Questions to ask - Are you suffering from night sweats? Have you lost weight ? Have you been having low-grade fever? Have you been having SOB and coughing up anything from your lungs? Have you had chest pain? Where? Have you had weight loss?
Chronic inflammatory disease of the airways - bronchial linings overreact to various stimuli- causes episodic smooth muscle spasms that severely constrict the airway - thickened secretions & mucosal edema further block the airways.
Acute symptoms last from minutes to hours, to days and then periods without symptoms
Most common chronic disease of childhood
Risk Factors: allergy, chronic exposure to airway irritants of allergens, stress, exertion, sinusitis
Clinical Manifestations: SOB on exertion, use of accessory muscles to breath, late cough after onset of SOB (if productive sputum- scanty & mucoid), “pink puffer”, barrel chest (increase in anterior-posterior diameter of chest), thin in appearance, diminished breath sounds & prolonged expiration, speaks in short jerky sentences, anxious
Injury allows air to leak into pleural space during inspiration- prevents air from leaking out during expiration
Each inspiration-amount of air increases- becomes trapped to point causing increased thoracic pressure- pushes the heart, vena cava, and aorta out of position (mediastinum shift)- results in poor venous return to heart - leads to poor cardiac output
Medical emergency- disruption of cardiac output & respiratory distress
Be concern about any changes in orientation. This may be a first indication of pneumonia in older adults.
Be cautious in fluid administration. Overhydration may initiate CHF.
Older clients may become confused with multiple drug therapies and may not follow the regimen correctly. Theses clients may need assistance to ensure proper administration. In older clients, the thoracic muscles are weaker which may make the older adult unable to tolerate the increased work of breathing required of COPD.
Older adult clients have fewer alveoli than younger adults- oxygen exchange will be even more impaired in older adult clients with COPD.