This paper will identify the pathogenesis of emphysema, normal functioning of the respiratory system, the signs and symptoms of the disease and the effects of emphysema has on the body.
Emphysema is one of the several diseases identified as chronic obstructive pulmonary disease (COPD). The leading cause of emphysema is smoking. The discussion will relate to the case study of COPD/Emphysema with the normal function and dysfunctions of the respiratory system, test used to diagnose emphysema, medications used to treat the disease and nursing interventions to help manage the disease.
CB is a 57-year-old male presents to your clinic for cough for past two months. States he has been having some shortness of breath when going up stairs. Denies any fevers or congestion, denies any chest pain or recent travel outside US. Patient states he does smoke ½ to 1 pack per day for the past 30 years. Patient does have history of HPTN and Hyperlipidemia which are controlled with medication. VS 130/78; rr 18; pulse ox 96%, hr 88.
The case study presents a middle-aged male of 57 years old with complaints of a cough for the past couple of months and shortness of breath when climbing stairs. His history that consists of smoking ½ to 1 pack per day for 30 years. He also has
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This manifestation begins slowly and there may be no signs or symptoms for many years without noticing. It eventually causes shortness of breath during rest. The cause of emphysema is long term exposure to airborne irritants such as smoking, marijuana smoke, air pollution and manufacturing fumes. Seldom, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. When this occurs, it is called alpha-1-antitrypsin deficiency emphysema. Individuals that have emphysema are more probable to develop a pneumothorax (collapsed lung), heart problems (cor pulmonale), and giant bullae (holes in the
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 has a history of COPD. She was already taking albuterol for her illness and it was ineffective when she took it that day. Mrs. Jones had been a smoker but had quit several years ago. According to Chojnowski (2003), smoking is a major causative factor in the development of COPD. Mrs. Jones's primary provider stated that she had a mixed type of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to address the growing problem of COPD. The GOLD standards identify three conditions that contribute to the structural changes found in COPD: Chronic bronchiolitis, emphysema, and chronic bronchitis. A mixed diagnosis means that the patient has a combination of these conditions (D., Chojnowski, 2003). Mrs. Jones chronically displayed the characteristic symptoms of COPD. "The characteristic symptoms are cough, sputum production, dyspnea on exertion, and decreased exercise tolerance." (D., Chojnowski, 2003, p. 27).
My PICOT question was developed after reading the case study about a patient named Vincent Brody who had for the last 50 years of his life consumed 40 cigarettes a day and despite his diagnosis of Chronic obstructive pulmonary disease (COPD) and a recent episode of exacerbation of his condition that required him to be admitted to hospital he was continuing to smoke.
Having emphysema and bronchitis together is known as chronic obstructive pulmonary disease. Symptoms will include:
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...
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.
The main symptom of the disease is shortness of breath, which gets worse as the disease progresses. In severe cases, the patient may develop cor pulmonale, which is an enlargement and strain on the right side of the heart caused by chronic lung disease. Eventually, this may cause right-sided heart failure. Some patients develop emphysema as a complication of black lung disease. Others develop a severe type of black lung disease in which damage continues to the upper part of the lungs even after exposure to the dust has ended called progressive massive fibrosis.
One of the long-term breathlessness is usually caused by obesity or being unfit. Other is asthma that is not controlled properly. Moreover, chronic obstructive pulmonary disease (COPD), which is not temporarily damage to the lungs usually caused by prolonged of smoking.
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that affects breathing. This disease is one that blocks or obstructs air flow which then affects the way that one breathes. It diminishes the capability of airflow in and out of the lungs. COPD is the term used for a group of different diseases that affect the lungs. The two most common types of COPD are emphysema and chronic bronchitis. Emphysema is a destruction of the small bronchioles in the lungs and chronic bronchitis is an inflammation of the lining of the bronchial tubes. Both emphysema and chronic bronchitis are obstructive diseases that impact breathing in a negative manner. (COPD, 2014)
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).
The causes of Pulmonary Fibrosis vary from a patient’s occupation to their medical conditions. Pulmonary Fibrosis is caused by environmental factors along with genetic factors. Genetics plays a role in the contraction by determining a person’s vulnerability. A person being in an environment with asbestos fibers, silica dust, grain dust, and bird or animal droppings is at risk for this disease. Patients who also have gone through radiation could be at risk depending on how much the lung was exposed and how long it was exposed to the radiation. Medications can also factor in to the cause of the disease. Chemotherapy drugs, heart medications, and some antibiotics have been linked to Pulmonary Fibrosis. A patient’s previous medical conditions can aid in the formation of this disease such as pneumonia, tuberculosis, scleroderma, and systemic lupus erythematosus. Some other known causes are smoking and lung infection.
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
Scientists and health officials have been arguing the detrimental effects smoking has on our health for many years. Smoking can lead to serious complications including asthma, pancreas, lung and stomach cancer due to the large number of carcinogens (cancer causing chemicals) and other various substances added to it. It is a health hazard for both smokers and non-smokers and it is especially harmful to unborn babies. Although smokers claim that it helps them to relax and release stress, the negative aspects of the habit take over the positive. As it has been stressed by the scientists and experts, there are some very severe reasons of smoking but its crucial consequences should also be taken into consideration.