Alterations in Pulmonary Functions

Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students

Introduction

Alterations in pulmonary functions lead to breathing difficulties and often progress to respiratory failure or distress if not managed well. Both allergies and asthma occur correspondingly, whereas lung cancer starts in the lungs. COPD results from a reduced flow of air following inflammation of the airways similar to asthma which is also a respiratory disease that causes the narrowing of airways after which the airway swells to produce extra mucus. The objective of this paper is to discuss the pathophysiologic relationship between allergies and asthma, lung cancer along with its clinical manifestations and tests for diagnosis, the pathophysiologic differences between changes in asthma and COPD and to discuss how oxygen therapy is vital to treat COPD along with its merits and demerits.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)

Pathophysiologic Connection between Asthma and Allergies

Both asthma and allergies have a pathophysiological connection and often occur together. For example, the substances used to trigger a fever, such as pollen, can also cause signs of asthma. Food allergies result in asthma symptoms in some people. Allergies lead to asthmatic symptoms (Virchow & Agache, 2012). Allergic reactions take place when the body’s immune system identifies by mistake substances that are harmless like tree pollens as invaders. The antibodies bind to the allergen to protect the patient’s body from the substance. The allergic symptoms like itchy skin are caused by the chemicals that are produced by the body’s immune system (Mohit & Rina, 2019). The reaction affects the airways and lungs, causing asthmatic symptoms. Allergies and asthma are treated alike; the leukotriene modifier is consumed by the patient daily to control the immune system chemicals that are released when allergic reactions occur (McCance, Huether, Brashers, & Rote, 2014). Immuno-therapy also treats asthma and allergies, improving the immune system response. (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
A variety of factors intricately link asthma to allergic reactions. Chabra & Gupta (2019) point out that a family history of allergic reactions increases the risk of asthma. Moreover, patients with higher fever and allergies have a higher chance of suffering from asthmatic symptoms (Chabra & Gupta, 2019). Asthma is also triggered by infections, stress and cold air. Asthma is a respiratory disease classified according to mild intermittent symptoms that last twice each week, mild, moderate and severe persistent asthma whose symptoms last up to six weeks (Chabra & Gupta, 2019). Asthma can be life-threatening to patients. However, its symptoms can be controlled. (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Bronchial thermoplastic, a way to open up a patient’s airways is used as a treatment for asthma (Fraser, Spooner, Dunster, Anstey, & Corley, 2016). This procedure employs gentle heat that is used to shrink the smooth lung muscles which tighten during asthmatic attacks, making it difficult to breathe. Bronchial thermos-plasty is given in three different sessions with a duration of 3 weeks after every session. This treatment is administered to patients with severe asthma between the ages of 18 years to 65 years with asthmatic attacks that are not controlled by inhalers. However, the manifestation of the respiratory disease varies from one patient to another. Symptoms for asthma flare up in different situations including allergy, occupational and exercise-induced asthma (McCance, Huether, Brashers, & Rote, 2014). The triggers of asthma include air pollution, chemical irritants, smoking tobacco, and allergens like dust, pollen and mounds.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)

Pathophysiology of Lung Cancer, Clinical Manifestations, and Diagnostic Tests

Lung cancer is categorized based on how it appears as small and non-small. Patients that suffer from lung cancer cough a lot lose weight, and suffer from dyspnea and hemoptysis. Patients that have lung cancer are treated using chest radiography (Hammerschmidt, & Wirtz, 2009). Non-small cell lung cancer is categorized into squamous and larger cell carcinoma. This type of cancer is realized through molecular tests and histochemical stains. When a smaller amount of tissue can be tested, the entire testing process becomes problematic (Virchow & Agache, 2012). The treatment option depends on both the tumour’s phenotypic and genotypic characterization.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Patients who have cancer always indicate positive symptoms whenever they are dragonized. The signs that show upon diagnosis are as a result of the primary tumor, hemoptysis, coughs and distant metastases (Hammerschmidt, & Wirtz, 2009). The signs also occur due to the paraneoplastic syndromes caused by ectopic hormonal changes from the tumor’s reaction to the body. Small cell Patients who have lung cancer have a paraneoplastic syndrome that should be treated (McCone & Rote, 2014). NSCLC has digital clubbing syndrome. Data from the referral centers is used to deduce data about the symptoms of lung cancer which makes primary care difficult. The symptoms which increase the likelihood of lung cancer include hemoptysis, loss of appetite, fatigue, rib pains and constant coughs. Whenever patients are tested and show more than one symptom, the positive predictive value is higher than 10% (Pisani & Nava, 2017). The patients who have lung cancer are at the age of 41 years. Ultimately, lung cancer also occurs in young people who show more risk factors as well as older adults.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)

Pathophysiologic Changes in COPD and How Does It Differ From Asthma

A life-threatening process which affects the breathing process and lungs is called COPD. COPD also refers to multiple chronic lung diseases, including emphysema and bronchitis. Patients suffering from COPD begin to experience damaged lung air sacs and airways. The symptoms advance from excessive coughing to problems with breathing, and the changes are irreversible (Yeh, & Horwitz, 2017). During this stage, preventive actions are taken to prevent the risk of severe COPD development. The COPD diseases damage the lungs of the patient creating breathing complications. The damage of capillaries in the alveoli causes a condition known as Emphysema (Fraser et al., 2016). The destruction of the alveoli fibers makes them unable to recoil when breathing out carbon dioxide from the lungs. The inflammation of the lung airways leads to the continuous production of mucus and with consistency, this process creates chronic bronchitis. Temporary acute bronchitis bouts also occur but are not similar to COPD. (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
The breathing process for patients suffering from COPD does not return to its normal state while breathing in asthmatic patients returns to normal states when attacks occur. The symptoms in both cases become severe gradually, with COPD patients generating more phlegm and mucus than asthmatic patients (Fraser et al., 2016). COPD patients experience chronic coughing and blueness to fingernail or lips that create a cyanosis condition. This disease occurs because of too much exposure to lung irritants which lead to cell damage. (Mohit & Rina, 2019). COPD is caused mainly by smoking cigarettes or tobacco for both first hand, and second hand smokers. Genetic aspects also cause COPD through inheritance, deficiency of alpha-1, and toxic fumes. However, smoking cigarette remains the first cause of COPD (Pisani & Nava, 2017). Cigarette smoking acts as an asthmatic trigger in patients despite varying from one patient to another. For example, it can be caused by airborne substances like pollen grains, mold spores, dust and pet food. In some patients, asthma is caused by inflammatory immune reactions. (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)

Use of Oxygen Therapy in Patients with a Diagnosis of COPD

Obstructive pulmonary disorder causes difficulties in breathing. The treatment used to cure this condition offers the patient extra oxygen to enable them to breath much easier and even become active at the same time (Yeh, & Horwitz, 2017). Patients that suffer from this condition require the treatment later on even if they do not feel like having it right away. This aspect happens because their lungs take in and let out less air than before, and as such, their lungs are destroyed or damaged (White & Stevenson, 2018). Patients have COPD whenever their airway walls get inflamed and generate mucus which also gets clogged. This is because the tiny air sacs in your lungs have become damaged or destroyed. COPD is also experienced when the walls of your airways are inflamed or if your airways start making more mucus so that it gets clogged. This process enables more supplemental oxygen inhalation in to the lungs (Bruyere, 2012). (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
The process of inhaling more oxygen in the body system enables few bouts of being breathless, creating less sleepless nights. This process boosts the will, ability and enhances a person’s breathing speed reducing challenges in inhalation. This procedure improves a patient’s mood, focus and prevents heart attacks leading to healthier lives (Fraser et al., 2016). The challenge which occurs with oxygen therapy is the change of a fire accident. The physicians are advised to stay more than 5 feet from the flame when carrying out the oxygen therapy using a tank that is portable or practicing the therapy at home (Fraser et al., 2016). The practitioner should not take the tank filled with oxygen in a space that is confined. Ultimately, patients undertaking the therapy may experience irritation around their nose or skin, their noses might dry on the inside or bleed once in a while whenever they have headaches, stay for long on the sun or get tired.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)

Case study 13 – BACTERIAL PNEUMONIA

Patient case question 1: the type of illness is considered community-acquired because it is not acquired in the hospital.
Patient case question 1: Lethargy is the state of sluggishness, drowsiness and a state of lack of energy and mental alertness. This state is caused by several things such as drugs, illness and injuries. (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Patient case question 3:
Atenolol – HTN
HCTZ – HTN
Nortriptyline – depression
Patient case question 4:
Female, age 84-10 = 74 points
CVA, suffered a stroke four years ago 10 points
AMS = 20 Points
Arterial PaO2 < 60 mm Hg = 10 points
Respiratory rate ≥ breaths per minute = 20 points
Total score 134
Patient case question 5: Mrs. I’s Pneumonia severity of illness score is > 91 points, she is considered seriously ill and should be admitted to the hospital for treatment. The PSISS Score above 130 pts places her in the highest risk class V, which is taken to be seriously ill and needs hospital admission.
Patient case question 6:
Patient case question 7: the patient is taking terazosin for BPH
Patient case question 8: are there any indications that this patient needed oxygen supplementation during his hospital stay.
Patient case question 9: bibasilar crackles, pulmonary edema, absence of jugular vein distention and absence of edema of the extremities(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Patient case question 10: a likely microbe is pseudomonas aeruginosa. This microbe commonly causes of pneumonia in people with severely compromised respiratory defenses similar to this case and displays green sputum like the patient.
Patient case question 11: the mainstay of pharmacotherapy for bacterial pneumonia is antibiotic treatment” (White & Stevenson, 2018). Antimicrobial therapy should be started as soon as the diagnosis of bacterial pneumonia is determined, and laboratory specimens are obtained. Choice of therapy is based on the severity of illness, comorbidities, age, and the presumed organism. Preferred pharmacotherapy for bacterial pneumonia caused by H. influenza includes Cefotaxime, doxycycline and erythromycin. (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Patient case question 12: The patient’s elevated blood sugar is caused by the infection reacting in her body.
Patient case question 13: the patient is afebrile because of the elderly age.
Patient case question 14: there is no significant probability that bacterial pneumonia may have developed from a urinary tract infection in this patient
Patient case question 15: the pathophysiologic basis that underlies the patient’s high blood pH is that the pulmonary arteries are constricted due to pneumonia.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Patient case question 16: pneumonia depicted in patient case Figure 13.1 is most prominent in the left lower lobe. This is evidenced by the large region of opacity visualized on the CXR.

Conclusion

Nursing management should be put in place to manage the airway and maintain the inflammation of the lungs. The common signs of alterations in the respiratory functions include altered patterns of breathing and coughing. This paper discusses the pathophysiologic relationship between allergies and asthma, lung cancer along with its clinical manifestations and tests for diagnosis, the pathophysiologic differences between changes in asthma and COPD and to discuss how oxygen therapy is vital to treat COPD along with its merits and demerits. In my opinion, compromising the airway should be managed effectively using methods like oxygen therapy to prevent death, asthma and COPD.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)

References

Bruyere, H. J. (2012). 100 Case studies in pathophysiology. Place of publication not identified: LWW.
Chabra R, & Gupta, M. (2019). Allergic and Environmental Induced Asthma. [Updated 2019 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526018/
Fraser, J. F., Spooner, A. J., Dunster, K. R., Anstey, C. M., & Corley, A. (2016). Nasal high flow oxygen therapy in patients with COPD reduces respiratory rate and tissue carbon dioxide while increasing tidal and end-expiratory lung volumes: a randomized crossover trial. Thorax, 71(8), 759-761.(Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Hammerschmidt, S., & Wirtz, H. (2009). Lung cancer: current diagnosis and treatment. Deutsches Arzteblatt international, 106(49), 809–820. https://doi.org/10.3238/arztebl.2009.0809
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NIH, (2019) What is Asthma Retrieved from https://www.nhlbi.nih.gov/health-pro/resources/lung/naci/asthma-info/
Pisani, L., Fasano, L., Corcione, N., Comellini, V., Musti, M. A., Brandao, M., & Nava, S. (2017). Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnia COPD. Thorax, 72(4), 373-375.
Sophia T. and George V.G. (2017). Relationship of allergy with asthma: there are more than the allergy “eggs” in asthma “basket”. NCBI. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408007/ (Comprehensive Essay on Alterations in Pulmonary Functions for Nursing Students)
Virchow, J.C and Agache. I. (2012) Untangling asthma phenotypes and endotypes. European Journal of allergy and clinical immunology. Retrieved from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1398-9995.2012.02832.x
White, A. A., & Stevenson, D. D. (2018). Aspirin-exacerbated respiratory disease. New England Journal of Medicine, 379(11), 1060-1070.
Yeh, G. Y., & Horwitz, R. (2017). Integrative Medicine for Respiratory Conditions: Asthma and Chronic Obstructive Pulmonary Disease. The Medical clinics of North America, 101(5), 925–941. https://doi.org/10.1016/j.mcna.2017.04.008

https://www.ncbi.nlm.nih.gov/