PHYSIOLOGICAL

CHANGES IN AGING
AFFECTING THE
RESPIRATORY &
CARDIOVASCULAR
SYSTEM
Respiratory
System
 The Respiratory System

The respiratory system is the network of organs and tissues that help you breathe. It
includes your airways, lungs, and blood vessels. The muscles that power your lungs
are also part of the respiratory system. These parts work together to move oxygen
throughout the body and clean out waste gases like carbon dioxide. The respiratory
system has many functions. Besides helping you inhale (breathe in) and exhale
(breathe out), it:
● Allows you to talk and to smell.
● Brings air to body temperature and moisturizes it to the humidity level your body
needs.
● Delivers oxygen to the cells in your body.
● Removes waste gases, including carbon dioxide, from the body when you exhale.
● Protects your airways from harmful substances and irritants.
The Respiratory System
 The Respiratory System

ASSESSMENT:

Determining a patient’s needs related to the respiratory system requires an accurate health
history and a thorough physical examination. A respiratory assessment can be done as part
of a comprehensive physical examination or as a focused respiratory examination.

A. Chest excursion.
B. Auscultate lungs/breath sounds.
C. Quality of cough, if present; sputum.
D. Rib cage deformity.
E. Dyspnea, hypoxia, and hypercapnia (hypercarbia).
F. Need for oxygen therapy.
G. Activity intolerance.
H. Anxiety.
I. Rate and rhythm.
The Respiratory System
The Respiratory System
The Respiratory System
 The Respiratory System
Nursing Diagnosis:
1. Ineffective Airway Clearance
2. Ineffective Breathing Pattern
3. Impaired Gas Exchange
Goals:
1. Maintain airway patency with
breath sounds clear/clearing.
2. Demonstrate behaviors to
improve airway clearance, e.g.,
cough effectively and expectorate
secretions.
Implementation:
A. Manage airway clearance.
● Clean nares if nasal passages are clogged.
● Postural drainage, if necessary.
B. Monitor hydration status.
C. Promote respiratory activity with exercises.
● Teach deep-breathing exercises.
● Forced expiration.
● Coughing.
D. Monitor oxygen therapy.
● Caution: check for carbon dioxide narcosis.
● Symptoms: confusion, profuse perspiration,
visual disturbance, muscle twitching,
hypotension, cerebral dysfunction.
Cardiovascular
System
 The Cardiovascular System
It can be challenging to distinguish between disease pathology and normal aging changes
in the cardiovascular system. A decrease in cardiac tolerance may be due to disease or
simply an effect of the aging process. However, age does not necessarily equate with
cardiac health. A middle-aged person who eats a diet high in saturated fat, smokes and
leads a sedentary lifestyle may very well have poorer cardiac functioning than an elderly
person who has maintained an active lifestyle, exercises and eats a “heart healthy” diet.

One of the greatest risk factors for cardiovascular disease (CVD) is age. CVD remains the
leading cause of death in adults older than age 85. It is the most common cause of
hospitalization and the second leading cause of death in adults younger than age 85. The
most common cardiovascular problem is coronary artery disease (CAD) secondary to
atherosclerosis. It is difficult to separate normal aging changes from the pathophysiologic
changes of atherosclerosis. Many of the physiologic changes in the cardiovascular system
of older adults are a result of the combined effects of the aging process, disease,
environmental factors, and lifetime health behaviors rather than just age alone.
 The Cardiovascular System
ASSESSMENT:
A. Peripheral circulation, pulses, color, warmth.
● Widened pulse pressure.
● Jugular vein distention.
B. Circulatory status; orthostatic hypotension; hypertension.
● Dizziness; fainting.
● Auscultate heart sounds.
C. Premature beats and dysrhythmias.
D. Edema—decreased venous return.
E. Activity intolerance.
● Weakness.
● Fatigue.
F. Dyspnea.
G. Transient ischemic attacks (TIAs).
H. Anemia.
The Cardiovascular System
The Cardiovascular System
 The Cardiovascular System
Common Cardiovascular Problems Related to Aging
● Angina (chest pain caused by temporarily reduced blood flow to the heart muscle),
shortness of breath with exertion, and heart attack can result from coronary artery disease.
● Abnormal heart rhythms (arrhythmias) of various types can occur.
● Anemia may occur, possibly related to malnutrition, chronic infections, blood loss from the
gastrointestinal tract, or as a complication of other diseases or medicines.
● Arteriosclerosis (hardening of the arteries) is very common. Fatty plaque deposits inside
the blood vessels cause them to narrow and totally block blood vessels.
● Congestive heart failure is also very common in older people. In people older than 75,
congestive heart failure occurs 10 times more often than in younger adults.
● Coronary artery disease is fairly common. It is often a result of arteriosclerosis.
● High blood pressure and orthostatic hypotension are more common with older age. Older
people on blood pressure medicines need to work with their doctor to find the best way to
manage their high blood pressure. This is because too much medicine may cause low
blood pressure and could lead to a fall.
 The Cardiovascular System
Nursing Diagnosis:
1. Risk for decreased cardiac output
2. Activity intolerance
3. Fatigue
Goals:
1. Reduce BP/cardiac workload
2. Increase energy and improved well-being
Implementation:
A. Monitor vital signs—pulse, blood pressure.
● Apical pulse for 1 minute so premature
beats are not missed.
● Take blood pressure in both arms.
B. Monitor medications—digitalis, diuretics, etc.
C. Maintain dietary restrictions (low salt).
D. Change position slowly, especially from
horizontal to vertical, to prevent hypotensive
reaction.
E. Maintain circulatory homeostasis.
● Encourage activity to increase circulatory
stimulation; leg exercises, leg elevation
while sitting.
● Provide warmth by applying blankets and
clothing.
● Use gentle friction during bath.
● Avoid tight/restrictive clothing.
Evaluation:
1. Patient maintained BP within individually
acceptable range.
2.. Patient verbalized increased energy and
improved well-being.