The Silver Breathers
This common age-related change involves a decrease in lung elasticity and stiffening of the chest wall.
What is reduced elastic recoil?
These two primary immune cells are typically the first to arrive at a site of injury or "cut".
What are neutrophils and monocytes?
Order: Prednisone 5 mg PO daily. Available: 2.5 mg tablets. How many tablets?
What is 2 tablets? (5 mg ÷ 2.5 mg = 2)
This simple technique involves exhaling through puckered lips to keep airways open longer.
What is pursed-lip breathing?
This term refers to the age-related decline in immune function—affecting both innate and adaptive systems—that increases an older adult's susceptibility to infection.
What is immunosenescence?
Older adults are encouraged to receive these two specific vaccines to prevent major respiratory complications.
What are influenza and pneumonia vaccines?
This "cardinal sign" of inflammation is caused by vasodilation and increased blood flow to the area.
What is redness (rubor)?
Order: 0.5 g of Cephalexin. Available: 250 mg capsules. How many capsules?
What is 2 capsules? (500 mg ÷ 250 mg = 2)
This is the single most important measure for a nurse to perform to prevent nosocomial infections.
What is hand hygiene (hand washing)?
While Total Lung Capacity (TLC) remains constant with age, these two specific lung volumes change: one decreases while the other increases proportionally.
What are Vital Capacity (decreases) and Residual Volume (increases)?
This condition may be indicated if a nurse auscultates "dullness" during percussion of the lungs.
What is pneumonia (or pleural effusion/atelectasis)?
In frail older adults, this typical sign of systemic infection may be absent or blunted.
What is a fever (elevated temperature)?
Order: 0.4 mg of a med. Available: 0.25 mg in 1.2 mL. How many mL?
What is 1.92 mL? (0.4 ÷ 0.25 × 1.2 = 1.92)
To prevent acute temperature swings in an infected patient, antipyretics should be given in this manner.
What is around-the-clock (scheduled)?
Because the typical "shift to the left" (increased bands) may be absent, a nurse should look for these two primary atypical early indicators of infection in a cognitively impaired older adult.
What are confusion (delirium) and tachypnea? (also: loss of appetite)
This is the primary site of gas exchange where capillaries and alveoli meet.
What is the capillary-alveolar membrane?
This term describes life-threatening organ dysfunction caused by a dysregulated host response to infection.
What is sepsis?
Order: 1,000,000 units IM. Available: 500,000 units/mL. How many mL?
What is 2 mL? (1,000,000 ÷ 500,000 = 2)
For an older adult with thick secretions, the nurse should encourage this to liquefy mucus.
What is increased hydration (fluid intake)?
This phenomenon occurs when an older adult with chronic lung disease receives too much supplemental oxygen, potentially suppressing their drive to breathe.
What is CO2 narcosis (or carbon dioxide narcosis)?
This "normal" geriatric finding involves a slight increase in the anterior-posterior chest diameter.
What is a barrel chest (or increased costal angle)?
These age-related changes in the liver can impact how an older adult metabolizes anti-infective drugs.
What is a decrease in liver size and mass?
Order: 40 mg PO. Available: 100 mg in 2 mL. How many mL?
What is 0.8 mL? (40 ÷ 100 × 2 = 0.8)
This non-pharmacological tool helps patients visualize deep breathing and prevents atelectasis.
What is an incentive spirometer?
During a respiratory assessment, the presence of this abnormal vocal resonance—where the patient's whispered words are heard clearly through the stethoscope—indicates lung consolidation.
What is whispered pectoriloquy?