NURS 6501 CASE STUDY ANALYSIS WEEK 4
The patient’s chief complaint of shortness of breath, cough with thick green sputum production, and fevers, along with her medical history of COPD, suggest an exacerbation of her chronic condition. The CXR findings of flattened diaphragm and increased AP diameter indicate the presence of hyperinflation, which is a characteristic feature of COPD. The auscultation findings of hyper resonance and coarse rales and rhonchi throughout all lung fields suggest the presence of airway obstruction and inflammation.
COPD is a chronic inflammatory lung disease that is characterized by the progressive obstruction of airflow, resulting in symptoms such as cough, sputum production, and shortness of breath. The pathophysiology of COPD involves the destruction of lung tissue, airway inflammation, and mucus hypersecretion, which lead to the narrowing of the airways and the development of hyperinflation. The hyperinflation of the lungs in COPD is caused by the loss of elastic recoil of the lung tissue, which makes it difficult for the patient to exhale and leads to air trapping in the lungs. This results in an increased work of breathing and the development of dyspnea.
The patient’s fevers suggest the presence of an infection, which is a common trigger for exacerbations of COPD. The thick green sputum production is also indicative of an infection, which may be bacterial or viral in nature. The presence of airway obstruction and inflammation in COPD makes the patient more susceptible to infections, as the mucus buildup in the airways provides a favorable environment for bacterial growth.
There are several racial/ethnic variables that may impact physiological functioning in patients with COPD. Studies have shown that African Americans and Hispanics have a higher prevalence of COPD and are more likely to experience exacerbations and hospitalizations compared to Caucasians. This may be due to differences in genetic susceptibility, environmental exposures, and healthcare access and utilization.
The cardiovascular system and the respiratory system are closely interconnected, and the pathophysiological processes that affect one system can have significant effects on the other. In COPD, the chronic inflammation and hypoxia that result from airway obstruction can lead to pulmonary hypertension, right ventricular hypertrophy, and cor pulmonale. These cardiovascular complications can further exacerbate the patient’s symptoms and increase the risk of morbidity and mortality.
References:
Celli, B. R., & Barnes, P. J. (2019). Exacerbations of chronic obstructive pulmonary disease. European Respiratory Journal, 54(3), 1900506. https://doi.org/10.1183/13993003.00506-2019
Dransfield, M. T., & Rowe, S. M. (2019). Genetics and racial disparities in COPD. Current Opinion in Pulmonary Medicine, 25(2), 115–120. https://doi.org/10.1097/MCP.0000000000000557
Global Initiative for Chronic Obstructive Lung Disease. (2021). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2021 report). https://goldcopd.org/2021-gold-reports/NURS 6501 WEEK 5 Gastrointestinal Disorders
