Explain the pathophysiology behind the signs and symptoms of COPD
Bronchitis and emphysema are both classified as a chronic obstructive pulmonary disease (COPD). These chronic illnesses obstruct airflow (McCance & Huether, 2019). Because of the elevated mucus in the airway, COPD allows it to close. As a consequence of cilia dysfunction, mucus causes narrowing, which causes shortness of breath, coughing, and difficulty clearing secretions. The obstruction is caused by a narrowed airway, which makes it impossible for oxygen to reach the lungs and prevents CO2 from exiting the lungs, resulting in hypercapnia (Santus et al., 2020). Ventilation-perfusion imbalance is caused by hypercapnia and hypoxia.
Individuals with COPD develop symptoms such as barrel chest and clubbing of the fingers over time as a result of trapped CO2 (also known as air trapping). Distention of the alveoli occurs as a result of air trapping, which may lead to failure. Excessive work of breathing and puffing causes weight loss in some people, especially those with emphysema. Understanding and recognizing the signs and symptoms of COPD are critical for establishing care and management strategies.
What relationship do you see with Mr. Brown’s vital signs – 26 RR, 91% oxygen saturation, temp: 37.8, HR: 93 BP: 150/70
As a result of hypoxia and hypocapnia, Mr. Brown’s respiratory rate has increased. As a result of the faulty gas exchange, the patient is out of breath and has to work hard to breathe in order to expel CO2. Bad oxygenation is caused by mucus blockage and bronchial narrowing, resulting in a decrease in SPO2. Inflammation and infection are the causes of fever. Mr. Brown’s heart rate has risen as a result of a compensatory process in response to the reduced oxygen and increased CO2 levels. As a result of the ventilation-perfusion imbalance, blood pressure rises.
Describe the goals of care for Mr. Brown. Make sure to use the COPD gold standards of care( https://goldcopd.org/wp-content/uploads/2018/02/WMS-GOLD-2018-Feb-Final-to-print-v2.pdf (Links to an external site.) (Links to an external site.)) for your plan.
The plan of care’s main aim is to prevent COPD exacerbations, keep symptoms under control, and avoid/prevent going to the emergency room. It is possible to use both pharmacological and non-pharmacological treatments. Bronchodilators may be used as preventative medicine or to relieve an exacerbation for a brief period of time. Inflammation may be treated with corticosteroids. Pulmonary rehabilitation, oxygen therapy, and lifestyle changes are examples of nonpharmacological treatments. It is important to have education on how to avoid irritants and adhere to treatment plans. Also, recommendations on the use of peak flow meters to assess the degree of obstruction, participating in smoking cessation, avoid cold weather, and restoring optimum ventilation and oxygen exchange should be the top priorities for the target of treatment.
How would you follow up on your proposed plan of care?’
Mr. Brown should return for a follow-up appointment in 1 to 2 weeks to see if his symptoms have changed, and to re-evaluate the lungs, and a chest x-ray may be taken. Mr. Brown may benefit from instruction on how to use the reward spirometer and pursed-lip breathing to alleviate shortness of breath and keep the airway clear. To avoid COPD exacerbations, I will also educate the patient about how to reduce their exposure to chemical irritants and air pollution.