COPD: A Case Study

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Module 6 Discussion Forum

A 74 year old male with a history of COPD presents to the ED with severe difficulty breathing. His respirations are 26; chest expansion is retracting; BP is 154/76; pulse is 100 bpm; and temperature is 99 degrees F.

His skin color is pale gray, his chest is barrel shaped and he appears anxious and is sitting in a tripod position. His nail beds are a bluish color; his oxygen saturation by pulse oximetry is 72%.

Chest auscultation reveals wheezes and decreased to absent breath sounds over the lower lung bases. Hyperresonance was noted upon percussion of the chest wall. Chest x-ray showed atelectasis in the lower lung bases. The patient has a cough with minimal amounts of clear sputum production.

What findings from …show more content…

The surface area for gas exchange decline and lung mass decrease, residual volume increases as the alveoli enlarge. In addition, the speed of breathing out with maximal effort gradually diminishes, and coughing becomes less effective which also increase the risk of pulmonary illness (Bickley &Szilagyi, 2016). There is a decrease in arterial pO2, but the O2 saturation normally remains above 90% (Bickley &Szilagyi, 2016). When the patient has COPD - a disease state characterized by the presence pf airway obstruction that is not fully reversible , with chronic inflammation found in the airways, lung parenchyma, and blood vessels- as they age the disease becomes more progressive due to the natural changes of aging to the pulmonary system (Lewis, 2007). The defining features of COPD are irreversible airflow limitation during forced echalation caused by loss of elastic recoil and airflow obstruction caused by mucus hypersecretion, mucosal edema, and brochospasm (Lewis, 2007). Gas exchange abnormalitites result in hypoxemia and hypercarbia (Lewis, 2007). Air trapping worsen and alveoli are destroyed (Lewis, 2007).There is a siginificant ventilation/perfusion mismatch and hypoxemia resutlts (Lewis, 2007). Pulmonary hypertension may occur late in the course of COPD leading to hypertrophy of the right ventricle

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