Russell Smart Case Study

SCENARIO :
Russell Smart is 88 years old and has lived in a residential aged care facility since the age of 60 when his right leg was amputated below the knee due to poor circulation resulting in gangrene in his right foot. Russell smoked 50 cigarettes a day in the past even though he has been diagnosed with emphysema for 15 years. Russell suffers from poor circulation to the left leg and has gangrene to his left little toe. Russell requires oxygen most of the time due to his breathlessness. Oxygen is delivered via nasal prongs.
Russell is vibrant and enduring to staff. He is empowered and good natured, he enjoys and joke and is mates and with Stan, another client at the facility. Russell has a brother who lives close by and visits regularly.
Explain how normal breathing occurs in a healthy body.
The purpose of breathing is to supply oxygen to the body and remove carbon dioxide. Normal breathing occurs when air is breathed in through the nasal passages, warmed, moistened and filtered – passes through the pharynx into the larynx and trachea. The air then continues into the lungs via the right and left bronchi. In the lungs, the bronchi branch into smaller bronchioles, each with alveoli (air sacs) attached to them. – between the alveoli and the blood capillaries is where the gas exchange of oxygen and carbon dioxide takes place which is carried out of the lungs as we breathe out.

2. What is the normal ageing process associated with the respiratory system?
As the body ages there is a progressive decrease in the thickness of the alveolar walls and the elasticity within the lungs. The costal cartilage also typically calcifies (becomes harder) and calcium reduces from the ribs. These factors cause the gas exchange associated with the respiratory system to become less efficient causes a reduction in oxygen transferred into the blood in turn causing increased use of accessory muscles to breathe, breathlessness on exertion, difficulty breathing at high altitudes and weakened cough and gag reflexes. It can also cause a higher risk of chest infections and decreased in blood flow to the
Other symptoms include barrel chest (due to air tapping) and signs of cardiac problems.

4. Explain how normal blood flow occurs in a healthy body.
The process of blood flow occurs as part of the cardiovascular system. Contractions of the heart (systole) and relaxation of the heart (diastole) form the cardiac cycle. During this cycle the following occurs:
• The upper chambers of the heart relax and fill with blood as the lower ventricles contract forcing blood through the aorta and pulmonary arteries.
• The ventricles relax allowing the flow of blood from the contracting upper chambers.
This cycle takes only 0.8seconds and occurs approximately 70-80 times per minute. Blood flows around the body continuously due to the regular beat of the heart.
Deoxygenated blood cells enter the right atrium and passes into the right ventricle. The blood cell leaves the heart where it travels to the lungs to be oxygenated. This oxygenated blood cell returns to the heart into the left atrium. Moves into the left ventricle, moves from the heart into the