Module 2 Assignment: Advanced Pathophysiology

Module 2 Assignment: Advanced Pathophysiology

Module 2 Assignment: Advanced Pathophysiology

Advanced Pathophysiology

Chronic obstructive pulmonary disease (COPD) is a manageable disease with its primary characterization being airflow limitation which is usually progressive. COPD presents two major phenotypes that often overlap, including emphysema and chronic bronchitis. Emphysema is an abnormal gas exchange airway enlargement that involves alveolar wall destructions in the absence of fibrosis (MacLeod et al., 2021). On the other hand, chronic bronchitis exhibits chronic productive cough and mucus hypersecretion, which occurs mostly three months per year, especially during winter, and is prevalent for two consecutive years. Such COPD phenotypes are present in the patients with an increased chronic inflammatory airways responses to gases or toxic particles. In the case study, the patient’s condition presents as chronic bronchitis. With such knowledge, the paper will discuss the case study patient’s pathophysiologic processes of cardiovascular and cardiopulmonary. Also, there will be an evaluation of racial/ethnic variables impacting COPD physiological functioning and how the process interact.

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Pathophysiologic Processes of Cardiovascular and Cardiopulmonary

COPD affects a patient’s lungs and, in most cases, the heart. The main reason is that the lungs and the heart collaborate in providing different body cells with oxygen, making cardiac and COPD comorbidities share similar risk factors, signs, and symptoms, including the pathophysiological process (Santus et al., 2019). Expiratory flow limitation is common with COPD patients when tidal respiration holds maximal possible flow volume. When such flow limitation occurs, the lung’s expiratory time for spontaneous breathing is usually limited, thus declining the natural relaxation of the end-expiratory lung volume (EELV), causing lung overinflation (Santus et al., 2019). Hence, when patients experience such limitations, EELV becomes more dynamic and a continuous process that fluctuates though it depends highly on prevailing ventilator demand and expiratory flow limitation. Hence, when the case study patient experiences COPD exacerbations, the airway resistance increases due to factors like sputum inspissation, mucosal edema, and bronchospasm, thus worsening expiratory flow limitation (Santus et al., 2019). Such reactions prolong lung emptying time, thus increasing the EELV dynamic. That explains why the patient experiences shortness of breath since the patient has a shallow breathing pattern, limiting lung emptying time. Such condition increases COPD morbidities, and the healthcare providers’ interventions are essential.

Racial/Ethnic Variables Impacting Physiological Functioning and Ways the Processes Interact

There is a high possibility of COPD being influenced by racial or ethnic factors. Currently, there is limited data on COPD occurrence in different ethnic and racial groups; however, the existing data proves that there are different occurrences of COPD in different patients, which largely depends on biological and genetic differences (Ritchie & Wedzicha, 2020). Such differences also mean that COPD diagnosis, treatment, and management may differ among individuals. The main cause of COPD worldwide is cigarette smoking among most non-white patient populations. Also, in a research conducted by Lee et al. (2018), the authors found that ethnicity and race factors project an association with COPD. Their research revealed that non-Hispanic blacks were the highest smokers and presented a variety of comorbidities like asthma and hypertension, which are associated with COPD. Also, non-Hispanic Whites present a variety of comorbidities like myocardial infarction and osteoarthritis, with the Hispanics having the highest BMI levels and asthma. Such considerations of the coexisting comorbidities among different racial and ethnic groups since they impact the COPD prognosis make their early diagnosis and management essential among different racial groups (Ryrsø et al., 2018).

Conclusion

The case study patient has been experiencing chronic bronchitis, one of the COPD phenotypes. The pathophysiological process of COPD affects both the heart and lungs since these two organs collaborate in providing the body cells with oxygen. Hence, once oxygen limitation occurs in the airwaves, it becomes an issue for the patients. Also, COPD is associated with different ethnic and racial groups, thus presenting different causes. Hence, it will always be essential to consider racial and ethnic groups’ impact on COPD to manage the condition effectively.

References

Lee, H., Shin, S. H., Gu, S., Zhao, D., Kang, D., Joi, Y. R., … & Park, H. Y. (2018). Racial differences in comorbidity profile among patients with chronic obstructive pulmonary disease. BMC medicine, 16(1), 1-8. https://doi.org/10.1186/s12916-018-1159-7

MacLeod, M., Papi, A., Contoli, M., Beghé, B., Celli, B. R., Wedzicha, J. A., & Fabbri, L. M. (2021). Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention and disease impact. Respirology, 26(6), 532-551. https://doi.org/10.1111/resp.14041

Ritchie, A. I., & Wedzicha, J. A. (2020). Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clinics in chest medicine, 41(3), 421-438. DOI:https://doi.org/10.1016/j.ccm.2020.06.007

Ryrsø, C. K., Godtfredsen, N. S., Kofod, L. M., Lavesen, M., Mogensen, L., Tobberup, R., … & Iepsen, U. W. (2018). Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC pulmonary medicine, 18(1), 1-18. https://doi.org/10.1186/s12890-018-0718-1

Santus, P., Pecchiari, M., Tursi, F., Valenti, V., Saad, M., & Radovanovic, D. (2019). The airways’ mechanical stress in lung disease: implications for COPD pathophysiology and treatment evaluation. Canadian Respiratory Journal, 2019. https://doi.org/10.1155/2019/3546056

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Module 2 Assignment advanced patho 6164

Scenario 45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. Patient has history of COPD with chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals flattened diaphragm and increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided
Introduction
Explain the following
• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.
Conclusion
Give 5 references

Reading links

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
https://go.openathens.net/redirector/waldenu.edu?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961993/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
• Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
• Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
• Chapter 35: Structure and Function of the Pulmonary System; Summary Review
• Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review