Introduction to Respiratory Changes (Nursing)

00:01 Hello, welcome to our series on Geriatric Nursing.

00:05 We're looking at age-related changes in health.

00:07 And in this part, we're looking specifically at the respiratory system.

00:11 Now if this is your first video series with us, we use Jose and Enrique.

00:17 They've been lifelong friends.

00:18 But they've had two very different health journeys.

00:21 Jose has stayed active, made healthy lifestyle choices, and he hasn't had any major health events.

00:28 Poor Enrique, on the other hand, had a heart attack at age 52.

00:33 He's developed into congestive heart failure.

00:35 So he's had a much different course.

00:37 That's the whole point of this video series is for you to recognize the difference between normal age related changes, and those that are associated with chronic illness.

00:47 So I want to start with a story.

00:49 So picture Enrique, he's out for a walk one day.

00:53 He's at the park, he's talking with a friend.

00:56 Now both of them are complaining about how difficult it's become for them to walk without getting tired.

01:01 And then they see these people jogging around the course.

01:05 The next thing Enrique knows, someone whips by them fast as a bullet.

01:12 Then he realizes who it was.

01:14 It's Jose.

01:16 Enrique's old friend.

01:18 Now they're about the same age.

01:20 And Jose can jog, even run up some of the stairs.

01:24 What's the difference between Jose and Enrique? Why is that? I mean, is like Jose some kind of superhero? No, not really but let's take a look at what the normal signs of aging are in the respiratory system.

01:40 So we're going to use Jose is our model.

01:43 Remember, he's the guy jogging at the park.

01:46 Know that normally, if Jose is at rest, or just has minimal exertion, you're not going to see a big change in his respiratory function because his lungs can provide adequate oxygen.

01:56 So if he's not being pushed, he's not pushing his heart rate, he's not stressing himself, you're not going to see a big difference.

02:04 However, when he does push himself, when he does exercise, we'll call that greater than normal exertion, the respiratory reserve is lower than when he was younger.

02:15 Okay, so that's when Jose will become dyspneic or feel short of breath.

02:20 If you've looked at our cardiac series, we talked about how as we age, there's less cardiac reserve.

02:26 And at rest, there's not as big a change that is noticeable.

02:29 Same thing with the lungs, there's less respiratory reserve.

02:34 So it's going to be harder for him to catch his breath than when he was 20.

02:39 No I know, you realize that geriatric patients become more short of breath than when they were younger.

02:45 But I want you to be clear on why that is.

02:48 So if Jose were to start jogging or running faster and faster, he's going to become more short of breath and he would have when he was younger.

02:58 The real purpose is why is that? Because he has less respiratory reserve.

03:04 Okay, that's the main takeaway from that, that I want you to know from our story of Enrique walking in complaining in the park, and Jose zipping right by him.

03:17 So let's take a look at the normal aging of the respiratory system.

03:20 You notice we have Jose as a little guy, Jose as a middle adult, and Jose as a geriatric client.

03:28 Now there's lots of age dependent anatomical and physiological changes that impact your functional reserve of your lungs.

03:36 So first, respiratory function deteriorate slowly and progressively.

03:41 So I start as a little guy, as he goes into an adult, you'll start to see a decline as he begins to age into the geriatric stage.

03:50 So the respiratory function is slow and progressive.

03:54 Unless there's some type of major event, it's not going to be noticeable from day to day.

04:00 Now your maximum breathing capacity also declines.

04:03 Now, we're going to use a lot of terms in this video series that use for measurement of lung function.

04:10 So I'm going to slow down a little bit and break that down for you.

04:13 The maximum breathing capacity is the minute volume or the ventilation that the client can maintain for 12 to 15 seconds.

04:22 So maximum breathing capacity is what the minute volume of the ventilations that you can maintain for 12 to 15 seconds.

04:31 And this is something that we can measure in a clinical setting.

04:34 This will decline over a period of time progressively as the patient ages.