Respiratory Diseases and Gas Exchange in the Older Adult Gas Exchange is defined as the process by which oxygen is transported to cells and carbon dioxide is transported from cells (Giddens, 2013). Simply, it is breathing in oxygen from the air to our blood, and breathing out carbon dioxide from our blood to the air, which all takes place in our lungs. As a person ages, physiological changes to the body happen; changes that can affect proper gas exchange. This paper will identify some of these changes that affect gas exchange in the older adult, some common pulmonary diseases affecting this population, as well the relationship these diseases have to gas exchange and my personal clinical experience.
Gas Exchange in the Older Adult As mentioned, gas exchange is the transfer of oxygen and carbon dioxide in the lungs.
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Changes that can affect the gas exchange process in the older adult include alterations to major systems such as the respiratory, musculoskeletal and immune systems. Lung tissue changes; alveoli (tiny air sacs in the lungs) lose shape over time and becoming baggy, thus allowing air to get trapped in the lungs, and not allowing enough oxygen to the blood and carbon dioxide out, making it harder to breathe (Martin, 2014). The diaphragm weakens over time, which in turn makes it more difficult to get air in and out of the lungs. An older adult’s immune system changes with age as well. An aging adult may not recover from a respiratory infection or exposure to smoke or other irritants as easily as they used to. These alterations in the older adult can lead to many respiratory problems. Some examples of these issues will be discussed
The two body organ systems involved in gas exchange are the respiratory and cardiovascular systems. O2 and CO2 cross the cell membrane via simple diffusion. Because cells all throughout the body require oxygen and the removal of carbon dioxide, this simple method of diffusion is the best way to transport such small molecules over a large area as efficiently as possible.
Cari’s po2 is 54 mm Hg so therefore her lungs were working as if she was doing intense exercise although she wasn’t. Decreased oxygen saturation and PO2, decrease the efficiency of gas exchange between the arterial blood and tissues of the body.
The complexity of the respiratory system and the physiology behind pulmonary respiration can be considered extraordinary high. Within the single system, individual organs, actions and co-ordinations are culminated to equate in the survival of humans. The respiratory system carries out many roles within the body; control of bodily pH, aid in speech production and olfaction, regulation of blood pressure and promotion of venous and lymphatic flow. Although these function are necessary to optimally function, the exchange of gases from the internal bodily environment to the external bodily environment is the most important function and role of the respiratory system (Martini, Ober, Nath 2011).
* COPD: Chronic obstructive lung disease decreases the lungs ability to exchange carbon dioxide for oxygen. As the disease progress the patient has to work harder and harder to breathe often feeling as if they are suffocating. These disease are often link to a lifetime of smoking but be due to environmental factors.
Emphysema damage to the alveoli causes a significant decrease in the surface area available for adequate gas exchange ability.
As you already know, Chronic Obstructive Pulmonary Disease (COPD), manifests itself when the passageway of air to the lungs is severely obstructed, thus preventing sufficient flow of oxygen into the bloodstream.1 The pathophysiology of COPD is a complex process that is the result of multiple airway diseases that simultaneously contribute to the impairment of airflow in the lungs.1 Specifically, the overlapping outcome of chronic bronchitis and emphysema is the pathogenesis of COPD.1 The risk factor for the COPD is influenced by the individual’s genetics, age, gender, exposure to air pollution, socioeconomic status, and the use of tobacco products.1 The use of tobacco products can increase the development of COPD.1 However, individuals that don’t smoke can also attain COPD.1 Therefore, COPD is not exclusive to individuals that smoke on a daily basis.1 In fact, genetics and the natural aging process plays a part in the development of pulmonary issues.1 For example, it has been proven that a deficiency in the alpha -1 antitrypsin gene is correlated with the development of COPD.1 The natural deterioration of lung tissue, coupled with the long term exposure to environmental elements, explains why the risk of attaining COPD increases as one progresses to the latter stages of their lives.1 In a healthy individual, goblet cells secrete about one liter of mucous that provides a moist surface over the lungs, trachea, and esophagus.1 The cilia on the pseuodocolumnar epithelial cells continuously sweep the mucus in the lungs in an upward motion.1 The cilia sweeps the mucosal trapped debris up, and removes pathogens and other foreign particles out the pulmonary tissue.1 In individuals with COPD, the pathogenesis of the disease creates structural modifications of the lung tissue, which result in deformed and nonfunctioning cilia.2 The lack of functioning cilia leads to the buildup of mucous, pathogens, and subsequent respiratory infections.2 Furthermore, the body tries to combat
Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,
The respiratory system is a complex organ structure of the human body anatomy, and the primary purpose of this system is to supply the blood with oxygen in order for the blood vessels to carry the precious gaseous element to all parts of the body to accomplish cell respiration. The respiratory system completes this important function of breathing throughout inspiration. In the breathing process inhaling oxygen is essential for cells to metabolize nutrients and carry out some other tasks, but it must occur simultaneously with exhaling when the carbon dioxide is excreted, this exchange of gases is the respiratory system's means of getting oxygen to the blood (McGowan, Jefferies & Turley, 2004).
According to the Australian Nurses’ Dictionary (King, J, et.al, 2012) COPD is defined as “A combination of chronic bronchitis and emphysema in which there is disruption of air flow into or out of the lungs. Dyspnoea, wheezing and cough predominate, often made worse by any exertion or pollution in any environment. Patients may be severely disabled and require oxygen for long periods of time.” The most common cause of COPD is chronic cigarette smoking, although only 25% of smokers will develop COPD of a moderate severity. Others may develop COPD as a result of a normal decline in lung function as age progresses, these patients may suffer airflow obstruction without abnormal inflammatory changes. The airflow limitation results in three different pathological mechanisms: thickening of small airways, emphysema and luminal obstruction with mucus and plasma exudate.
Gas exchange is when oxygen is delivered from the lungs to the blood stream and carbon dioxide is taken out of the bloodstream and into the lungs. Gas exchange occurs within the lungs between the alveoli and capillaries which are in the walls of the alveoli. The walls of the alveoli share a membrane with the capillaries in which oxygen and carbon dioxide move freely between the respiratory system and the bloodstream. Oxygen molecules attach to red blood cells, which travel back to the heart. At the same time, the carbon dioxide in the alveoli are exhaled out of the body.
Chronic Obstructive Pulmonary Disease is a disease that effects the respiratory system. It is a progressive disease, which means the get gets worse as time passes ("What Is COPD?"). Although their are different types of COPD, the common similarity in the disease is increasing breathlessness. The main symptoms are increasing of breathlessness, frequent coughing, wheezing and tightness in the chest. One major issue is that when people age they assume that these COPD symptoms are symptoms of aging. People think their bodies are just waring out. This makes it hard to diagnose people with the disease, because they are unaware of the symptoms.
One of the most common forms of COPD is emphysema. A major sign of emphysema is a feeling that the patient cannot take a deep breath. This is because alveoli, which are small sacs in the lungs that hold air, decompose and form larger sacs. This causes the sacs to become less flexible
Small air sacks called alveoli are at the tips of the bronchioles. When air reaches them, the oxygen concentration is high, which causes diffusion into red blood cells travelling through pulmonary capillaries (7). The red blood cells then distribute the new oxygen to the rest of the body. When they reach the alveoli again, they exchange carbon dioxide (a form of cell waste) for new oxygen, and repeat the process. The carbon dioxide is moved through the bronchioles, bronchi, and trachea in the form of exhalation.
The respiratory system is the process responsible for the transportation and exchange of gases into and out of the human body. As we breath in, oxygen in the air containing oxygen is drawn into the lungs through a series of air pipes known as the airway and into the lungs. As air is drawn into the lungs and waste gas excreted, it passes through the airway, first through the mouth or nose and through the pharynx, larynx and windpipe – also known as the trachea. At this point it then enters the lungs through the bronchi before finally reaching the air sacs known as alveoli. Within the lungs, through a process known as diffusion, the oxygen is transferred to the blood stream through the alveoli (air ducts) where it is then transported inside
Gas Exchange is a physical process. During that physical process diffusion is involved which are two main gases oxygen (O2) which is needed for respiration, Carbon dioxide (CO2) that is produced in respiration.