1. Wheezing occurs with COPD as the airways become more inflamed via the immune and inflammatory responses, smooth bronchial muscles contract, and congestion with increased mucus production causes turbulent airflow. This turbulent airflow will be heard on exhalation because of the narrowed and mucus logged airways (Mitchell, 2015). The increased mucus production occurs when inflammation causes hypertrophy and hyperplasia of the goblet cells (Brashier & Kodgule, 2012).
2. The feeling of fullness in the abdomen is related to the narrowing of pulmonary vessels from chronic long-term hypoxia and pulmonary hypertension. In turn, blood is backed up into the right ventricle of the heart causing systemic and dependent edema. This backflow of blood
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Shortness of breath or dyspnea in COPD happens because the demand for ventilation exceeds the person’s ability to meet the demand (Mitchell, 2015). The basics behind breathlessness in COPD is an increased ventilatory demand with a decreased capacity of the respiratory muscles to relax and generate forceful and efficient ventilation (Brashier & Kodgule, 2012). CD8+ lymphocytes release enzymes causing apoptosis of bronchial epithelial cells and pulmonary capillaries, creating a ventilation-perfusion mismatch as the body becomes hypoxic and hypercarbic (Brashier & Kodgule, 2012). Decreased lung elasticity and compliance from fibrotic damage to air sacs are responsible for the inability to expand and recoil to generate effective ventilation. This loss of elasticity also causes air trapping, as the lungs are less effective at removing air (Brashier & Kodgule, 2012). The lungs become hyperinflated and contribute to dyspnea. Loss of parenchymal tissue causes decreased pressure and inability of alveoli to remain open. Less oxygen is able to pass the alveoli-capillary membrane into the red blood cells and less C02 is able to transfuse to be removed from the blood. Inflammation, mucus, apoptosis, fibrosis, loss of elastic recoil all lead to decreased oxygenation and ventilation causing the person to feel short of breath, particularly during exertion (Brashier & Kodgule,
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
Introduction BiPAP is a form of noninvasive mechanical ventilation used in patients with acute respiratory failure. Many of these patients go on noninvasive ventilation due to COPD exacerbations that are infectious, with congestive heart failure, and ventilator parameters based on their clinical assessment and changes in arterial blood gases. Two different studies were conducted on COPD patients, using a BiPAP machine to improve exacerbations and their activities of daily living. There are many positive outcomes for using these noninvasive ventilators, however when used incorrectly, negative outcomes or no changes at all are always possible. Positive Use for COPD Exacerbations
To better understand how COPD affects an individual you should first know how the lungs function. When you breathe in air it first goes through your trachea then into your bronchioles. Once in the bronchioles the air goes to the air sacs called alveoli. In the alveoli, the gas exchange occurs with the capillaries. Gas exchange is when the oxygen enters the bloodstream and carbon dioxide enters the alveoli. During the breathing process, alveoli will inflate when inhaling and deflate while exhaling.
Chronic obstructive pulmonary disease or COPD is a group of progressive lung diseases that block airflow and make it hard to breathe. Emphysema and chronic bronchitis are the most common types of COPD (Ignatavicius & Workman, 2016, p 557). Primary symptoms include coughing, mucus, chest pain, shortness of breath, and wheezing (Ignatavicius & Workman, 2016, p.557). COPD develops slowly and worsens over time if not treated during early stages. The disease has no cure, but medication and disease management can slow its progress and make one feel better (NIH, 2013)
results in the need for more blood. Since more blood is needed to fill the
The purpose of this essay is to explore nursing care priorities for a patient with a common health condition. A common health condition is a disease or condition which occurs most often within a population. The author has chosen scenario 3 for this essay and will describe the nursing assessment and care planning provided to a patient with Chronic Obstructive Pulmonary Disease (COPD). The WHO definition of COPD is a lung disease which has a chronic obstruction of the airways that impedes normal breathing and is not fully reversible (). According to), there are estimated to be over 3 million people in the UK with COPD. It is common in later life and there are approximately 25,000 deaths each year, with 15% of COPD being work related (The identity of the patient will remain anonymous in adherence with the Nursing and Midwifery Council, Code of Conduct on patient confidentiality (). However, the patient will be referred to as Mr B in this essay. The author has chosen the priority of eating and drinking for Mr B. Patients with COPD are at increased risk of malnutrition and nurses must make certain they screen patients and offer advice or refer as necessary (). If this priority is managed well it will have a positive effect on the other priorities (, 2012). In accordance with NICE Guideline 101 (), the treatment and care provided should consider each persons’ individual requirements and preference. Care and treatment should take into account people’s individual needs and choices. To allow people to reach informed decisions there must be good communication, supported by evidence-based practice (). This essay will provide an evidence based discussion on how care will be implemented in relation to Mr B and his eating and drin...
•Hypertension occurrence within the hepatic portal system generally restricts the movement of blood sequentially minimizing scar tissue. Clinical symptoms such as vomiting blood occurs because the flow of blood linking the veins are miniature in size transporting immeasurable quantities of blood from within the body.
The simple act of breathing is often taken for granted. As an automated function sustaining life, most of us do not have to think about the act of breathing. However, for many others, respiratory diseases make this simple act thought consuming. Emphysema is one such disease taking away the ease, but instead inflicting labored breathing and a hope for a cure.
The functioning of the chronic obstructive pulmonary diseases (COPD) is that it has a permanent decrease in the ability to force air out of the lungs. Consequently, it causes emphysema to become a more advanced disease with no cure. Emphysema is known for their permanent enlargement of the alveoli, which are accompanied by the destruction of the alveolar walls. The lungs lose their elasticity, so it loses its ability to recoil passively during expiration. People who have emphysema becomes exhausted fast because they need about fifteen to twenty percent of their body energy to breath which is more than what a healthy person needs. Smoking inhibits and destroys cilia in the conducting zone structures, which is the line of defense for the respiratory system.
Second is pneumonia, which is a lung inflammation, may also cause short of breath and a cough. An infection is usually the caused of the disease so, so you will need to take antibiotics. If you have chronic obstructive pulmonary disease (COPD), it is likely your breathlessness is a sign this condition has suddenly got worse. (Manning & Mahler, 2001)
-Shortness of breath=described as tightness of the chest. Some people have trouble breathing during exercise, others experience it after inhaling smoke, while others need to ingest a particular food-regardless of the circumstance, all people with asthma have trouble breathing.
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
Parker, Steve. "Chronic Pulmonary Diseases." The Human Body Book. New ed. New York: DK Pub., 2007.
The clinical manifestation one may see in patients with chronic bronchitis are chronic cough, weight loss, excessive sputum, and dyspnea. Chronic cough is from the body trying to expel the excessive mucus build up to return breathing back to normal. Dyspnea is from the thickening of the bronchial walls causing constriction, thereby altering the breathing pattern. This causes the body to use other surrounding muscles to help with breathing which can be exhausting. These patients ca...