Pathophysiology of COPD and its Relationship with Clinical Condition: A Case Study

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

1NURSING
This case study is based on Mr. Brown who was presented to the emergency unit of
the hospital with respiratory failure arising out of Chronic Obstructive Pulmonary Disease
(COPD). The essay will begin by giving a brief overview of the pathological condition of Mr.
Brown including his past medical history along with a brief description of his symptoms and
the subsequent representation of the assessment findings. The underlying physiological
mechanism of the cardiopulmonary system will be illustrated along with a brief definition of
COPD. This will be followed by a detailed discussion of the pathophysiology of the COPD
including the principal issues and pathophysiology specific to Mr. Brown’s physiological
state of health. In the following discussion, the essay will try to inter-relate the underlying
pathophysiology of the symptoms, assessment findings and the current clinical condition of
Mr. Brown and will relate with the pathophysiology of COPD. In the conclusion there will be
a compilation of all the significant points raised in the essay and no new information will be
stated.
In this case study, a 65 years old man will be referred as Mr. Brown, it is his pseudo
name. Pseudo name is used in order to keep his identity confidential as her the nursing ethics
and hospital guidelines (Anderson et al. 2015). He was admitted to the emergency unit to the
hospital two days after suffering from ischemic heart disease (IHD). After initial assessment
in the emergency unit, he was shifted to the intensive care unit (ICU). He also has a history of
type 2 diabetes mellitus (T2DM), obesity, bronchial asthma, high blood pressure
(hypertension), high level of blood cholesterol (hypercholesterolemia), chronic renal failure
and severe obstructive sleep apnoea. She was presented to the emergency unit of the hospital
with breathless, persistent cough in the chest as evident from his cough sound along with
wheezing in breath. He was using his accessory muscles to breath. He also had informed the
sensation of pain upon inspiration with swollen ankles highlighting fluid build up. The poster
anterior and lateral chest x-ray revealed that presence of thick phlegm in both the side of the

2NURSING
lungs with pulmonary oedema and bilateral pleural effusions. The chest X-ray results also
revealed Emphysema, an abnormal enlargement of the airspaces present distal to the
respiratory bronchioles and mainly results from the destruction of the septal walls of the
pulmonary cavity (Milne and King 2014). All full set of observation were studied and
recorded followed by an echocardiogram (ECG) test. He was placed on a continuous cardiac
and SPo2 monitoring and his arterial blood gas was obtained. His SpO2 was found low,
recording in between 88 to 90% along with acidic value in the arterial blood gas. Pathological
report was also collected in the parameters like complete blood count, electrolyte balance of
the body and complete renal function test. Since he was suffering from renal problems he was
fitted with indwelling urinary catheter and was placed in loop diuretic. In the loop diuretic,
furosemide (frusemide). Furosemide binds reversibly with the carrier protein Na+/2Cl-/K+
and thus promotes reducing or abolishing NaCl re-absorption in the ascending limb of the
loop of Henle. This in turn decreases the interstitial hypertonicity and thereby reducing water
reabsorption (Duffy et al. 2015). He was also given external supply of oxygen in order to
reducing his high respiratory rate and poor level of oxygen saturation. The external oxygen
supply was given through nasal canula (Frat et al. 2015). Mr. Brown as given intravenous
injection of analgesic in the form of morphine in order to decrease his respiratory effort and
high cardiac output and at the same time reduce the sensation pain during inspiration.
Sivaraman and Yellon (2014) reported that Morphine or opoids have limited direct negative
effects on the overall cardiac contractility. However, opoid administration is associated with
reduced cardiac function when it is administered with additional medication like
benzodiazepines. Opoids caused bradycardia along with bronchila vasodilation and thereby
helping to reduce blood pressure, chest pain, cardiac output and severity of bronchial asthma.
It was observed that Mr. Brown was suffering from fatigue and nausea as he was becoming
drowsy. This might be due to his poor level of oxygen saturation within the b ody along with