Respiratory, Integumentary, Sleep & Thermoregulation

Question 1

Age-related changes for Respiratory

Answer 1

• increased stiffness of chest wall and trachea (calcification of cartilage)
• enlarged alveoli
• weaker respiratory muscles
• smaller and more fatty lungs
• decreased response to hypercapnia (high CO2) or hypoxia (low O2)

Question 2

3 Pathologic conditions for Respiratory

Answer 2

COPD
- chronic bronchitis AND emphysema (SOB from over-inflated alveoli and damaged lung tissue)
- chronic airflow obstruction
- 4th leading cause of death in Canada for OA
- risks: smoking, increased age, genetics, low socioeconomic status
- symptoms: chronic productive cough, SOB, wheezing, barrel-chest (trapped air in lungs), cyanosis

Pneumonia
- INFECTION in one or both lungs causing alveoli to fill with fluid/pus
- risks: smoking, increased age, asthma/COPD/CHF/other chronic diseases
- symptoms: cough, fever, purulent (pus) in sputum, chest tightness/pain, acute delirium/confusion, dizziness

Tuberculosis
- bacterial INFECTION in the lungs, curable and preventable
- risks: exposure, weakened immunity due to other diseases
- symptoms: persistent coughing, hemoptysis, chest tightness/pain

Question 3

Pressure ulcers

Answer 3

• any lesion caused by unrelieved pressure that damages underlying tissue
• braden scale used to predict risk for pressure sores (lower number = higher risk)
• recommendations to re-position at least q2hrs

Stages

1: discoloration of intact skin

2: partial thickness skin loss in epidermis and/or dermis

3: full-thickness skin loss in subcutaneous tissue

4: full-thickness skin loss with tissue necrosis extending to underlying bone, tendon, or joint capsule

Question 4

Obstructive Sleep Apnea (OSA)

Answer 4

• pathologic condition affecting rest through involuntary cessation of airflow for 10 seconds or longer
• 5-8 episodes/hour
• risks: obesity, diabetes, Parkinson’s, alcohol, genetics, CHF
• causes: muscles responsible for holding the throat open relax during sleep and block air passage
• symptoms: daytime fatigue, morning headaches, periods of loud snoring and sudden brief silence
• if untreated: associated with HTN, CVA, coronary artery disease, arrhythmias
• treatment: CPAP (continuous positive airway pressure)

Question 5

Age-related changes to thermoregulation

Answer 5

• reduced subcutaneous tissue
• reduced shivering
• reduced ability respond to heat
• reduced sweating
• reduced peripheral circulation
• inefficient vasoconstriction