Respiratory Flashcards
age-related changes to the respiratory system
- increased stiffness of chest wall
- enlarged alveoli
- weaker respiratory muscles
- decreased response to hypercapnia or hypoxia
Risk Factors that Affect Respiratory Function in Older Adults
- tobacco smoking
> > drug-nicotine interactions - environmental pollutants
- occupational exposure to respiratory toxins
> > asbestos - obesity or chronic illness that interferes w/ the ability to obtain physical activity
- kyphosis
- meds
> > anticholinergics dry up upper airway
> > angiotensin-converting enzyme (ACE) inhibitors can cause persistent cough
upper vs lower
separate upper (bronchus up) and lower respiratory tracts (lungs)
- structure
- function
lower = gas exchange
functional consequences
- pneumonia and influenza
- fragility, dysphagia, serious illness and reduced functional status
- poor oral care
functional consequences
– aspiration pneumonia
- most commonly related to dysphagia
risk factors: - general debility
- decreased LOC
- decreased cough reflex
- reduced salivary flow
- compromised immune function
functional consequences
– TB
increased susceptibility to TB
- due to weaker immune systems
COPD
chronic obstructive pulmonary disease
- causing SOB from over inflated alveoli and damaged lung tissue involved in O2/CO2 gas exchange
risk factors:
- smoking (primary cause)
- exposure to second-hand smoke/other air pollutants
- increased age
- genetic predisposition
- low socioeconomic status
- hx of significant childhood respiratory disease
COPD symptoms
- chronic productive cough worsening dyspnea especially w/ exertion
- wheezing and chronic sputum production
- barrel-chest over time due to trapped air in the lungs
- chest tightness
- fatigue
- cyanosis of the fingernail beds and lops
COPD is …
progressive and cumulative
COPD treatment summary
bronchodilators
> nebulized, metered dosed inhalers or MDIs
inhaled steroids
> nebulized or MDI
oral steroids
> exacerbations of COPD only
continuous or intermittent O2 therapy
> later stages
pneumonia
def: infection in one or both lungs which causes the alveoli to fill with fluid or pus, making breathing difficult
risk factors:
- age
- recent upper respiratory illness
- asthma/COPD/CHF/ other chronic diseases
- smoking
- weakened or suppressed immune system
symptoms of pneumonia
present atypically in OA
normal adult:
- cough, fever, purulent sputum, SOB, fatigue, chest
tightness/pain
older adults often present additionally with:
- acute delirium/ confusion
- dizziness
- lower than normal body temperature (cold vs warm sepsis, with T < 36 C)
treatment for pneumonia
antipyretics for fever
> acetaminophen
antibiotics
> if bacterial vs viral
bronchodilators
> if wheezes present
O2 therapy
> if needed
deep breathing and coughing
> incentive spirometer
TB
def: bacterial infection (caused by the
Mycobacterium tuberculosis) that most commonly affects the lungs
- now a curable and preventable condition in most developed countries
- spread person-to-person through aerosolized
droplets
- need minimal exposure to become infected
- often occurs in North American older adults due
to reactivation of dormant disease
> nurses need to know older adults’ Past Medical
History (PMHx)
risk factors for TB
- persons who have been recently exposed to
someone with active TB - persons who have come from a country where TB
is endemic - persons with weakened immune systems related
to chronic disease or high risk behavior:
> HIV+
> malnourished
> cancer patients
> IV Drug users
> those on immunosuppressive drugs
