Respiratory Infections And The Aged Adult

This paper explores Pneumonia and the respiratory disease process associated with bacterial and viral pathogens most commonly located in the lung. The paper examines the process, symptoms and treatments most commonly viewed in patient cases of Pneumonia. My goal is to educate the reader and to warn of the

* Pneumonia: Pneumonia is the fifth highest killer of older adults, especially during the winter months of flu season. At high risk are seniors with chronic disease such as diabetes heart disease and reparatory conditions. The flu and pneumonia shot are recommended for all adults over the age 55 to help prevent this killer.

When CAP occurs, it is determined if the need for hospitalisation is necessary as it depends on the seriousness of the infection. Gram- positive organisms such as S. pneumoniae, naturally occur in the upper respiratory tract, is one cause of lower respiratory infections such as pneumonia, but is also a culprit in causing upper respiratory infections like otitis media. H. influenzae is just one of many bacterial infections that can result in CAP, it therefore can be subacute and present with a low-grade fever and a persistent cough for a few weeks before a patient has a diagnosis. Adults that have very little or no immunity are an easier target for certain viruses such as that of the Cytomegalovirus, which is a viral pathogen that is commonly contracted within the community, other common virus are adenovirus and herpes simplex. When a virus starts to become acute, it starts an infection within the ciliated cells within the airway. When pneumonia occurs from this viral infection, the inflammatory action starts to seep into the alveolar areas and leads to the problem of excess exudation and oedema within the respiratory tract. It is sometimes often difficult to differentiate symptoms of a viral pneumonia from that of bacterial pneumonia (Smeltzer &

At around 0953 on June 8, 2017, I contacted Mrs. BV the director of the geriatric social worker who is in charge of older adults home, long-term and nursing facilities visitations in the community. She has few different ways of collecting her data, one of them is by interviewing residents face-to-face in their homes. She stated that this method has been efficient because she gets honest information from the residents by speaking to them directly. She also reviews long-term and nursing facilities including the city health department data to compare with her assessment findings. After evaluating all the data, community-acquired pneumonia was identified as the priority health problem due to the lack of knowledge on signs and symptoms of the disease.

Respiratory disorder, mostly affect the upper or lower respiratory tract, however bacterial or viral infection are the causative agent and the disease is common in all ages. In addition, the lungs and the bronchi can also be affected, causing inflammation and obstruction of the airflow resulting in wheezing, chest tightness, stridor, low grade fever, cough, and hemoptysis due severe damage to the lung tissues. Most common diseases of the respiratory system include; pneumonia, croup, asthma, bronchitis, laryngitis, and tuberculosis, affected disease location determines the signs and symptoms. Hereditary and environmental factors such as allergens and other irritants can be a contributory factor, especially in children. However, respiratory compromise occur as a result of incomplete airway development among this vulnerable population predisposing them to chronic asthma (Huether & McCance, 2012).

The last few days of summer are upon us, the leaves are beginning to change and it is once again fall in East Tennessee. While many are beginning to enjoy a relaxing break before the stresses of winter and the holidays, healthcare providers are bracing for the rush. The rush I speak of is that of doctor’s offices which are over run with those complaining of fevers, aches, and chills. Influenza season begins as early as August and can run as long as in to late March. Those affected by the virus can range from infants to the elderly, but most complications occur in those over 65, including death. According to the World Health Organization, the number of elderly persons is expected to increase from 600 million currently to over 2 billion worldwide by 2050. (WHO, 2015) Due to the rapid increase of this age group in the upcoming years, the need to prevent and establish treatment for illnesses that have the potential to be fatal in this population is a top priority. Greater risks of mortality in those over 65 who contract influenza can be attributed to several factors including: the elderly’s decline in immunity response, the inability of the elderly’s body to fully recover from infection, and finally, the long term complications of influenza among those who are already compromised.

Estimation of the actual asthma prevalence in the elderly community is challenging, mainly because the elderly attribute the breathing problem with other causes including ageing. More so, there is difficulty with making definitive asthma diagnosis by providers, as they could label a condition as being asthma only, asthma and emphysema, chronic bronchitis, and emphysema, among other possibilities. Hence, the end result likely creates underestimation of the actual prevalence of asthma among the elderly community (Jones et al., 2011). Notably, asthma in the elderly is still underdiagnosed and undertreated due to misattribution of symptoms and signs to other diseases common in the aged, such as COPD or cardiac disease, or acceptance of symptoms and limitations as a normal result of aging. With the elderly subjects, asthma might have a different pathophysiology than in childhood disease, subsequent from complex interactions with several factors including age-related lung and immune changes, epigenetic factors, environmental exposures, microbial triggers, or different comorbidities (Yanez et al.,

The client’s secondary diagnosis is community-acquired pneumonia. Typically, immune defense mechanisms, such as the secretion of alveolar macrophages and immunoglobulins A and G, protect the lower airway from infection. Streptococcus pneumoniae, the most common causative agent of community-acquired pneumonia, invades the lungs. The organism triggers an inflammatory response, resulting in increased blood flow and vascular permeability. Neutrophil activation occurs, to surround the kill the invading organism. A combination of the offending organism, neutrophils and fluid from the surrounding blood vessels flood the alveoli, inhibiting normal oxygen transportation. This filling of the alveoli may lead to tachypnea, tachycardia and dyspnea. Further obstruction of airflow and an increased impairment of gas exchange occur as mucous production increases. When

Aging impacts both the thermoregulation and the immune system. The geriatric population has lower body temperatures and dysregulated thermoregulation. It is hypothesized that these mechanisms are effected with aging due to decreased subcutaneous tissue, which mean this tissue cannot perform as an insulator. Vasoconstriction does not work adequately and diminished cardiac output can diminish peripheral blood flow. Fevers in the elderly often present atypically. This indicated that in the elderly population, a fever may not occur at all or will be 20 to 20 percent lower than in a younger individual. If an elderly patient presents with a higher temperature, it may be indicative that the patient has a severe infection and this should be taken quite

Pneumonia is one of the most common infectious diseases prevalent nowadays and affects all ages. It is an acute or chronic infection of one or both lungs caused by microorganisms, such as viruses, bacteria or chemical irritants. (Schmitt, 2011) It has different types, and one of them is Community Acquired Pneumonia (CAP). CAP is a disease in which individuals who have not recently been hospitalized develop an infection of the lungs. It occurs because the areas of the lung which absorbs oxygen (alveoli) from the atmosphere become filled with fluid and cannot work effectively. (Makati Medical Center, 2012)

Pneumonia is a serious infection in the lungs that causes illness in all ages and can be mild to severe, to the extent of causing death. Pneumonia is characterized by inflammation of the alveoli in one or both lungs that leads to fluid/pus filled the alveoli and is commonly a complication from respiratory infections like the Flu, Chronic Obstructive Pulmonary Disease (COPD) and Asthma, just to name a few. Though it is most serious for older adults, babies, people with impaired immune systems and people suffering from other diseases; anyone can get this infection even healthy young people (Crosta, 2015).

Pneumonia can affect anyone, but more importantly who and what qualifies as being at risk? There two age groups that are at greater risk of developing pneumonia: infants, 2 years old and younger and adults, 65 years old and older (NIH 2011). The reason, pneumonia tends to affect people with a weak immune system. Conditions and factors that increase your risk are organ transplant, lung diseases such as asthma, AIDS, HIV, diabetes, heart failure, tuberculosis, sickle cell anemia, and any other serious illness (NIH 2011). People who are hospitalized and placed on ventilators are at a higher risk, for it affects those who’s natural defenses are down. Hospital-acquired pneumonia is very common and it is fatal compared to cases acquired outside the hospital (Ferrara 2010).

CLABI, pneumonia and urinary tract infections are the main hospital acquired infections most commonly affect adults age group above 65 years old. this age groups usually have many chronic illnesses which predispose them to more frequent visit to the health care facilities for care and for also predispose them to hospital admission and more frequent than other population. also lack proper individual hygiene assist in spreading the infection.

Pneumonia is the leading infectious cause of death in children and the fourth leading cause of death in the elderly worldwide.1,2 Although pneumonia is a common disease, it rarely affects healthy individuals. This condition affects people of all ages, however it is most dangerous in immunocompromised individuals such as children, infants, and older adults.1 Other populations that are vulnerable are those who are bedridden, inactive, or immobile; those with altered consciousness; those who have difficulty swallowing; and those who have impaired cough reflexes.1 Risk factors for pneumonia include cigarette smoking, acute respiratory infections, chronic bronchitis, uncontrolled diabetes mellitus, uremia, dehydration,

Infectious diseases have a great impact on morbidity and mortality of people living in long-term care facilities (LTCFs). It is reported that 1 to 3 million serious infections and several thousand outbreaks occur every year in LTCFs.1 Utsumi and colleagues showed in their review paper that influenza was the most reported outbreaks in LTCFs.2 The important source of influenza is infected person. An infected but asymptomatic person can shed the virus and be infectious.3 Influenza vaccination is the most effective way to prevent outbreaks. Older people, however, are less likely to be protected by vaccination because the antibody response in older people is considerably lower than in younger people.4 Older people living in LTCFs have frequent