This document provides information on respiratory function and aging-related changes. It discusses how the lungs, airways, chest wall, and respiratory muscles undergo anatomical and physiological changes with normal aging. These include stiffening of lung tissue, decreased lung capacity and compliance, weaker respiratory muscles, and altered breathing patterns. Age-related changes in the immune system, cardiovascular system, and neurological function can also impact pulmonary status. Common respiratory conditions that affect older adults like COPD are then reviewed in terms of symptoms, diagnostic testing, treatment options, and nursing management.
Emphysema is defined pathologically as an abnormal, permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis. Together, emphysema and chronic bronchitis are known as Chronic Obstructive Pulmonary Disease (COPD), and involves the enlargement of the air sacs in the lung.
The damage is permanent - not reversible - and it causes reduced respiratory function. When the hazards of smoking are bought up, the most common disease discussed is
cancer and no one brings up emphysema. Although, most cases of COPD, and therefore emphysema, are caused by cigarette smoking.
Emphysema is rarely caused by a congenital condition known as α1-antitrypsin
deficiency, for which there is a lab test.
The most common symptoms are breathlessness, or a 'need for air', excessive sputum
production, and a chronic cough. However, COPD is not just simply a "smoker's
cough", but an under-diagnosed, life threatening lung disease that may progressively
lead to death.
Doctors diagnose COPD and emphysema with lung function tests to measure lung capacity. Spirometry is used in diagnosis - to measure the volume of air a patient can
blow out in one second after a deep breath.
Treatment does not halt or reverse lung damage but eases symptoms and prevents exacerbations. Drugs and supportive therapies are the mainstay of emphysema treatment.
Drugs may include inhaled bronchodilators, corticosteroids and, when there is an infection, antibiotics.
Support therapy includes oxygen supplementation, nutrition, help with smoking cessation, and other educational interventions.
Surgical intervention, including lung transplantation, is reserved for severe cases of emphysema.
People with emphysema and COPD should have an annual flu jab and may be recommended for a pneumonia shot once every 5 years.
Emphysema is defined pathologically as an abnormal, permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis. Together, emphysema and chronic bronchitis are known as Chronic Obstructive Pulmonary Disease (COPD), and involves the enlargement of the air sacs in the lung.
The damage is permanent - not reversible - and it causes reduced respiratory function. When the hazards of smoking are bought up, the most common disease discussed is
cancer and no one brings up emphysema. Although, most cases of COPD, and therefore emphysema, are caused by cigarette smoking.
Emphysema is rarely caused by a congenital condition known as α1-antitrypsin
deficiency, for which there is a lab test.
The most common symptoms are breathlessness, or a 'need for air', excessive sputum
production, and a chronic cough. However, COPD is not just simply a "smoker's
cough", but an under-diagnosed, life threatening lung disease that may progressively
lead to death.
Doctors diagnose COPD and emphysema with lung function tests to measure lung capacity. Spirometry is used in diagnosis - to measure the volume of air a patient can
blow out in one second after a deep breath.
Treatment does not halt or reverse lung damage but eases symptoms and prevents exacerbations. Drugs and supportive therapies are the mainstay of emphysema treatment.
Drugs may include inhaled bronchodilators, corticosteroids and, when there is an infection, antibiotics.
Support therapy includes oxygen supplementation, nutrition, help with smoking cessation, and other educational interventions.
Surgical intervention, including lung transplantation, is reserved for severe cases of emphysema.
People with emphysema and COPD should have an annual flu jab and may be recommended for a pneumonia shot once every 5 years.
Emphysema is a type of chronic obstructive pulmonary disease (COPD) involving damage to the air sacs (alveoli) in
the lungs. As a result, your body does not get the oxygen it needs. Emphysema
makes it hard to catch your breath. You may also have a chronic cough and have
trouble breathing during exercise.
The most common cause is cigarette smoking.
If you smoke, quitting can
help prevent you from getting the disease. If you already have emphysema, not smoking
might keep it from getting worse. Treatment is based on whether your symptoms
are mild, moderate or severe. Treatments include inhalers, oxygen, medications
and sometimes surgery to relieve symptoms and prevent complications.
Emphysema is a type of chronic obstructive pulmonary disease (COPD) involving damage to the air sacs (alveoli) in
the lungs. As a result, your body does not get the oxygen it needs. Emphysema
makes it hard to catch your breath. You may also have a chronic cough and have
trouble breathing during exercise.
The most common cause is cigarette smoking.
If you smoke, quitting can
help prevent you from getting the disease. If you already have emphysema, not smoking
might keep it from getting worse. Treatment is based on whether your symptoms
are mild, moderate or severe. Treatments include inhalers, oxygen, medications
and sometimes surgery to relieve symptoms and prevent complications.
Reading material on COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE) for Nursing students and teachers. It tells pathophysiology, clinical manifestations, diagnostic evaluations, medical and nursing management of COPD.
Chronic obstructive pulmonary disease (COPD)- Preeti sharmaEducate with smile
COPD is a type of obstructive lung disease and related conditions. it is very helpful presentation to you about information of COPD.
It includes all things that is definition, causes, symptoms, pathophysiology, diagnostic evaluation, types, treatment and role of nurses for COPD patient.
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Oxygen Insufficiency By - Jitendra Bokha .pptxJitendra Bokha
Oxygen is very essential component for living things so as a nurse it is fundamental to assess the level of oxygen in body, and if it is less than necessary action should be taken. Oxygen insufficiency can lead serious illness like lung diseases or breathing difficulties, heart conditions, or certain medical emergencies. When the body doesn't receive enough oxygen, it can lead to symptoms like shortness of breath, dizziness, confusion, rapid heart rate, and in severe cases, it can be life-threatening. Treatment typically involves addressing the underlying cause and, if necessary, providing supplemental oxygen therapy.
Toward the summarize today we are discussed introduction of o2 insufficiency, meaning & physiology of oxygenation, oxygenation results from the co-operative function of 3 major systems - respiratory/pulmonary system / haematological system / cardiovascular system / lung volumes and capacities / there are three steps in the process of oxygenation - ventilation, perfusion, diffusion / terminology related to ventilation & how its possible / regulation of respiration / factors affecting oxygenation - physiological factors / developmental factor & behavioural factors, environmental factors. Sign and symptom of inadequate oxygenation, etiological factors, disease / abnormalities which cause oxygen insufficiency/diagnosis & evaluation of the patient that who is having oxygen insufficiency, management of o2 insufficiency, nursing diagnosis and interventions.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Learning Objectives
1. Describe anatomic changes in the lungs
resulting from the normal aging process.
2. Describe age related changes in ventilation.
3. List nursing diagnoses for older adults with
respiratory diseases.
4. Identify nursing interventions and outcomes
for older adults with various respiratory
alterations.
5. Discuss smoking cessation methods and
interventions.
6. Identify risk factors for the development of
tuberculosis in older adults.
7. List the benefits of pulmonary rehabilitation
for older adults with chronic obstructive
pulmonary disease.
3. Respiratory System
Components
Lungs
Airways leading to the lungs
Blood vessels serving the lungs
Chest wall
5. Normal Aging Changes
Differentiatingnormal aging changes
from disease-related changes is difficult.
Lung structure and function with normal
aging include
Stiffeningof elastin + collagen connective
tissue supporting the lungs
Altered alveolar shape increased alveolar
diameter
Decreased alveolar surface area available
for gas exchange
Increased chest wall stiffness
6. Thoracic cage
The
ribs become less mobile and the
compliance of the chest wall
decreases
Osteoporosis and calcification of the
costal cartilage
Kyphosis or Scoliosis degeneration of
the intervertebral => shorter thorax
with an increased AP diameter
7. Respiratory muscles
Respiratory muscles weaken =>
Inspiratory and expiratory forces are
decreased
The diaphragm does not lose mass with
aging but it may flatten and become
less efficient specially in patients with
COPD
Older adults use the less efficient
accessory muscles of respiration such
as the
abdominals, sternocleidomastoid and
trapezius muscle
8. Breathing patterns
More dependent on intraabdominal
pressure changes and positioning
Normal rate of 16 to 25 breaths/min
Decrease in tidal volume (Vt)
Alveoli at the base of the lungs are
underventilated => hypoxemia and
hypercarbia
9. Lung Parenchyma
Progressiveloss of elastic recoil of the
lung parenchyma and conducting
airways => respiratory system
compliance decreases
Lungbecomes less elastic as
collagenic substances surrounding
the alveoli and alveolar ducts stiffen
and form cross linkages
10. Lung Capacity
Total lung capacity (TLC) changes
little with age
Vital capacity (VC) is decreased
Rate of reduction of VC is greater in
older men than in older women
Decreased compliance of the thorax
accounts for the increase in residual
volume (RV) and expiratory reserve
volume (ERV).
11. Lung Capacity
Inspiratorycapacity of older adults
is affected by the decreased ability
to take a deep breath
Functionaldead space ventilation
in increased from one third to as
much as one half of each breath
12. Airway
Affected by four factors:
(1) Size of the airway
(2) Resistance in the airway
(3) Muscle strength
(4) Elastic recoil.
When measured in the older
client, all of these indices are
decreased
Early airway closure is seen in older
clients
13. Alveoli
Alveoli decrease in number
Progressive loss of the intraalveolar
septum
Alveolienlarge because of dilation
of the proximal bronchioles
14. Immune system
Decrease in the number and
effectiveness of cilia => increased
difficulty in clearing secretions and
increased risk for the development
of respiratory tract infections
Alveolar macrophage activity is
defective
Decreased IgA
15. Gas Exchange
PaO2 falls at a rate of 4 mmHg per
decade of life.
A normal PaO2 for a 70 year old is
between 75 and 80 mmHg. “70 at
70”
Fall in PaO2 is most likely caused by
an increased closing volume during
tidal breathing.
16. Cardiovascular Changes
Affecting the Pulmonary System
Increased stiffness of heart + blood vessels
vessels less compliant to increased blood flow
demands
Impaired diastolic filling diastolic dysfunction
Increased left ventricular afterload systolic
dysfunction
Decreased cardiac output with rest and
exercise
oxygen-carrying capacity(hemoglobin x 1.34)
of the blood is reduced with age
The arterial pH of the older person remains
within normal adult range of 7.35 to 7.45
less increase in heart rate and a lower
response to increasing carbon dioxide
17. Normal Aging of Immune Function
Can Affect Pulmonary
Function
Decrease in the nature + quantity of
antibodies produced
Cilia less effective in removing debris
more foreign bodies in lungs
Decreased antibody production after
immunization
Use of medications suppress immune
function
18. Neurological Changes of
Aging and the Respiratory
System
Neuronloss in the brain and central
nervous system
Increased reaction time
Decreased response to multiple
complex stimuli
Impaired ability to adapt and interact
with the environment
19. Changes That Affect
Pulmonary Function
Loss of muscle tone
Exacerbated by deconditioning +
sedentary lifestyle
Increased thoracic rigidity
Osteoporotic changes to the spine
(kyphosis)
20. Changes That Affect
Pulmonary Function
Medication use
Fatigue
Depressed cough reflex
Insomnia
Dehydration
Bronchospasm
21. Changes Affect Pulmonary
Function
Diagnosis
of neurological disease or
impairment
Dementia
Parkinson’s disease
Stroke or CVA
Increasedanteroposterior diameter of
thorax barrel chest appearance
23. Exercise and Immobility
Exercisehas a positive effect on the
respiratory and cardiovascular
systems
24. Smoking
Smoking has long been known to damage
the lungs.
Recently prolonged exposure to
secondhand smoke has been shown to
damage the lungs of nonsmokers.
Heavy smokers may demonstrate a ninefold
increase in the reduction of Forced
Expiratory Volume over normal expected
reductions.
Cilia, which are paralyzed by nicotine, are
unable to clean the lungs
25. Smoking
Cigarette smoking causes
bronchoconstriction, increased airway
resistance and increased closing
volumes
Smoking interferes with gas exchange
because the carbon monoxide
byproduct competes with oxygen for
the hemoglobin molecule
26. Smoking Cessation
Smoking cessation is imperative. The five
components of smoking cessation consist of THE
5 AS: ASK, ADVISE, ASSESS, ASSIST AND ARRANGE.
NEW TREATMENTS :
bupropion hydrochloride, nicotine gum, nicotine
patches and nicotine inhalation systems.
Bupropion hydrochloride given for 3 days at 150
mg per day and then increased to 150 mg twice
a day with doses 8 hours apart and the first dose
in the morning. Older clients are encouraged to
smoke during the first week of treatment and to
set a quit smoking date before the end of the
first 14 days treatment
27. Obesity
Obesityresults in a decrease in chest wall
compliance.
Inolder clients with already decreased chest
wall mobility and stiffening of the
chest, added weight greatly reduces
pulmonary functions and increases
breathlessness.
Ventilationat the bases of the lungs may be
diminished because of the clients inability to
take a deep breath
28. Sleep
Increased sleep time of older adults
increases the risk of aspiration and
oxygen desaturation during sleep
29. Anesthesia and Surgery
An older client undergoing surgery has an
increased risk of aspiration as a result of loss
of laryngeal reflexes.
If surgery is an emergency, risk in increased
because of the older clients delayed gastric
emptying and the potential for a full
stomach.
Incisions, pain and decreased postoperative
deep breathing increase the older clients
chance of developing postoperative
atelectasis.
30. Anesthesia and Surgery
Subsequent immobility decreases ventilation
and effective airway clearance.
Hypovolemia contributes to thickened
secretions.
Because older clients have a less effective
cough, a painful incision further diminishes the
likelihood of effective airway clearance.
Promotion of deep breathing, adequate
hydration, frequents position changes and early
mobilization will decrease the risk of developing
atelectasis
31. Common Respiratory Symptoms
elevated respiratory rate of 16 to 25
breaths/min
Abnormal breathing patterns in older
clients can be indicative of other
metabolic and respiratory illnesses
change in the mental status – 1st sign
responses to hypoxemia and
hypercapnia are blunted
32. Common Respiratory Symptoms
Dyspnea is a perception of breathlessness
Older clients most often describe their
breathlessness as a sensation of an inability
to get enough air, or a choking or
smothering feeling.
associated with an acute respiratory or
cardiac illness
most common complaint in older clients with
pulmonary disease.
older clients usually do not complain of
dyspnea until it begins to interfere with their
activities of daily living (ADLs)
33. Common Respiratory Symptoms
cough mechanism
Causes of coughing in older clients include
postnasal drip, chronic bronchitis, acute
respiratory tract
infections, aspiration, gastroesophageal
reflux, congestive heart failure (CHF), interstitial
lung disease, cancer and angiotensin-
converting enzyme inhibitor medications for
hypertension and CHF.
recommend cough suppressants with caution
Suppression of the cough and depression of
any respiratory function could lead to
retention of pulmonary secretions, plugged
airways and atelectasis.
35. COPD
characterized by airway obstruction and
decreased expiratory flow rate
The 2 reversible components in COPD are
airway diameter and expiratory flow rate
Emphysema, chronis bronchitis, and
bronchiectasis are often referred to as
COPD
progressive and ultimately fatal disease
more than two times high in men as in
women between the ages of 65 and 74
and three times as high between ages of
75 nad 84
36. COPD
Rick factors for COPD include:
age, male gender, reduced lung
function, air pollution, exposure to
secondhand smoke, familial allergies, poor
nutrition, and alcohol intake.
COPD is often a comorbid factor in deaths
from pneumonia and influenza, and it
accounts for increased physician visits.
37. COPD
Symptoms:
Depending on whether emphysema or
chronic bronchitis is the predominant factor.
Symptoms include dyspnea (especially on
exertion), cough, sputum
production, weight loss, and fatigue.
Diagnosis is based on client history and
alterations in the PFTs.
38. Diagnostic Tests and Procedures
history exposure to tobacco smoke;
occupational dusts and chemical; smoke
from home cooking and heating fuels; and
progressive dyspnea, chronic cough, and
chornic sputum production, usually in the
morning.
PFTs or simple spirometry is used for the initial
diagnosis of airflow obstruction.
A resting ABG measurement
a standard baseline posteroanterior chest x-
ray study are also obtained.
The blood hemoglobin level is staged based
in the percent if the predicted value of FEV₁.
40. Nursing Management
ASSESSMENT
Assessing their ADLs, quantifying
breathlessness on a scale of 1 to 10, and
identifying environmental and social factors
Precipitating factors
Physical assessment includes assessment of
the shape and symmtery of the chest;
respiratory rate and pattern; body position;
use of accessory muscles of respiration;
color, temperature, and appearance of
extremities; and sputum
color, amount, consistency, and odor.
41. Nursing Management
Assess cyanosis in darkly pigmented older
adults, the nurse shouls examine the client
with favorable lighting conditions (e.g., use
overbed light or natural sunlight).
The lips, nail beds, circumoral region, cheek
bones and earlobes.
Changes in level of consciousness, increased
respiratory rate, use of accessory muscles of
respiration, nasal flaring, and positional
changes and other manifestations of
respiratory distress.
Fremitus, chest wall movement, and
diaphargmatic excursion
42. Nursing Management
DIAGNOSIS
Nursing diagnoses common for an older client with COPD
include:
Ineffective airway clearance related to retained
secretions.
Impaired gas exchange related to altered oxygen
supply.
Risk for infection related to inadequate primary and
secondary defenses and chronic disease.
Knowledge deficit: COPD related to lack of previous
exposure.
Inadequate nutrition related to inability to digest or ingest
food or to absorb nutrients.
Ineffective breathing pattern related to musculoskeletal
impairement and decreased energy or fatigue.
43. Nursing Management
Planning
Client will maintain patent airway.
Client will maintain stable weight.
Client will maintain ABG values at baseline.
Client will maintain a balanced intake and output.
Client will be able to effectively clear secretions.
Client will be able to demonstrate diaphragmatic and
pursed-lip breathing.
Client will be able to demonstrate relaxation
techniques to control breathing.
Client will maintain a respiratory rate between 16 and
25 breaths/min.
Client will be able to list significant and reportable
signs and symptoms.
44. Nursing Management
Intervention
Pulmonary Rehabilitation pulmonary rehabilitation
includes 20 to 30 minutes of exercise 3 to 5 times a week
Smoking Cessation
Nutrition reduce carbohydrates to only 50% of the diet
(the breakdown of carbohydrates has been shown to
increase the CO₂ load
Breathing Retraining diaphragmatic breathing and
pursed-lip breathing
Chest Physiotherapy
Pulmonary Hygiene oral fluids of 4 t 6 quarts a day
Medication Inhaled medications are only as effective as
the delivery
Exercise
Home Oxygen therapy