Health Assessment: Emphysema Pathophysiology and Treatment Overview

This report provides a comprehensive overview of emphysema, a chronic obstructive pulmonary disease (COPD) affecting a significant number of individuals globally, with a focus on the Australian context. The paper begins by defining emphysema, highlighting its prevalence, particularly among smokers, and the damage it causes to the alveoli in the lungs. The pathophysiology section details the mechanisms of the disease, including the destruction of alveoli and its impact on gas exchange, leading to breathing difficulties and other health complications. It then explores the immunological aspects of emphysema, such as the activation of epithelial cells in the alveoli due to irritants. The report also covers pharmacological treatments, including bronchodilators and steroids, and emphasizes that there is no cure, only symptom management. Finally, the report discusses the importance of patient education, focusing on factors such as the severity of the condition, home care, medication adherence, smoking cessation, and the patient's age, to help them manage the disease and improve their quality of life. The report concludes by emphasizing the impact of emphysema on physical health.

Running head: HEALTH ASSESSMENT: EMPHYSEMA
Health Assessment: Emphysema
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HEALTH ASSESSMENT: EMPHYSEMA 2
Health Assessment: Emphysema
Introduction
Emphysema is one of the leading causes of death in Australia and around the globe. It is
one of the smoke-induced conditions that are associated with infection and damaging of the
lung. According to Healthdirect Australia (2019), emphysema affects one in twenty people
above the age of thirty-five years. Even though this disease is more pronounced in people that
smoke tobacco, it also affects people exposed to irritants. According to Barnes (2016),
emphysema causes the inflammation of the alveoli in the lungs to the point where they break.
The Cancer Institute of Australia (NSW) reported that nearly seven thousand deaths annually are
attributed to emphysema and COPD (NSW, 2019). NSW further estimates that nearly 1.5
million Australians suffer from this condition. The most affected group is men and people above
the age of thirty-five years. According to Healthdirect (2019), smokers are six times likely to
contract emphysema compared to non-smokers. Additionally, people who have quit smoking are
five times likely to contract emphysema compared to non-smokers. People suffering from
emphysema cannot inhale or exhale air due to damaged air sacs. This paper discusses the
pathophysiology of emphysema, pharmacological treatments, and patient education
considerations for people affected by this condition.
Pathophysiology, Immunology, and Impact on Homeostatic Processes
Pathophysiology refers to the changes caused in the body by the presence of a disease.
For emphysema, the changes start with the damage to the airways and destruction to alveoli
(Craft, Gordon, Huether, McCance, Brashers, 2018). According to Boka (2016), emphysema is
mainly the disease of alveoli or the air sacs. Alveoli are tiny structures in the lungs that allow the
exchange of oxygen and carbon dioxide. Gas exchange in lungs requires that the alveoli are

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intact. Since inflated alveoli do not have the capacity to handle gaseous exchange, the infection
from emphysema interferes with the respiratory process by rendering the alveoli ineffective.
When emphysema attacks the alveoli, the fibers become damaged or less elastic to the extent that
they cannot recoil when a person inhales or exhales. The lungs are then filled with mucus as they
become flabby and less elastic to recoil after breathing out. In cases where the alveoli have
reached permanent damage, the alveoli collapses when one breathes out, making it impossible
for the person to breath in after managing to breath out. Since homeostatic processes rely on
oxygen for respiratory processes, an analysis of the impact of emphysema reveals how the
disease interferes with the normal functioning of the body.
When the alveoli are damaged, it becomes difficult for them to allow the exchange of
carbon dioxide and oxygen. As a result, oxygen cannot move into the tissue effectively. Initially,
a person can breathe but when it reaches a point where the alveoli have become stiff to take in
air, the patient may succumb to emphysema due to lack of oxygen supply to the body
(Goldklang & Stockley, 2016). Additionally, the inflation of alveoli causes accumulation of
mucus and dust in the alveoli because of damage to the airways caused by emphysema. In cases
where the person cannot get rid of carbon dioxide from the body, the higher concentration of the
gas in the body may cause death. Additionally, lack of sufficient distribution of oxygen to vital
organs such as the heart, kidney, and the liver makes it impossible for the body to function
normally. The effects of lack of oxygen and impairment may be evident through difficulties in
breathing, wheezing sound when breathing, fatigue, anxiety, and swelling in legs. Bhavani, Tsai,
Perusich, Hesselbacha, and Farah (2015) explain that the immunology of emphysema occurs
when the epithelial cells in the alveoli are activated by cigarette smoke or exposure to gas fumes
and irritants. For active smokers, it may take time before the person notices that he is suffering

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from emphysema. The fact that the inflammation and destruction of alveoli is irreversible,
people diagnosed with emphysema are encouraged to quit smoking to avoid further damage to
their lungs.
Pharmacology Treatments for Emphysema
Currently, there is no cure for emphysema because the damage caused to the lungs is
irreversible. As a result, the treatment options available only help reduce the symptoms of the
disease and the progression to other parts of the lung. According to Craft, Gordon, Huether,
McCance, and Brashers (2018), bronchodilators, steroids, and antibiotics are the treatment
options used for people diagnosed with emphysema. Bronchodilators reduce the resistance in the
airways, allowing air to flow to the lungs (Fairview, n.d.). When administered, bronchodilators
and steroids help relieve breathing difficulties and shortness of breath. Examples of inhaled
bronchodilators include albuterol, levalbuterol, and long-acting beta agonists. Bronchodilators
relax the bronchial muscles so that the affected person can breathe normally. Heitz (2016)
further explains that bronchodilators help in reducing the inflation of the alveoli by reducing the
resistance to the airflow and preventing the accumulation of mucus in the alveoli. It is advisable
that people on medication avoid smoking to reduce the dangers associated with this condition.
Patient Education as an Intervention
Patient education applies to people that have been diagnosed with emphysema and are
undergoing medication. The physician should take into consideration some key factors including
but not limited to:
 The severity of the condition in the patient. If the condition is severe, one may be asked
to quit smoking

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 Home care may be considered for patients that need emotional and family support to
cope with the condition. The person may be asked to join rehabilitation programs or
religious groups if they are available within the community (Bhavani, Tsai, Perusich,
Hesselbacha, & Farah, 2015).
 In cases where the medications have been prescribed to the patient, the physician should
encourage the patient to take medications as instructed.
 In cases of early diagnosis, the physician should encourage the person to quit smoking
and avoid irritants or change of work schedule if one works in areas prone to gas fumes
(Boka, 2016)
 The age of the patient should also be taken into consideration. Younger patients could be
encouraged to stay physically fit through regular exercises.
Conclusion
Emphysema is one of the chronic obstructive pulmonary diseases that affect a significant
number of people in Australian by interfering with their physical health. The primary cause of
this disease is cigarette smoking. It occurs as a result of damage and inflammation of alveoli that
renders them ineffective to facilitate gaseous exchange. Even though the disease is not curable,
bronchodilators are used to manage it.

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References
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disease. Journal of Allergy and Clinical Immunology, 138(1). Retrieved from
https://www.jacionline.org/article/S0091-6749(16)30362-1/pdf
Bhavani, S., Tsai, C., Perusich, S., Hesselbacha, S., & Farah, K. (2015). Clinical and
immunological factors in emphysema progression. American Journal of Respiratory and
Critical Care Medicine 192(10). Retrieved from
https://www.atsjournals.org/doi/pdf/10.1164/rccm.201504-0736OC
Boka, K. (2016). Emphysema. MedScape. Retrieved from
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Craft, J., Gordon, C., Huether, S., McCance, L., & Brashers, V., L. (2018). Understanding
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Cancer Institute NSW (2019). What is COPD? Retrieved from
https://www.healthdirect.gov.au/emphysema-and-copd-statistics
Fairview (n.d.). Discharge instructions for emphysema. Retrieved from
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Goldklang, M., & Stockley, R. (2016). Pathophysiology of emphysema and implications.
Chronic Obstructive Pulmonary Diseases, 3(1), 454–458. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559126/
Healthdirect (2019). Emphysema and COPD statistics. Retrieved from
https://www.healthdirect.gov.au/emphysema-and-copd-statistics
Heitz, D. (2016). Emphysema. Healthline. Retrieved from
https://www.healthline.com/health/emphysema