Care Disparities Among Age Groups, As They Relate To Heart Failure, Kidney Disease, Diabetes and HypertensionAs a group, the diagnoses of heart failure, kidney disease, diabetes and hypertension are all closely interlinked and affect an ever-increasing segment of the American population. Each diagnosis can be present on its own, or be cause or result of any of the other three. They all present in relatively consistent ways, and are generally manageable with medication and lifestyle changes. Obesity and smoking are common denominators among all four diseases and any treatment plan will include weight management, as well as smoking cessation. Nursing care models for patients with those or related diagnoses are evidenced based and well established. That said, for a nurse practicing in a period of historic demands on healthcare by people over 65, it is imperative he be aware of any differences in approach to the nursing process for different age groups. Are the signs and symptoms the same for the older adult? Are there variances in appropriate laboratory values for younger adults? How does age determine general treatment regimens for these diseases? Finally, and most important, how does it impact effective nursing care?Heart failure is the leading cause of death among Americans. It is responsible for 27% of all deaths for those over 65 (Minino, 2012). For ages 45-64 that number drops to 21%, and lower still to 12% in the 25-44 set. Causes of CHF in the older adult include, While it is clear that heart failure is overwhelmingly more prevalent among the elderly, signs and symptoms are generally the same. Clinical manifestations for CHF include: SOB, dyspnea, swelling, crackles, peripheral edema, fatigue, nausea, and low O2 sats. Key laboratory indicators also seem to be consistent between age groups. Appropriate ranges for BNP, H&H, BUN/Creatinine, Albumin, Na, K, Mg, liver function tests, thyroid studies, ABG's, PTT are just as crucial for both patient groups. The approach to treatment for CHF includes lifestyle modification for patients of all ages. Weight management, smoking cessation, dietary changes and exercise are important for all patients with heart failure, but there are some differences in drug therapy. Beta-blockers, ACE inhibitors, diuretics, ARB's and CCB's remain the standard; however, doses for these medications in older adults should be about half of what would be prescribed for younger adults (Meiner 2011). Ultimately, nursing interventions for CHF patients are very similar, regardless of age. It is just as important for the nurse to monitor heart rate, BP, heart sounds, urine output, lab values, and ECG whether the patient is old or young.Like heart failure, chronic kidney disease affects the aged disproportionately compared to younger adults. According to the US Department of Health and Human Services, 26% of the population over 60 is in stage 3 CKD. Meanwhile, only 0.2% of those between 20 and 39 are affected. Also similarly,...
