Aaronson L, Seaman L P
J Gerontol Nurs. 1989 Jul;15(7):29-34. doi: 10.3928/0098-9134-19890701-08.
The institutionalized elderly are at risk for developing fluid volume depletion with progression to hypernatremia. This is particularly common in patients transferred to an acute care setting from a nursing home. A marked reduction in intracellular fluid and the increase in body fat associated with normal aging predispose the elderly to water loss with very little environmental prompting. Conditions contributing to the development of fluid volume deficit include febrile illness, utilization of enteral supplements, gastrointestinal bleeding, use of loop diuretics, renal failure, prolonged vomiting, diarrhea, diabetes, and disability induced fluid restriction. This can lead to apathy and confusion, which are often incorrectly attributed to dementia. The utilization of Roy's Adaptation Model to this problem focuses on the regulator subsystem and the physiologic mode.
机构养老的老年人有发生体液量减少并进展为高钠血症的风险。这在从养老院转入急性护理机构的患者中尤为常见。随着正常衰老，细胞内液显著减少以及体脂增加，使得老年人在极少的环境诱因下就容易失水。导致体液量不足的情况包括发热性疾病、使用肠内营养补充剂、胃肠道出血、使用袢利尿剂、肾衰竭、长期呕吐、腹泻、糖尿病以及因残疾导致的液体限制。这可能导致冷漠和意识模糊，而这些症状常常被错误地归因于痴呆。将罗伊适应模式应用于此问题，重点关注调节子系统和生理模式。
