Chapter 22: Respiratory Function & Aging

Respiratory Function & Aging details the decline in chest wall compliance and the loss of elastic recoil in lung tissue, which often results in faster, shallower breathing and a significant increase in residual volume despite a relatively stable total lung capacity. Key concepts such as ventilation and oxygenation are discussed in the context of geriatric health, where decreased alveolar surface area leads to lower baseline arterial oxygen levels, a phenomenon often referred to as the "seventy at seventy" rule. Clinical management covers major obstructive diseases like chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis, emphasizing the critical role of smoking cessation through structured protocols such as the "Five As" framework. The text also addresses the nuances of managing asthma in older adults, advocating for a stepwise pharmacological approach while monitoring for comorbidities like osteoporosis that may be worsened by long-term steroid use. Infectious risks, including community-acquired and healthcare-associated pneumonia, tuberculosis reactivation, and seasonal influenza, are highlighted, noting that older patients often display atypical signs such as sudden confusion, forgetfulness, or irritability rather than classic high fevers. Further attention is given to restrictive lung diseases, bronchogenic carcinoma, and acute emergencies such as pulmonary edema and pulmonary emboli, where nursing care centers on stabilizing hemodynamics and maintaining airway patency. Additionally, the chapter examines obstructive sleep apnea syndrome (OSAS), its association with obesity, and the therapeutic use of continuous positive airway pressure (CPAP) for management. Nursing interventions are prioritized around pulmonary hygiene, adequate hydration, breathing retraining techniques like pursed-lip and diaphragmatic breathing, and the vital role of timely immunizations in preventing respiratory-related morbidity in the geriatric population.