knee pain after a fall that she had a week ago. She states she lives alone in her apartment on the ground floor and only leaves to go to church, the grocery store, and to get a haircut. Her hobbies include sitting at the table watching the birds and knitting. She is on a fixed income and usually eats canned meats and vegetables.
Bone density scans show that her bone density is low. X-Ray shows fractures of the long bones of one of her legs. Her bones appear porous and brittle. Mrs. C.T. would benefit from dietary of calcium, Vitamins A and C to strengthen her bones, and regular weight bearing exercise to prevent complications of osteoporosis.

Results of new knowledge that impact plan of care

Teaching patients how to modify their dietary intakes based on age and risk factors is important to preserve their health status and help to delay some of the negative changes of aging. Many aging people are unaware of the diet changes that need to be made for a healthy lifestyle. Teaching this to patients is primary and secondary prevention for cardiovascular diseases (Kolarzyk et al., 2018). Teaching patients about how to maintain an active lifestyle is important as well to reduce many health problems related to more sedentary activity. Encouragement of geriatric patients to go to the recreational center to engage in physical activity and social interaction would address many of the aging protective needs of this population.

Work 2

Major physiological changes associated with decreased sex hormones release to the body

Men

The purpose of this discussion will be to address the physiological changes seen in the aged related to the decreased secretion of sex hormones in the body. The major sex hormone testosterone peaks in early adulthood for men with a drop of about 1 % each year after age 30, changes are generally seen later in life and function does not completely end (Hubert & VanMeter, 2018). Aging has been described as a mild chronic proinflammatory process (Frungieri et al., 2018). Untreated inflammation from trauma, infections agents or medications of the male sex organs can lead to infertility, benign prostatic hyperplasia (BPH), and elevated prostate-specific antigen (PSA) (Frungieri et al., 2018). Older men are at risk for prostate cancer due to chronic inflammation, cyclooxygenase 2 (COX2) a key enzyme of prostaglandins is excessively produced (Frungieri et al., 2018). Treatments to decrease risk for development of inflammatory process include nonsteroidal anti-inflammatory drugs for example aspirin, soy and green tea (Frungieri et al., 2018). 

Women
The major sex hormonal changes occur in women around age 50, the ovaries stop producing estrogen and progesterone causing the anterior pituitary gland to raise the serum levels follicle-stimulating hormone (FSH) and luteinizing hormone (LH); ovulation begin to cease, the menses terminate with dropping estrogen and progesterone levels (Hubert & VanMeter, 2018). Older women experience thinning of vaginal mucosa, loss of elasticity, decreased glandular vaginal and cervical secretions causing inflammation, and dyspareunia (Hubert & VanMeter, 2018). Despite these findings, women appear to be immune privileged, they often respond to different vaccines with stronger humoral response offering greater protection overall (Giefing-Kröll et al., 2015). Unfortunately, as the protective effects of estrogen cease, so do the protective immunological benefits, postmenopausal women have fewer total lymphocytes, mostly B and CD4, T lymphocytes (Giefing-Kröll et al., 2015). Treatments to help boost immune system include hormone replacement therapy (HRT), estrogen, increased B-lymphocytes and decreased pro-inflammatory cytokine production (Giefing-Kröll et al., 2015).

Patient example for labs and diagnostic tests, give an injection

Mr. B.B age 55 had a PSA 4ng/m/L. Upon exam reviewed results and discussed causes and options. Since Mr. B.B has no family history is a European man and therefore he has lower risk. A urine was sent, and it came back abnormal with bacteria greater than 10,000. He will be treated with an oral antibiotic Amoxicillin for 7 days for this urinary tract infection.
Mrs. AW age 53 has been feeling weaker over the last few weeks, no cough, shortness of breath or chest pain noted. Appetite intact no recent weight loss to note, vitals all stable. After further evaluation patient states she stopped taking her HRT and did not think that would cause her to feel so bad. She will resume meds ASAP. Mrs. AW agreed to also receive a shingles vaccine today, given to her left deltoid.

Results of new knowledge that impact plan of care

The aging process is full of surprises for both men and women. Men, despite decreasing testosterone, testes shrinkage, and decreased sperm production, men can still father a child, if their spouse is still of childbearing age (Hubert & VanMeter, 2018). Women get to enjoy the effects and protective nature of all the hormones until after menopause and then the real party begins with hot flashes, severe mood swings, sweating, insomnia, visual changes and headaches (Hubert & VanMeter, 2018). Both pts would need good education regarding current plan treatment and a 1-month follow-up care to maintain optimal health.