Question

An elderly, 70-year-old, female patient recently retired from her long-term job in Fort Worth. Last week she moved to Denver, CO, to live closer to her daughter. (Denver is at a much higher elevation than Fort Worth.) She went to the emergency room for breathing difficulty, and upon examination you discover she has developed a viral infection of the lungs. She has been admitted for observation. She has fast, shallow breathing and a wet, wheezy cough. Fluid in the lungs is called pneumonia.

For each factor identified as a cause (age, location, infection), give the effects of these factors on her respiration. Consider why she has fast, shallow breathing, wet, wheezy cough, and fluid in the lungs. What is directly causing these problems, and what will happen if they are untreated? What are the interactions between her respiratory system and other systems (e.g. immune, circulatory, cardiovascular) that might be complicating her illness?

Answer 1

Fast and shallow breathing :

1. age: there are several body changes that happen as you get older this cause a decline in lung capacity:

• Alveoli can lose their shape and become baggy.
• The diaphragm can, over time, become weaker, decreasing the ability to inhale and exhale. This change will only be significant when exercising.
• Ribcage bones become thinner and change shape, altering the ribcage so that it is less able to expand and contract with breathing.
• Nerves in airways that trigger coughing become less sensitive to foreign particles. When particles build up in the lungs, they can damage the lung tissue.

These changes can result in symptoms such as fast and shallow breathing

2. Location : As mentioned above patient moved from fort wort to Denver and denver is at a much higher elevation than Fort Wort.The air at higher altitudes is colder, less dense, and contains fewer oxygen molecules. This means that you need to take more breaths (breath faster) in order to get the same amount of oxygen as you would at lower altitudes. The higher the elevation, the more difficult breathing becomes. And in combination with age it make it even harder to breath and make the symptoms of pneumonia more severe

Wet, wheezy cough, and fluid in the lung :

3. Infection: wet, wheezy cough, and fluid in the lung is due to pneumonia. Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid. Pneumonia is most common in two age group a. Children under 5 years of age and b. Adults above the age of 65. Pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. The most common are: a. Streptococcus pneumoniae – the most common cause of bacterial pneumonia in children, b. Haemophilus influenzae type b (Hib) – the second most common cause of bacterial pneumonia, c. respiratory syncytial virus is the most common viral cause of pneumonia;

If left untreated it can lead to complication and abnormalities in other systems eg,

• Bacteremia, in which bacteria spread into your blood. This can cause septic shock and organ failure.
• Trouble breathing, which might mean you need to use a breathing machine while your lungs heal.
• Fluid buildup between the layers of tissue that line your lungs and chest cavity. This fluid can also become infected.
• Lung abscess, when a pocket of pus forms inside or around your lung.