ASSESSMENT OF NEUROLOGIC GUNCTION

GERONTOLOGIC CONSIDERATION

STRUCTURAL AND PHYSIOLOGIC

Loss of neuron occurs, leading to a decrease in the number of synapse and neurotransmitters. result slowed nerve conduction and response time. Brain weight is decreased and the ventricle size increases to maintain cranial nerve volume.

 Cerebral blood flow and metabolism are reduce slower mental function Temperature regulation less efficient PNS myelin is lost- decrease conduction velocity in some nerves Visual/auditory degenerates loss of visual acuity and hearing Taste buds atrophy and nerve cells in the olfactory bulb degenerate

 Nerve cells in the vestibular, cerebellum, proprioception pathways leading to balance difficulties Deep tendon reflex can be decreased or in some absent Hypothalamic is modified stage IV sleep is reduced Autonomic nervous response over slowing Pupillary responses reduced or may not appear at all in the presence of cataracts.

MOTOR ALTERATION
Reduced nerve input decreased strength and agility, with increased reaction time. Gait is slowed and wide based. Changes making it difficult in maintaining balance, predisposing the older person to falls.

SENSOR ALTERATION
Tactile sensation dulled due to a decrease in the number of sensory receptors. Sensitivity to glare, decreased peripheral vision and a constricted visual field due to degeneration of visual pathways resulting in disorientation, especially at night when there is a little or no light in the room.

 Loss of hearing contribute to confusion, anxiety, disorientation, misinterpretation of the environment, feelings of inadequacy and social isolation.

TEMPERATURE REGULATION AND PAIN PERCEPTION

May feel cold more readily than heat require covering when in bed Painful stimuli decreased Two pain syndromes that are common in the neurologic system in older adults are: a. Diabetic neuropathies b. Postherpetic neuropathies

MENTAL STATUS
Change in mental status should never be assumed to be a normal part of aging. Delirium (mental confusion, usually with delusions and hallucinations) is seen in elderly who have underling CNS damage or are experiencing an acute infection such as infection, adverse medication reaction or dehydration.

NURSING IMPLICATION
Visual and hearing deficits require adaptations in activities such as preoperative teaching, diet therapy and instructions about new medications. When using visual materials for teaching or menu selection adequate lighting without glare, contrasting colors, and large print are used to offset visual difficulties caused by