Literature Review: Pathophysiology of COPD in Nursing Practice

This literature review examines Chronic Obstructive Pulmonary Disease (COPD) within a nursing context, focusing on the pathophysiology underpinning diagnosis, treatment, and management strategies. The review begins by highlighting the significant health risks associated with cigarette smoking and its contribution to COPD, discussing the impact of both active and passive exposure to tobacco smoke on cardiovascular occurrences. It delves into the pathophysiological factors, including oxidative stress and cellular mechanisms, that contribute to the development of COPD, emphasizing the role of inflammation, stenosis, and low-density lipoprotein cholesterol degradation. The review then explores the clinical manifestations of COPD, such as shortness of breath, mucus production, and coughing, along with the treatment modalities including medications like antibiotics, inhalers (bronchodilators and steroids), and self-care habits. Furthermore, it discusses the management of COPD, emphasizing the importance of lifestyle modifications, vaccinations, and regular health check-ups to mitigate the risk of disease progression and exacerbations. The review concludes by discussing the link between smoking and COPD and the importance of smoking cessation to preserve lung health and improve overall outcomes. This review provides a comprehensive overview of COPD, offering valuable insights for healthcare professionals and students alike.

Nursing literature review

Table of Contents
INTRODUCTION...........................................................................................................................3
Literature review..............................................................................................................................3
CONCLUSION ...............................................................................................................................9
REFERENCES .........................................................................................................................10

INTRODUCTION
Cigarette smoking (CS) remains an important health risk as well as contributes greatly to
death rates and metabolic morbidity. Cigarette smoking effects both stages of osteoporosis, the
latter of which is predominantly thrombotic, from endothelial failure through severe health
incidents. Active and passive (environmental) exposed to tobacco smoke both are predisposed to
Cardiovascular occurrences (Button, Harrington and Belan, 2014). It is questionable if there
really is a distinct clear dose-dependent association between smokers and danger, as a highly
nonlinear link to smoking active smoking has been seen in some new research clinical trials. The
exact toxic elements of cigar smoke as well as the factors underlying in cardiovascular
dysfunction associated with CS are largely unexplained, however CS increases inflammation,
stenosis, and degradation of low-density lipoprotein cholesterol. Latest experimental and clinical
findings support the notion that exposure to cigar smoke boosts cell death as a possible
mechanism.
Literature review
1. Pathophysiological factors or altered development underpinning the diagnosis of the
health problem in your speciality area.
In virtually all biomolecules, reactive nitrogen compounds (both socialists and non-radicals),
sensitive carbonyl substances, as well as other organisms may cause oxidative stress, sacrificing
the structure and/or work. Different in vitro and in vivo comparative including redox
transcriptomic methods have been used to test improvements in protein production and complex
endogenous protein modifications caused by tobacco active smoking, however, and are outlined
in this study. Several gel-based as well as gel-free transcriptomic approaches have also been
widely used in cultured cells, experimental animals, and individuals to gain clues regarding
smoking impact on distinct proteins. The further application of other responsive screening
methods could be helpful in integrating the understanding of the effects of tobacco smoke on
public health. Carbon dioxide is found but inside once the body consumes oxygen. The
replacement of oxygen through greenhouse gases is the responsibility of the lungs. Even though
with their lungs are not working as well, an individual with COPD does have more trouble
implementing this interchange. It might contribute to an atmospheric carbon accumulation and
low availability of blood (Gazza and Hunker, 2014).

It will become fatal if greenhouse gases ends up in the body when oxygenation become quite
small. The body's signs of too much greenhouse gases include:
 Uncertainty
 Headache that is serious
 Trouble strolling even small journeys
 Having trouble holding your breath
If these signs arise, then it is necessary to obtain medical care right away (Norman, 2012).
The doctor may recommend medications that can use at homes if the problems are not
serious. This include descriptions of:
Antibiotics: If the breathing disease is present by infection, getting treatment will either slow
down the disease or prevent it from becoming worse.
Inhalers: It's difficult to avoid whenever the tiny, treelike portions of the lung, called alveoli,
get small or packed with amniotic fluid. 2 categories of medications are available:
bronchodilators and inhalers with steroids. Bronchodilators loosen up air passages and need such
simpler. Ipratropium / salbutamol (Combivent Respimat) as well as Levalbuterol (Xopenex) are
instances. Drug inhalers, like fluticasone / warfarin (Advair), minimise respiratory disease but
are often combined.
PHYSICAL SYMPTOMS:
A person suffers from Chronic Obstructive Pulmonary Disease can sense shortness of breath
subsequently any physical activity or any common action like climbing stairs.
Lungs elicit more mucus and the bronchioles come to be swollen and thinner results in difficulty
breathing and excess mucus makes the lungs more vulnerable to infection.
Inhale of oxygen becomes difficult with excess mucus in airways. This means in lungs,
capillaries find less oxygen for gas exchange.
Exhale of carbon dioxide becomes less also.
Coughing in order to release mucus is one of the sign of COPD.
SOME OTHER SIGNS OF COPD:
Wheezing while breathing is one of the sign one can notice and Mucus can cause tightness in
chest. Fatigue or light-headedness can be the sign because of less circulation of blood to the
brain or throughout the body. Less energy than normal with minor other symptoms can also be
the symptom of COPD.

Along with this there are also several signs of symptoms of COPD exacerbation such as
difficulty in sleeping, fever, feeling confused or dizziness, increased breathlessness, enhanced
weakness or fatigue, increase quantity or quality of mucus, worsening cough, walking up along
with headache. These are the some common sign that are considered by Chronic Obstructive
Pulmonary Disease patient as well as conduct treatment accordingly as well as it is also essential
for them to visit to doctor or medical professional when they experienced these signs.
Smoking can also be the major cause of COPD so in order to prevent, one may not smoke. After
many years of smoking, one can conserve lung health if he quits having smoke. Better lung
functions can be maintained by healthy lifestyle.
Steroids: These medicines are meant to alleviate irritation of the lungs, leading to widening and
inflammation including the air passage for example is methylprednisolone (Medrol). By
following such self-care habits, they may help stop Side effects. They include:
 Prevent damage to allergic reactions in the house, like propane heaters
 Preventing huge crowds from being ill during the winter months
 Drinking loads of water to stop being too dense with mucus
 An regular flu vaccination in order to avoid a viral disease
 Hold regular meetings with their health professional, like the pulmonologist,
 Whenever practicable, tracking the oxygen content, maybe through the wellbeing of a
tiny system called another pulse oximeter.
 Good practises, such as having enough night's sleep through eating a balanced diet
 Even before the health professional advises that you stop smoking or prevent respiratory
problems, they earn a measles or varicella shot
 Frequent cleaning of the palms or using antibacterial wipes to avoid the transmission of
germs
2. Pathophysiological factors or altered development underpinning the treatment and
management for the common health problem in your specialty area.
The most common health problems can be physical inactivity, overweight and obesity, tobacco
consumption, HIV/AIDS, mental illness, injury and violence and the environmental quality (Li
and Jones, 2013).
TREATMENT:

Medicines are the primary interventions for the treatment and management of health problems.
Most of the countries have developed the treatment guidelines to ensure the rational use of
medicines. During the course of illness some people either seek medical attention in health
facilities or self-medication. They don’t even go for any treatment but to take a proper treatment
for any illness should be must. For instance treatment for obesity and overweight is to have a
healthy, reduced calorie diet and regular exercise. Joining a local weight loss group and by
taking up activities like walking, jogging, swimming. One can seek help from a trained
professional, and even if all this don’t help to lose weight, there is a medication recommended
called orlistat, which will help in reducing the amount of fat absorbed during digestion. Another
common health issue is mental illness and there could be many classes of mental illness and the
treatment depends on the type of mental illness a person have. In many cases a combination of
treatment works at its best. If a person having mild illness with controlled symptoms, primary
care provider would be enough for the treatment. A team approaches to make sure all the
psychiatric, medical and social needs are met. This is important for severe mental illness like
schizophrenia. The treatment team may include family or primary care doctor, nurse practitioner,
physician assistant, psychiatrist, psychotherapist, pharmacist.
MANAGEMENT OF HEALTH PROBLEMS
Being physically fit means chances of getting injured doing physical activity are reduced. Eating
a well-balanced diet that is high in fruits and vegetables will help you to maintain healthy
weight. Mental health is also important. Exercising daily and eating well can help guard against
depression. Being healthy stabilizes your mood and sharpens your memory. A less stressed life
help you to sleep better , which leads to more energy good mental health can also be about
maintaining healthy relationships and feeling positive about life. For professional mental health
advice, seek help to a doctor who might direct you to a psychologist, counsellor, or psychiatrist
(McCaffrey and McConnell, 2015).
VACCINATIONS
The most effective way of protecting childrens and adults against diseases is immunization. If a
vaccinated person comes in contact with a disease, their immune well equipped to fight with it,
preventing it either to develop or to reduce its severity. Immunization also protects the
community by helping to control serious infectious diseases. The best possible way to manage
the problems is to monitor on health or to seek a general practitioner for regular health check-

ups. Regular health check-ups are necessary part of personal health management at all stages of
life. At the age of 20 and 20 check-ups recommended includes blood pressure, Pap test, dental
checks, skin cancer check-ups for those at higher risk. At the age of 40 it is important to have eye
check-ups, breast check-ups for women, cholesterol check-ups, health assessment if you are at
risk of heart disease, cholesterol checks. If better health is managed then there are good chances
of living a healthy lifestyle. This includes reduced risk of diseases like heart diseases, stroke and
diabetes. Improving the stability, flexibility and strength, stamina and range of movement. From
Category A to Group D, physicians divide COPD into 4 phases. Category A has less effects as
well as a small likelihood of cardiac events, whereas Group D has much more signs as well as a
greater risk of recurrences.
They can advance through each of phases also because disease is chronic. This, though, typically
happens for several years. Such hypotension can be fatal. They would not have been able to
inhale without even a respirator unless the lungs are working improperly. It's also likely that a
respirator could not supply the lungs with adequate oxygen. The risk of a worsening may be
minimised by proactive self-care interventions like those described earlier. Contact the doctor for
extra precautions to avoid recurrences of COPD that they may take. An overall prevalence with
myocardial Infarction is correlated with smoking cigarettes. With such an exponential decrease
exceeding the threat of ex-smokers after 5 years of termination, withdrawal of smoking
substantially decreases this threat over even a 1 to 3 year (Nibbelink and Brewer, 2018).
Latest results show an immediate decrease in thrombotic incidents with the absence of smoking.
It is recorded at after a six-month time span in Helena, Montana, a nationwide ban on smoking
throughout public areas decreased the frequency of acute MI by 60 percent throughout that era.
In addition, pathological findings of sudden cardiac death suggest that CS raised the likelihood
of plaque breakup and acute stenosis of lipid-rich, thin-capped atherosclerotic plaque in boys;
membrane degradation with lipid-rich thin-capped atherosclerotic plaque was really the main
material in women smoking. This free radicals may theoretically originate from tobacco smoke
directly and even from compounds derived indirectly. In addition, potentiated by several
chromogenic and constant heat impact, the primary incidence of chronic coronary events is
intravenous thrombosis. A growing body of epidemiological, clinical, including laboratory
evidence have suggests that there could be nonlinear pathologic consequences of exposure to
tobacco smoke on cardiac health. Future research exploring the possible oxidative cellular

pathways that cause tobacco smoke can further the understanding pathology of cigar smoke and
cardiac dysfunction (Shen, 2015).
Chronic Obstructive Pulmonary Disease (COPD) is an ailment which can be endangered to life.
It affects lungs and a person’s ability to breathe. It involves development of unfavourable
functional modifications related with COPD, it is pathophysiology of COPD. Chronic
Obstructive Pulmonary Disease damages the airways and lung’s tiny air sacs. Some COPD
symptoms are cough, sputum, breathe lessens etc. COPD symptoms evolve from a cough with
mucus to difficulty in breathing.
Some preventive measures can be taken to reduce risk of developing COPD.
EFFECTS:
The ‘term’ COPD used for various chronic lung diseases. Chronic Bronchitis and Emphysema
are two major conditions of COPD. Different parts of the lungs can be affected by these two
diseases head to problematic breathing.
In order to understand pathophysiology of COPD, it’s important to understand the lung’s
structure.
Air moves down through the ‘Trachea’. It divides into two smaller tubes called ‘Bronchi and
each Bronchi divides and forms smaller tubes ‘Bronchiole’. Alveoli are pouch like air sacs found
at the end of each smallest bronchiole. Alveoli are lined by epithelial tissues which help in flow
of blood and gaseous exchange. ‘Capillaries’ are tiny blood vessels through which oxygen moves
from the lungs to the bloodstream. Before exhaling, carbon dioxide reaches to the capillaries
from the blood in exchange and then it moves to the lungs in order to exhale.
A disease called ‘Emphysema’ is a disease of alveoli in which walls of the alveoli made by fibre
becomes deteriorated. Exhale of carbon dioxide out of the lungs becomes hard because of less
flexibility of the walls caused by the disease Emphysema and as a result of inflammation of the
airways, Bronchitis occurs with subsequent mucus production.
CAUSES:
Tobacco smoking results in COPD. Inhale of fumes from chemicals or toxic substances
irritate/harm the air sacs and airways. This puts COPD’s patient in a susceptible state.
Some other causes of COPD are second-hand smoke like cigarettes, environmental chemicals
like pesticides and herbicides and fumes from gas can also be the cause of it.

CONCLUSION
By conducting analysis of above mentioned topic it can be summarised that in current
time huge population is doing smoking which is very injuries to the health as it may also leads to
the risk of death as well as it also leads to metabolic morbidity. There are several effect of
cigarette smoking such as it impact on both the stages of osteoporosis as well as it also leads to
several health incidents such as damage of lungs, breathing issues and so on. There are several
physical symptoms which help in determining whether a person is suffering from Chronic
Obstructive Pulmonary Disease or not such as it leads to shortness of breath, exhale of carbon
dioxide get decrease, feeling difficulties in climbing stairs and so on. Along with this, there are
several other signs of COPD such as wheezing during breathing, mucus get tight in chest, light
headedness and many others. In respect of this, there are numbers of preventive action which can
be used to overcome from COPD such as drink a lot of water, prevent from damage to allergic
reaction at house, conduct regular check up of health, take regular flu vaccination and many
others. In addition to this, there are several other management which can be adopt in respect of
health problems such eat healthy as well as seasonal food and vegetables, take proper sleep, do
regular exercises and many more. It is essential for a person to consider preventive measures in
order to avoid effect of Chronic Obstructive Pulmonary Disease such as leads to lungs diseases,
breathing issues and so on. The main aspects due to which COPD take place are second hand
smoke such as cigarettes as well as it also leads due to chemical environment like pesticide as
well as fumes from the gas.

REFERENCES
Books and Journals
Button, D., Harrington, A. and Belan, I., 2014. E-learning & information communication
technology (ICT) in nursing education: A review of the literature. Nurse education
today, 34(10), pp.1311-1323.
Gazza, E.A. and Hunker, D.F., 2014. Facilitating student retention in online graduate nursing
education programs: A review of the literature. Nurse education today, 34(7), pp.1125-
1129.
Li, Y.I.N. and Jones, C.B., 2013. A literature review of nursing turnover costs. Journal of
nursing management, 21(3), pp.405-418.
McCaffrey, G. and McConnell, S., 2015. Compassion: a critical review of peer‐reviewed nursing
literature. Journal of Clinical Nursing, 24(19-20), pp.3006-3015.
Nibbelink, C.W. and Brewer, B.B., 2018. Decision‐making in nursing practice: An integrative
literature review. Journal of clinical nursing, 27(5-6), pp.917-928.
Norman, J., 2012. Systematic review of the literature on simulation in nursing education. ABNF
Journal, 23(2).
Shen, Z., 2015. Cultural competence models and cultural competence assessment instruments in
nursing: a literature review. Journal of Transcultural Nursing, 26(3), pp.308-321.