Pathophysilogy

Admission course

The patient presented to the ED complaining of shortness of breath for the past four days. Pt states that he has been off steroids since January 2014. Etiology of the bronchospasms are unknown. The patient denies any fevers, sweats or chills. The patient states that he does have chest pain like someone sitting on his chest.

COPD

Chronic Obstructive Pulmonary Disease also known as Chronic Obstructive Lung Disease. Airflow into the lungs is limited and progressively deteriorates and is affected by the inflammatory process within the lungs in response to harmful irritants. The most common irritant associated with COPD is smoking however, environment such as occupational hazards, vehicle exhaust pollution and genetics can contribute or be the cause of COPD. Because of chronic inflammation the body tries to repair itself causing further narrowing of the airway. In the trachea and bronchi, excess goblet cells and enlarged submucosal glands put out copious amounts of mucous into the airway. In the peripheral airways inflammation causes thickening of the walls. As this process continuously repeats it leads to pulmonary fibrosis, scar tissue, that loses its elasticity and further narrows the airways. Structural changes affect the parenchyma as well, causing alveolar wall degradation leading to the loss of alveolar attachments negatively affecting elastic recoil. Chronic inflammation causes the hypertrophy of the smooth muscle in the vasculature of the lungs which can lead to or contribute to pulmonary hypertension. COPD patients can inflate their lungs easily but have trouble exhaling CO2 causing their drive to breathe to switch from oxygen driven to that of a hypoxic drive. They are stimulated to breathe in the presence of excess CO2, if too much oxygen is administered, the body will stop breathing because thinking that it is doing its job because of the oxygenation.

Smeltzer et al, (2010) Brunner & Suddarth’s Textbook of Medical-Surgical Nursing...