Question

1. what are the common age-related changes of respiratory system in older adult?
2. In selected respiratory conditions: Give nursing management and medication.
a. Chronic Obstructive Pulmonary Disease
b. Lung cancer
c. Pneumonia
3. What self-imposed and environmentally imposed risks to younger adults can contribute to the development of respiratory conditions in later life?

Answer 1

1. Respiratory muscle strength decreases with age and can impair effective cough, which is important for airway clearance. The lung matures by age 20–25 years, and thereafter aging is associated with progressive decline in lung function.
The structural changes include chest wall and thoracic spine deformities which impairs the total respiratory system compliance leading to increase work of breathing. The lung parenchyma loses its supporting structure causing dilation of air spaces: “senile emphysema”.

2. Medical management:-

Bronchodilators
Bronchodilators relieve bronchospasm by altering the smooth muscle tone and reduce airway obstruction by allowing increased oxygen distribution throughout the lungs and improving alveolar ventilation.

Corticosteroids
A short trial course of oral corticosteroids may be prescribed for patients to determine whether pulmonary function improves and symptoms decrease.

Other medications
Other pharmacologic treatments that may be used in COPD include alpha1-antitrypsin augmentation therapy, antibiotic agents, mucolytic agents, antitussive agents, vasodilators, and narcotics.

Nursing management:-

To achieve airway clearance:

The nurse must appropriately administer bronchodilators and corticosteroids and become alert for potential side effects.Direct or controlled coughing. The nurse instructs the patient in direct or controlled coughing, which is more effective and reduces fatigue associated with undirected forceful coughing.

To improve breathing pattern:

Inspiratory muscle training. This may help improve the breathing pattern.Diaphragmatic breathing. Diaphragmatic breathing reduces respiratory rate, increases alveolar ventilation, and sometimes helps expel as much air as possible during expiration.Pursed lip breathing. Pursed lip breathing helps slow expiration, prevents collapse of small airways, and control the rate and depth of respiration.

To improve activity intolerance:

Manage daily activities. Daily activities must be paced throughout the day and support devices can be also used to decrease energy expenditure.Exercise training. Exercise training can help strengthen muscles of the upper and lower extremities and improve exercise tolerance and endurance.Walking aids. Use of walking aids may be recommended to improve activity levels and ambulation

Lung cancer:-

Nursing management
With treatment planned, one patient was grateful for the way in which the lung cancer specialist nurse helped her to prepare for her chemotherapy. The nurse took her to the chemotherapy ward, where other nurses explained what was going to happen.

medication

Chemotherapy
Unwanted reactions to drugs given for the purpose of killing cancer cells.

Targeted therapy
Slows cancer cell growth by targeting a cancer cell's distinguishing features or factors.

pneumonia

Nursing management

Promoting good fluid intake through the use of intravenous fluids will help promote release of secretions; humidified oxygen therapy could also be helpful. Physiotherapy may also help to achieve sputum samples and promote recovery.

medication

Antibiotics
Stops the growth of or kills bacteria.

Penicillin
Stops growth of or kills specific bacteria.


3. A type of disease that affects the lungs and other parts of the respiratory system. Respiratory diseases may be caused by infection, by smoking tobacco, or by breathing in secondhand tobacco smoke, radon, asbestos, or other forms of air pollution.