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Musculoskeletal System Changes
Elders have decreased physical strength and agility because of changes in bones, muscles, and joints. Muscle cells atrophy so there is a loss of lean muscle mass. Bone density is decreased, leading to osteoporosis and an increased risk of fractures. Degenerative “wear and tear” changes occur in the joints (Miller, 2004). These musculoskeletal changes affect mobility and in-crease the risk of falls. Clinical Alert. Take special precautions while turning or lifting older adults and having them walk. Practice fall precautions. Carefully examine the patient if there is any possibility of compression fractures, Colles’ fractures of the wrist, and hip fractures. Be aware of exposure factors, and use combinations that will minimize voluntary and involuntary motion. Consider changes in the absorption coefficient of parts due to aging changes and pathological changes. Be prepared to accommodate alterations to positioning criteria through alternate positions of the x-ray tube and image receptor when the patient is unable to move into or maintain a particular position. Know your facility’s fall prevention and restraint policies.
Cardiovascular Changes
As people age, blood vessels become less elastic and the wall of the heart thickens. Cardiac reserve is diminished, leading to decreased performance under stress. Changes include a tendency toward orthostatic hypo-tension and a gradual increase in systolic blood pressure. The peripheral circulation decreases, especially in the feet, increasing the risk of injury to the lower extremities. Cardiovascular changes can cause dizziness, syncope, and fatigue (Lakatta, 2000). Clinical Alert. Observe clients for decreased endurance. Be specific when assessing cardiac status by asking questions such as, “Are you tired?,” “Are you comfortable?,” “Do you feel faint?,” and “Can you continue with more x-ray images?” Dizziness and syncope contribute to the risk of falling. Have the client sit up for a minute or so before standing to allow blood pressure to stabilize. Be especially careful to avoid in-jury to the lower extremities when positioning patients.
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