Discuss predisposing factors to respiratory problems in the elderly
Chest wall deformities affecting lung compliance causing increase work of breathing
lung parachyma loses supporting structure causing dilatation of airspaces
respiratory muscle decrease
impaired effective cough
aging lungs become stiffer and less able to expand and contract
Identify and describe the components of a comprehensive respiratory assessment
- Onset and symptoms of cough and SOB
- Vital signs
- Respiratory rate, rhythm and depth (shallow, normal or deep)
- use of accessory muscles
- patient’s position (tripod)
- airway, breathing, circulation
- O2 Saturation
Auscultation
- absence of breath sounds
- adventitious sound such as wheeze, crackles
Circulation
- skin condition
- cap refill
- chest expansion
- fremitus
Identify manifestation of pneumonia
- Vary, depending on age
- fever, malaise, chills
- rust colored sputum
- decreased air entry
- pleuritic pain
- elderly may not have temp change, loss of appetite, change in mental status
Identify the diagnostic assessments for pneumonia
Chest X-rays to confirm the presence of pneumonia and the extend and location f the infection
Blood tests to confirm the presence of infection and to identify the type of organism causing the infection. And to rule out bacteremia
Sputum test to confirm the type of organism
CBC and Diff may show an elevated of white blood count indicating the presence of an infection
Describe the pharmacological treatment of pneumonia
Antibiotic or antiviral medication
Cefuroxime -effective for COPD and those who had antibiotics in the past
MOA - binds to bacterial cell wall, causing cell death
AE - allergy, liver and kidney function
Azithromycin
MOA - inhibits protein synthesis at the level of the 50S bacterial ribosome
AE - liver and kidney function, hypersensitivity,
Describe the nursing management of a person with pneumonia
- effective airway
- monitor respiratory status
- o2 supplementation
- position patient in comfortable position (high semi fowler
- create a comfortable environment
- hydrate
- LOC, signs of cyanosis
- assist patients in activities, physical tolerance
