1.
What are the common age-related changes of respiratory system in older
adult?
Differentiating normal aging changes from disease-related changes is difficult.
Lung structure and function with normal aging include
Stiffening of elastin + collagen connective tissue supporting the lungs
Altered alveolar shape à increased alveolar diameter
Decreased alveolar surface area available for gas exchange
Increased chest wall stiffness
Neuron loss 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
2. In selected respiratory conditions: Give nursing management and
medication.
a. Chronic Obstructive Pulmonary Disease
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.
Medication therapy
Bronchodilators
Sympathomimetics (isoproterernol, metaproterenol, terbutaline, albuteral)
Parasympathomimetics (atropine, ipratropium bromide)
Methylxanthines (theophylline and its derivatives)
Corticosteroids
Inhaled steroids include beclomethasone, dexathesone, trimcinolone, flunisolide
Antibiotics—(tetracycline, ampicillin, erythromycin and trimethoprim-sulfamethoxazole
combinations)
b. Lung cancer
Nursing management-
Maintain patient airway and monitor respiratory status
Suction client as needed
Assess breathing pattern and auscultate lungs sound
Administer oxygen as needed
Medical:
Surgery
Chemotherapy
Radiation therapy
Medication:
Carboplatin or cisplatin
Docetaxel (Taxotere)
Gemcitabine (Gemzar)
Nab-paclitaxel (Abraxane)
Paclitaxel (Taxol)
Pemetrexed (Alimta)
Vinorelbine (Navelbine)
c. Pneumonia
Removal of secretions. Secretions should be removed because retained secretions
interfere with gas exchange and may slow recovery.
Adequate hydration of 2 to 3 liters per day thins and loosens pulmonary secretions.
Humidification may loosen secretions and improve ventilation.
Coughing exercises. An effective, directed cough can also improve airway patency.
Chest physiotherapy. Chest physiotherapy is important because it loosens and mobilizes
secretions.
Medication:
Macrolide antibiotics: Macrolide drugs are the preferred treatment for children and adults.
Macrolides include azithromycin (Zithromax®) and clarithromycin (Biaxin®).
Fluoroquinolones: These drugs include ciprofloxacin (Cipro®) and levofloxacin (Levaquin®).
Fluoroquinolones are not recommended for young children.
Tetracyclines: This group includes doxycycline and tetracycline. They are suitable for adults and
older children.
3. What self-imposed and environmentally imposed risks to younger adults can
contribute to the development of respiratory conditions in later life?
House-dust mites, Animals, Cockroaches, Tobacco smoke, Wood smoke, Strong odors and
sprays, Colds and infections, Exercise, Weather, Pollens, Molds
