Tabloski ch16 lecture

Gerontological Nursing
THIRD EDITION
CHAPTER
16
The Respiratory
System
Copyright © 2014, © 2010, © 2006 by Pearson Education, Inc.
All Rights Reserved

Learning Objectives
1. Define normal changes of aging of the
respiratory system.
2. Describe appropriate health promotion
and disease prevention guidelines
relating to the respiratory system.
3. Discuss the nurse’s role in caring for
older persons with respiratory
problems.
Gerontological Nursing, Third Edition
Patricia A. Tabloski

Learning Objectives
4. Classify common diseases of the
respiratory system.
5. Identify the nursing assessment
process and formulation of nursing
diagnoses relating to the respiratory
system.

Introduction
• During a normal day, the average
person takes 25,000 breaths and
inhales more than 10,000 liters of air.
• The lungs have a series of built-in
barriers and defenses to protect
function and life; however, with aging
and disease, damage to the lungs can
occur.

Anatomy and Physiology
• The respiratory system is composed of
the lungs, the airways leading to the
lungs, the blood vessels serving the
lungs, and the chest wall.
• The right lung has three lobes (upper,
middle, and lower). To leave space for
the heart, the left lung has two lobes
(upper and lower).

Anatomy and Physiology
• This coordinated system enables the
lung to perform its primary function of
rapidly exchanging oxygen from inhaled
air with the carbon dioxide in the blood.

Normal Changes of Aging
• The following changes occur in lung
structure and function with normal
aging:
– Stiffening of elastin and the collagen
connective tissue supporting the lungs
– Altered alveolar shape resulting in
increased alveolar diameter

Normal Changes of Aging
• The following changes occur in lung
structure and function with normal
aging:
– Decreased alveolar surface area
available for gas exchange
– Increased chest wall stiffness
– Stiffening of the diaphragm

Respiratory Diseases Common in
Older People
• Age-related changes in the lungs, years
of exposure to air pollutants and
cigarette smoke, and presence of
comorbidities may predispose the older
person to respiratory diseases and
pulmonary dysfunction.

Changes in Neurologic, Neuromuscular,
and Sensory Functions
• Aging results in neuron loss in the brain
and central nervous system
• Changes that can affect pulmonary
function

• Loss of muscle tone, exacerbated by
deconditioning, obesity, and sedentary
lifestyle
• Increased thoracic rigidity and
osteoporotic changes to the spine
(kyphosis)

• Use of medications that can cause
fatigue, depression of the cough reflex,
insomnia, dehydration, and
bronchospasm such as opioids,
diuretics, and beta-blockers
• Diagnosis of neurologic disease or
impairment (dementia, Parkinson’s
disease, stroke/ cerebrovascular
accident)

Common Respiratory Diseases
• Asthma
• Chronic Obstructive Pulmonary Disease
(COPD)
• Tuberculosis
• Lung cancer

Types of Respiratory Infections
• Pneumonia
• Acute bronchitis
• Pulmonary embolism
• Sinusitis
• Rhinitis
• Severe Acute Respiratory Syndrome
(SARS)
• Influenza

Asthma
• The gerontological nurse can greatly
improve the asthma management plan
by teaching the older patient and family
members about the peak flow meter
and diary so that asthma attacks can
be minimized or avoided.

Chronic Obstructive Pulmonary
Disease
• The nurse should investigate
community resources and availability of
smoking cessation support groups.

Disease
• Managing patients with COPD focuses
on the following broad goals:
– Careful assessment and monitoring of
the treatment of the disease
– Reducing risk factors (cigarette smoking
and environmental pollutants)
–Managing stable COPD and preventing
disease progression

Disease
• Managing patients with COPD focuses
on the following broad goals:
– Assessing and managing anxiety and
depression
–Mucolytic therapy
– Rehabilitation
–Managing exacerbations

Respiratory Infections
• Infections are a major cause of
respiratory illness.
• The gerontological nurse must be
cognizant of the atypical presentation
of respiratory infection in the older
person.

• Infections of the lower respiratory tract
are the sixth leading cause of death in
the United States and the fourth
leading cause of death in Americans
over the age of 65.

Lung Cancer
• The symptoms of lung cancer are
vague and mimic the symptoms of
other pulmonary illness, making
diagnosis difficult.

Lung Cancer
• Chronic cough, chest pain, shortness of
breath, fatigue, weight loss, and
frequent lung infections such as
pneumonia and bronchitis that do not
resolve with antibiotic treatment could
all be warning signs that indicate the
older person should be referred to the
primary care provider for further
testing.

Changes in Immune Function
• For older people, the overall decline in
immune function results in increased
susceptibility to tuberculosis,
pneumonia, and influenza.

• When the gerontological nurse suspects
pneumonia, health assessment should
include checking vital signs, inspecting
the thorax, and auscultating the lungs.
• The primary care provider probably will
request a chest X-ray.

Pulmonary Embolism
• Risk factors for formation of pulmonary
embolus include clotting disorders,
immobility, dehydration, recent
surgery, atherosclerotic changes in the
circulatory system, atrial fibrillation,
and obesity.
• Patients with leg swelling and duskiness
are at risk for pulmonary embolus.

Pulmonary Embolism
• Hypoxemia and hyperventilation are
suggestive of the diagnosis of
pulmonary embolus.
• The gerontological nurse can play a
vital role in the prevention of
pulmonary embolus by identifying
persons at risk and reducing risk
factors.

Tabloski ch16 lecture

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Tabloski ch16 lecture

Similar to Tabloski ch16 lecture (20)

More from stanbridge

More from stanbridge (20)

Tabloski ch16 lecture