What are the 3 primary physiological changes of aging?
1. Reduced physiological reserve of most body systems, esp. cardiac, resp, renal.
2. Reduced
... [Show More] homeostatic mechanisms that fail to adjust regulatory systems (i.e. temp control, fluid/lyte balance, etc.).
3. Impaired immunological function (infection risk is greater, autoimmune dz's more prevalent)
What is the preferred amount of exercise for elderly?
30min/day 5 days/wk of moderate exercise.
If trying to lose wt: 60min/day.
What are PFTs?
Group of tests that provide quantifiable measurement of lung function, used to dx resp abnormalities or assess progression/resolution of lung dz.
What is FEV1?
Forced Expiratory Volume in 1 second (80-120%)
What is FVC?
Forced Vital Capacity (80-120%)
What is normal FEV1/FVC ratio?
<0.7 (70%)
What is GOLD 1 criteria?
Mild
FEV1 >/= 80% predicted
What is GOLD 2 criteria?
Moderate
FEV1 50-79% predicted
What is GOLD 3 criteria?
Severe
FEV1 30-49% predicted
What is GOLD 4 criteria?
Very severe
FEV1 <30% predicted
What are the signal symptoms of COPD?
Dyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
What are characteristics of COPD?
Common, preventable, treatable.
Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory response in airways and lungs to noxious particles/gases
Airway fibrosis, luminal plugs, airway inflammation, increased airway resistance, small airway dz.
Decreased elastic recoil of alveoli.
What are risk factors for COPD?
Smoking (increasing w/number of pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
What is seen on phys exam in COPD?
May be normal in early states
As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance), accessory muscle use, pursed lip breathing, increased expiratory phase, neck vein distention.
How is COPD diagnosed?
Spirometry is gold standard (pre and post bronchodilator).
Irreversible airflow limitation is hallmark.
How is COPD treated?
Bronchodilators: beta agonists (long/short), anticholinergics (long/short), or combo.
What is the MOA of beta agonists?
Stimulates beta-2-adrenergic receptors, increasing cyclic AMP, resulting in relaxing airways.
What is the MOA of anticholinergics?
Block the effect of acetylcholine on muscarinic type 3 receptors, resulting in bronchodilation.
Why are long-acting beta agonists prescribed for COPD?
They are for moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number of exacerbations, improve QOL.
What are some non pulmonary diagnoses that result in COPD-type symptoms?
CHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
Obstructive sleep apnea
Aspergillosis
Chronic fatigue syndrome
What are signal symptoms of asthma?
Wheezing
Shortness of breath
Cough (esp at night)
Chest tightness
What is chronic bronchitis?
Daily chronic cough w/increased sputum for at least 3 consecutive months in at least 2 consecutive years.
Usually worse on wakening.
May or may not be associated with COPD.
What is emphysema?
Characterized by obstruction to airflow caused by abnormal airspace enlargement distal to terminal bronchioles.
Chronic inflammation/remodeling, trapping air, hindering effective O2/CO2 exchange (all due to inflammatory mediators infiltrating airways).
What are signal symptoms of ischemic heart dz?
Chest pain
Chest tightness
Chest discomfort
What is ischemic heart dz?
Imbalance between supply and demand for blood flow to myocardium
What are signal symptoms of lung CA?
Cough
Dyspnea
Wt loss
Anorexia
Hemoptysis
What is lung CA?
Malignant neoplasm originating in parenchyma of lung/airways
What are signal symptoms of MI?
Prolonged CP (>20min duration)
SOB
Confusion
Weakness
Worsening HF
What is an MI?
Necrosis of heart tissue caused by lack of blood and O2 supply to the heart
What are signal symptoms of pneumonia?
Fever
Chills
Hypothermia
New cough w/or w/out sputum
Chest discomfort or dyspnea
Fatigue
HA
Some older adults will be asymptomatic but may experience falls/confusion [Show Less]