Box 12-2: Individuals at High Risk for Respiratory Infection ▪ Older than 65 years of age ▪ Cigarette smoking ▪ Residing in extended care facilities ▪ Chronic respiratory disorders ▪ Congenital or chronic cardiovascular disorders ▪ Chronic renal disease ▪ Diabetes mellitus or a chronic metabolic disorder ▪ Compromised immune response Older adults should not be exposed to children with colds and coughs. If an older adult is confined to the house or a long term care facility, he/she will not have the immunity to common viruses and bacteria that younger, active people do
Preventing Respiratory Disorders ▪ Hand hygiene ▪ Stay out of crowds especially during cold and flu season ▪ Refrain from smoking ▪ Avoid known allergens ▪ Adequate nutrition ▪ Sufficient rest ▪ Avoid irritating substances – Tobacco smoke, industrial gases, coal dust, particulates from agriculture activities, soot and other carbons, car KNOW THESE TESTS ABGs Pulmonary Function Test Bronchoscopy O2 Sat Chest X-Ray Victor Cube Scan Thorosentesis
Physical Assessment ▪ Enlarged lymph nodes ▪ Cough and sputum table 12-2 – Thick, tenacious, and “ropey” sign of chronic bronchitis ▪ Respirations, posture, and use of accessory respiratory muscles ▪ Wheezes, rhonchi, crackles, and pleural friction rub ▪ Extreme restlessness and agitation may signal O2 deficit ▪ Respirations : 12-20, but up to 24 in elderly ▪ Tachypnea : fast breathing Bradypnea : slow breathing
Adventitious lung sounds ▪ Wheezes : whistling, musical, high pitched sound (air being forced through a narrow airway) ▪ Rhonchi (low wheeze) : coarse, low-pitched, rattling, snoring (secretions in airway) ▪ Crackles : like rubbing hairs between fingers close to ear (end of inspiration or end of expirations) – Fine: high pitched, found in pts with atelectasis, pneum – Coarse: louder and low in pitch in pts with bronchitis ▪ Stridor : “croaking” sounds d/t partial obstruction in upper airways – Heard in children with croup ▪ Pleural friction rub : grating, scratchy sound similar to creaking shoe leather or opening squeaky door. (sounds scratchy) ▪ ***See table 12-3 for “normal” lung sounds***
Pulmonary Function Tests ▪ Total lung capacity (TLC ): amount of gas the lung can hold at end of a maximal inspiration ▪ Vital capacity (VC) : volume of gas that a person can exhale after inhaling as much air as possible (maximal inspiration) ▪
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- Fall '19
- cough, Upper Respiratory, of Respiratory Disorders