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Essay on Pulmonary Obstructive Case Study - Desklib

   

Added on  2020-04-13

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A PULMONARY OBSTRUCTIVE CASE STUDY 1Name InstructorName of the ClassInstitutionCity and StateDate

A PULMONARY OBSTRUCTIVE CASE STUDY 2IntroductionThe rationale of this essay is to systematically discuss the long term condition on a patient. A long-term condition is a state which cannot be immediately treated, instead it can be managed through therapies as well as medications (Conway et al. 2015). The chronic obstructivepulmonary disease abbreviated as COPD is a condition of airflow problems or limitations that are not entirely reversible (British Lung Foundation, 2017). Both the severity as well as the occurrence of the disease are highly connected to age and globally, where the mortality and morbidity incidences are increasing at a higher rate. Currently, there are over 3.5 million citizens with the disease in the United Kingdom and only 0.9million diagnosed cases in Wales and England (Anon, 2017). The disease causes over 30, 000 deaths in the country and is also leading with high hospital admission rates in the country. Worldwide, it is projected that over 3.2 milliondeaths are as a result the condition (Nice.org.uk. 2017). At early development, the condition is neither recognized nor treated/diagnosed yet early diagnosis can slow the progression of the disease (Conway et al., 2015). Some of most common COPD symptoms include shortness of breath, wheezing and having constant coughs (Janson et al., 2013). The symptoms can appear or even get worse when a person has an infection or is a smoker. For those with severe COPD, they experience loss of weight, appetite, and swelling of the ankles.Pain is a significant symptom associated with COPD persons and there are a couple of elements that might lead to higher pain occurrence especially in patients with COPD (Anon, 2017). For example, the systemic inflammatory process is one of the elements that might activatecytokines thus generating neuropathic as well as chronic pain (Gionfriddo et al., 2017). Comorbidities and musculoskeletal problems are also considered to be factors that may lead to pain for persons with COPD (Leung & Sin, 2017). A case of Mr X whose real name is not

A PULMONARY OBSTRUCTIVE CASE STUDY 3identified to maintain confidentiality is a 76-year-old pan paper factory worker with COPD is presented in this write up. He has complications such as hypertension, heart failure as well as post-traumatic stress disorder. Mr X has been smoking since the age of 18 and smokes up to 12 cigarettes per day. The patients respiratory status has been worsening and this presented by the inability to walk beyond a 200 meters distant without the need to rest. His prescriptions were three inhalers; mometasone twice a day, albuterol for every six hours and formoterol twice a day.He also takes oral medicines such as aspirin, metmorphin, esomeprazole, and mirtazapine amongothers. His wife died two years ago, and he has two sons who are his care proxy. The patient moved to a nursing facility in anticipation to get proper care. Before the move, he was an active farmer and did all the activities of daily living by himself apart from shopping due to his mobility problem. Before his admission to the hospital, Mr X fell with a motorbike en route to the market. He was later diagnosed with COPD exacerbations and with the continued use of medication, his condition began to improve and was later discharged from the hospital.Pathophysiology of Chronic Obstruction Pulmonary DiseasesThe pathological ramifications of obstructive pulmonary disease prompt a chain of physiological transformations that affects the quality of life as well as survival in the real progression of the disease (Networks.nhs.uk, 2017)). First and foremost, elastin proteolysis leadsto a reduction in the elastic recoil pressures persuaded by the nearby elastic tissues. However, damage to the elastin in the COPD leads to the narrowing of the airways hence a decline of airflow in the bronchioles as well as the tapping of air in the lungs (Networks.nhs.uk. 2017). Next, the fibrotic alteration of the airways leads to fixed air passages narrowing thus causing

A PULMONARY OBSTRUCTIVE CASE STUDY 4increased air passage resistance that does not at any given moment revert. According to Anon (2017), the bronchial epithelial cells plus the extensive alveolar and the histological features including emphysema as well as the decrease surface area of the alveoli for ventilation and gaseous exchange. The emphysema lowers the elastic recoil pressure of the lung that results to a decreased driving pressure for processes like exhalation flow via the narrowed air passages where air flow resistance is very high (Nice.org.uk. 2017) The fixed air passage obstruction is cardinal the COPD diagnosis plus the severity grading that shows the intensity of small inflammation of the air passage plus the increased muscle tone of the cholinergic airway (Nmc.org.uk. 2017) Because of the increased air passage resistance, there’s a decline in the air flow especially during exhalation that derails the passage ofair from the lung. Ideally, the physiological feature of the COPD is therefore hence detected using spirometric ways. (Nice.org.uk. 2017). According to the patient presented in the case study, pathologically weakening of the elastic tissues produces less inward lung elastic recoil pressure that leads to the removal of air outside the lungs. Transformations in the Respiratory DriveThe destruction of the pulmonary vasculature, as well as alveoli in patients with chronic obstruction, lowers the surface area for diffusion of air thus leading to chronic hypersonic as wellas hypoxic forms (RCP London. 2017). However, the chronic carbon dioxide retention lowers the sensitivity of the gas chemoreceptor apparatus that are not involved in the contribution as the key mechanism of the respiratory drive in persons having the COPD. However, the respiratory insuch disease is driven by hypoxia via receptors situated at the carotid arterioles as well as the aortic arch. According to Wise (2016) hypoxia can also lead to the vasoconstriction of the

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