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.