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- NURS 6501 Week 4 Assignment Case Study Analysis
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Walden University
NURS 6501
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Case Study Analysis
Introducing the disease analysis to APRN education, it is substantial to assess what in the respiratory system has been learnt, and how it is related to the other systems. The next section is devoted to the real case of a 50-year-old white woman patient with a history of chronic obstructive pulmonary disease (COPD), the worsening of the symptoms: chest congestion, dyspnea, and ineffectiveness of the albuterol inhaler. In this scenario, the analysis will outline the alterations in the pulmonary area, their connection with the other systems, the impact of racial and ethnic factors in the patients, and the interaction leading to the issue impacting the patient.
Case Study Summary
Sharita Masha Cole presented to the emergency room with the complaint of a rise in the congestion in the chest and putrid sputum over the past 3 days. The patient claimed that her dyspnea was getting worse, and she did not get sufficient relief using an albuterol inhaler. Investigate: Cole has a 10-year history of tobacco use, and the patient was previously diagnosed with COPD a year before the present date.
She was unable to purchase an inhaler that is suggested to control COPD, as she did not have the financial resources to do so. She had; blood pressure – 148/90; pulse-108; respiration-22; oxygen saturation-92%; and temperature -98 F. 1°F. Basically, a chest x-ray performed on the patient indicated that there was hyperinflation, a flattened diaphragm with no effusion or infiltrates.
Pulmonary Pathophysiological Processes
The pathophysiological process most prevalent in this situation is COPD, which is a form of chronic inflammatory lung disease leading to the obstruction of airflow in the lungs. The hyperinflation can be justified by the flattened diaphragm in the chest x-ray being a typical indication of emphysema found in COPD (Bofarid et al., 2021). Emphysema involves the slow process of destroying the alveoli and, as a result, decreases the surface area to exchange gases and oxygenate the body, resulting in such symptoms as Dyspnea and hypoxia, as seen by a 92% O2 saturation level. The other component of COPD is chronic bronchitis, which is marked by inflammation and the secretion of excess mucus in the bronchial tubes, which can lead to the secretion of purulent sputum.
The fact that Cole takes the bronchodilator albuterol inhaler means that he has severe airflow symptoms that can only be reversed to some extent, typical of the final stage of COPD. Normal values of hypoxemia and respiratory disturbances include hypercapnia of 47 mm Hg, tachycardia of 22 breaths per minute, and an increased pulse of 108 beats per minute (Rasmi et al., 2021).
Racial/Ethnic Variables Impacting Physiological Functioning
The aspects of race and ethnicity contribute to the manifestation and management of respiratory disorders. Therefore, there are a number of concerns that may potentially affect the patient, a White woman, Sharita Masha Cole, and her outcomes of COPD and care. Indicatively, there is combined evidence that perceived socioeconomic status (SES), insurance, and culturally-tagged beliefs on smoking and compliance with treatment also vary across different racial/ethnic lines (Javed et al., 2022). Using the example of poverty and lack of choice in the case of health and healthcare, i.e., the case of Cole being unable to afford her medication, are also applicable reasons, which do not allow patients to control their diseases.
Moreover, patients with COPD can possess a specific gene expression that can influence the effectiveness and severity of the treatment. The discovery of the real genetic markers that are associated with COPD is still in its early stages; nevertheless, it has been observed that genetic factors can influence the worsening of lung functioning and the lungs’ ability to resist the effects of tobacco smoke (Javed et al., 2022).
Interaction of Pathophysiological Processes
Emphysema and chronic bronchitis are both components of COPD that cause the worst functional changes in the lungs. Emphysema causes the loss of air distensibility in the alveoli, which results in the air being trapped in the airways, resulting in the hyperinflation of the lungs, flattening of the diaphragm, and increased work of breathing. The destruction of the airways, the growth of mucus, and, consequently, the additional constriction of the airways are also a part of the long-term inflammatory case of bronchitis (Li et al., 2020).
The result of these processes is decreased alveolar ventilation and gas exchange, hypoxemia. The body attempts to counter it by raising the respiratory rate and cardiac output (via the high pulse), thereby partially compensating for the deficit in lung function, but is unable to completely cope with the consequences of COPD, which continues and reduces exercise tolerance (Li et al., 2020).
Conclusion
To sum up, the case of Sharita Masha Cole offers a description of the interaction of various pulmonary pathophysiologic processes in COPD, as well as the impact of the social determinants on the treatment process. Since the factors influence individuals with COPD, APRNs should be aware of the cause of the disease and how racial/ethnic factors influence the provision of care and patient education. Both curative and non-curative activities and interventions concerning the socioeconomic status of the patients should be integrated to achieve the best results for COPD.
References
Bofarid, S., Hosman, A. E., Mager, J. J., Snijder, R. J., & Post, M. C. (2021). Pulmonary vascular complications in hereditary hemorrhagic telangiectasia and the underlying pathophysiology. International Journal of Molecular Sciences, 22(7), 3471. https://doi.org/10.3390/ijms22073471
Javed, Z., Haisum Maqsood, M., Yahya, T., Amin, Z., Acquah, I., Valero-Elizondo, J., Andrieni, J., Dubey, P., Jackson, R. K., Daffin, M. A., Cainzos-Achirica, M., Hyder, A. A., & Nasir, K. (2022). Race, racism, and cardiovascular health: applying a social determinants of health framework to racial/ethnic disparities in cardiovascular disease. Circulation: Cardiovascular Quality and Outcomes, 15(1). https://doi.org/10.1161/circoutcomes.121.007917
Rasmi, Y., Babaei, G., Nisar, M. F., Noreen, H., & Gholizadeh-Ghaleh Aziz, S. (2021). Revealed pathophysiological mechanisms of crosslinking interaction of affected vital organs in COVID-19. Comparative Clinical Pathology, 30(6), 1005–1021. https://doi.org/10.1007/s00580-021-03269-2
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