Many elderly patients have these issues. Along with the complex issues associated with the aging process, which increases the risk of respiratory infection there is also changes in food intake, increased risk of aspiration, structural lung hangs and a decline in immunity. The treatment would have to match the severity of the illness. Because bacteria cause as many as 50% to 70% of CB episodes, it is important to approach older patients with CB by evaluating the severity of the exacerbation using the three cardinal symptoms of CB increased sputum volume, increased purulence, and increased dyspnea from baseline. Furthermore, consideration of underlying comorbidities, underlying severity of lung disease, and the frequency of exacerbations help determine whether the episode is an uncomplicated or moderate to severe (Lung Institute, 2016). Elderly patients are at high risk for COPD with CB and bronchiectasis. Episodes of Acute Exacerbation of COPD and Acute Exacerbation of CB are associated with viral, bacterial, and atypical organisms, along with environmental factors acting as triggers. Elderly patients also have greater risk for resistant bacterial organisms such as multiple drug–resistant S. pneumoniae, and non-enteric gram- negative organisms such as H. influenza, Stenotrophomonas, and P. aeruginosa (Albertson, Louie & Chan, 2010). Measures to Reduce Negative Side Effects
To help with the negative side effects the patient may need to be admitted into a hospital setting for monitoring and observation. To help with the gastrointestinal upset or nausea and vomiting associated with taking antibiotics, prescribing medications such as Zofran could be recommended. Making sure that the diarrhea is managed if the patient can tolerate a BRAT type diet avoiding fatty food and dairy could help. Patients to avoid irritants such as perfumes. And if the patient develops any rash type symptoms, an anti-itch cream would help or Benadryl if it is not an allergic reaction to the medication. Corticosteroid and breathing treatments will help with relieving respiratory symptoms. References Albertson, T., Louie, S., & Chan, A. (2010). The diagnosis and treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease and chronic bronchitis. Journal Of The American Geriatrics Society, 58(3), 570-579 10p. doi:10.1111/j.1532-5415.2010.02741.x Arcangelo, V. P., & Peterson, A. M. (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Lung Institute (2016). Chronic Bronchitis. Retrieved from - diseases/chronic-bronchitis/
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- Summer '15
- Chronic obstructive pulmonary disease, Common cold, Arcangelo, Upper respiratory tract infection