Common Respiratory Problems

Chronic Obstructive Pulmonary Disease (COPD)

When a person has COPD, it is challenging for air to enter and exit their lungs. It is impossible to reverse the airflow obstruction that characterizes COPD, despite the fact that medication may occasionally temporarily improve it.

Risk factors:

• Tobacco smoke,
• Air pollution,
• Occupational dust and chemicals,
• Frequent lower respiratory infections during childhood.

Symptoms:

• Dyspnea,
• Chronic cough,
• Sputum production.

Management:

• Smoking cessation,
• Medications,
• Bronchodilators,
• Inhaled steroids,
• Oral steroids,
• Theophylline,
• Antibiotics,
• Oxygen therapy.

Asthma

Wheezing and intermittent airway obstruction are symptoms of asthma, an inflammatory airway disease marked by the hyperresponsiveness of the airways and bronchospasm.

Treatment:

Long term As the controlling medication

• Corticosteroids inhaled. Fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), mometasone (Asmanex), and fluticasone furoate are some of the anti-inflammatory medications on this list (Arnuity Ellipta).
• Modifiers of leukotriene. These oral drugs, such as zileuton (Zyflo), zafirlukast (Accolate), and montelukast (Singulair), reduce asthma symptoms for up to 24 hours.
• Prolonged beta agonists. These inhaled medications, which include formoterol (Foradil, Perforomist) and salmeterol (Serevent), widen the airways.
• modification of leukotriene. These oral drugs, such as zileuton (Zyflo), montelukast (Singulair), and zafirlukast (Accolate), help to relieve asthma symptoms for up to 24 hours lengthy beta agonists. Salmeterol (Serevent) and formoterol (Foradil, Perforomist), two of these drugs that are breathed, widen the airways.
• Theophylline

Quick relief medication

• Short-acting beta antagonist,
• Ipratropium,
• Oral and intravenous corticosteroids.

Pneumonia

It is an inflammatory process of the lung parenchyma that affects the terminal airways and alveoli and is frequently brought on by microbial agents. It is typically accompanied by a marked increase in interstitial and alveolar fluids.

Symptoms:

• Malaise or feeling weak,
• Cough,
• Green or yellow sputum,
• Pain in the chest,
• Confusion,
• Fever,
• Chills,
• Shortness of breath.

Prevention:

• Pneumococcal vaccine,
• Influenza vaccine,
• Hand washing,
• Dental hygiene,
• Good health habits: exercise, rest, and healthy eating can all increase resistance to pneumonia.

Tuberculosis

Tuberculosis is an infection brought on by Mycobacterium bacilli. Due to the frequent coexistence of other respiratory, cardiovascular, or systemic diseases with similar clinical profiles as well as their lack of specificity when compared to non-elderly patients, the signs and symptoms of TB presentation in old age are challenging to measure.

Types of Tuberculosis:

• Pulmonary tuberculosis:
  It is by far the most prevalent type of tuberculosis among the elderly. Although elderly patients with pulmonary tuberculosis can exhibit typical respiratory and systemic symptoms (such as sputum production, hemoptysis, fever, night sweats, weight loss, and anorexia), a sizable portion of these patients may also present with atypical complaints or minimal pulmonary symptoms.
• Miliary tuberculosis:
  A high, intermittent fever with meningeal or serous involvement and an acute or subacute pattern are typical symptoms of military tuberculosis. Undiagnosed fever, weight loss, and hepatosplenomegaly are examples of clinical features that don't have any other focal symptoms.
• Tuberculosis meningitis:
  In older patients, primary dormant focus reactivation or miliary seeding of infection are the two main causes of tuberculosis meningitis. Similar to younger patients, older patients typically exhibit a subacute onset of headache, confusion, and fever, along with concurrent or preceding system symptoms of anorexia, fatigue, and weakness.

Symptoms:

• Primary infection,
• Pleurisy with effusion,
• the typical signs of tuberculosis, including hemoptysis, sputum production, night sweats, and fever.

Treatment:

The essential anti-TB drugs

• Isoniazid,
• Rifampicin,
• Pyrazinamide,
• Ethambutol,
• Streptomycin.

TB Treatment Regimen

Initial phase (two months): The TB bacilli are rapidly eliminated during this phase. Within two weeks, infected patients become non-infectious. Symptoms become better. In the beginning, Directly Observed Therapy (DOTS) is necessary to make sure the patient takes each and every dose. As a result, rifampicin is shielded from the emergence of drug resistance.

Phase of continuation (4-5 months): In the phase of continuation, fewer medications are required but for a longer period of time. The medications kill any TB bacilli that are still present. When medication is provided for self-administration by repayment during a continuation phase without rifampicin, the risk of drug resistance is reduced. Directly observed therapy is provided for the first three months of the phase. With close supervision, the continuation phase lasts for 5 months.

Nursing Management of Respiratory Problems in Elderly

Nursing assessment:

• Find out if you have ever smoked, been exposed to something, have a history of respiratory disease, or just started having trouble breathing.
• Note the sputum's quantity, color, and consistency.
• Check for the use of abdominal and auxiliary muscles during expiration, and look for an increase in the chest's anterior-posterior diameter.
• Check your auscultation for decreased heart sounds and decreased breath sounds.
• Calculate your resting heart rate, breathing rate, and oxygen saturation.

Nursing interventions:

• Strategies for maintaining a high level of functioning and preventing decline.
  • Uphold a person's everyday routine. Through physical activity and social interaction, aid in maintaining physical, cognitive, and social function. Encourage walking, flexible visiting hours, the use of pets, and newspaper reading.
  • Inform older people, their loved ones, and professional carers on the importance of independent functioning and the effects of functional decline.
  • Encourage movement to maintain activity, flexibility, and function, including regular exercise, a range of motion, and walking.
  • Reduce the amount of time spent in bed.
  • Look at alternatives to using physical restraints.
  • Use medication, particularly psychoactive medication, in geriatric doses with discretion.
  • Identify and address suffering.
  • The design of the space includes handrails, wide doorways, raised toilet seats, shower seats, improved lighting, low beds, and chairs of various types and heights.
  • After an acute illness, assist patients in regaining their baseline abilities.
• Methods for assisting others in coping with functional decline
  • Interdisciplinary consultation can assist other adults and family members in determining realistic functional capacity.
  • Educate caregivers and support the individual's family.
  • Keep thorough records of all your intervention techniques and patient reactions.
  • To address the need for safety care for slips, falls, injuries, and common complications, provide education.
  • To ensure adequate intake and stop further decline, give enough protein and calories.
  • To manage functional decline, offer caregiver assistance and community services like home care, nursing, and physical and occupational therapy.