Respiratory System
Key Points
- The respiratory system delivers oxygen, removes carbon dioxide, and supports acid-base balance.
- Gas exchange occurs at alveoli-capillary interfaces and depends on airway patency and effective ventilation.
- Age-related respiratory decline increases susceptibility to acute infection and activity intolerance.
Pathophysiology
Respiration maintains cellular metabolism by transporting oxygen into blood and eliminating carbon dioxide. Airway structures and respiratory muscles move air to alveoli, where capillary exchange links pulmonary function with cardiovascular transport.
With aging, chest muscle strength and bronchiolar elasticity decline, reducing ventilation efficiency. This decreases reserve during illness and increases risk of dyspnea, fatigue, and oxygenation instability.
Classification
- Ventilation components: Airway patency, respiratory-muscle effort, and lung expansion.
- Gas-exchange components: Alveolar-capillary diffusion and oxygen transport in hemoglobin.
- Common chronic conditions: Asthma, COPD/emphysema, bronchitis, pneumonia, and lung-cancer contexts.
Nursing Assessment
NCLEX Focus
Priority questions center on identifying respiratory distress cues that require immediate nurse notification.
- Observe respiratory rate, effort, breath comfort, and ability to speak in full sentences.
- Identify cyanosis, disorientation, dizziness, chest discomfort, or sudden fatigue escalation.
- Track cough pattern and sputum changes, especially blood-tinged or purulent sputum.
- Report blocked-airway signs and acute breathing changes immediately.
Nursing Interventions
- Position for breathing comfort and segment ADLs to reduce oxygen demand.
- Encourage hydration (if appropriate) to thin secretions and improve clearance.
- Promote smoking cessation and trigger avoidance for chronic airway disease.
- Reinforce prescribed oxygen use and activity pacing.
Life-Threatening Airway/Oxygenation Risk
Any sudden breathing difficulty, cyanosis, or airway obstruction signs require immediate escalation.
Pharmacology
| Drug Class | Examples | Key Nursing Considerations |
|---|---|---|
| bronchodilators | Asthma/COPD management context | Monitor symptom relief and report persistent distress after therapy use. |
| antibiotics | Bacterial pneumonia context | Support adherence and monitor for fever, worsening cough, or confusion. |
Clinical Judgment Application
Clinical Scenario
An older resident with COPD becomes increasingly short of breath, dizzy, and mildly cyanotic during routine ambulation.
Recognize Cues: Escalating dyspnea, activity intolerance, and oxygenation warning signs. Analyze Cues: Respiratory reserve is insufficient for current exertion and may worsen quickly. Prioritize Hypotheses: Immediate priority is preventing hypoxemic deterioration. Generate Solutions: Stop activity, position for comfort, seek nurse support, and prepare ordered oxygen measures. Take Action: Escalate promptly with objective symptom/timing details. Evaluate Outcomes: Breathing stabilizes and safe activity plan is adjusted.
Related Concepts
- cardiovascular-system - Oxygen transport depends on integrated cardiopulmonary function.
- chronic-obstructive-pulmonary-disease - Major chronic cause of dyspnea and reduced exercise tolerance.
- pneumonia - Acute infectious process requiring early recognition and escalation.
- oxygen-therapy - Common supportive intervention for hypoxemia management.
- airway-management - Immediate priority in acute obstruction or severe distress.
Self-Check
- Which respiratory findings indicate urgent escalation versus routine monitoring?
- How do age-related airway changes increase risk during respiratory infections?
- Which nonpharmacologic interventions best reduce dyspnea during ADLs?