Pulmonary Disorders – Chronic Obstructive Pulmonary Disease (COPD)
COPD refers to a chronic respiratory illness marked by long-term limitation of airflow due to structural alterations and chronic inflammation in the lungs. COPD is primarily worsened by noxious agents exposure, like cigarette smoke and other air particles (National Heart, Lung, and Blood Institute, 2024). COPD has a worldwide effect on rising mortality and morbidity rates for patients with repeated hospitalization and long-term disease management expenses.
In COPD, there is ventilatory impairment secondary to airflow limitation and alveolar destruction, leading to ventilation-perfusion (V/Q) mismatch. This leads to the inability to exchange gases, thus causing the patient to develop hypoxemia (inadequate oxygen) and hypercapnia (increased carbon dioxide in the blood). Chronic hypoxia tends to lead to the development of various complications, like right-sided heart failure as well as pulmonary hypertension (Powers & Dhamoon, 2023). Patients, therefore, present with progressive dyspnea, exercise intolerance, chronic cough, and wheezing (Powers & Dhamoon, 2023).
The pathophysiology of COPD involves chronic inflammation that triggers airway remodeling, mucus hypersecretion, and alveolar wall destruction. This results in the loss of lung compliance and airway resistance, together with airway obstruction development and air trapping, hence making the work of breathing higher (Agarwal et al., 2023). More so, the oxidative stress and protease-antiprotease imbalance also add to the extent of lung damage as they advance the disease progression.
COPD diagnosis is confirmed through spirometry, showing a decreased forced expiratory volume in one second (FEV₁) and a reduced FEV₁/forced vital capacity (FVC) ratio. Additional tests, such as arterial blood gas analysis and imaging, help assess disease severity (Vogelmeier et al., 2020). Treatment focuses on smoking cessation, symptom management, pulmonary rehabilitation, bronchodilators, and inhaled corticosteroids.
Nurse practitioners (NPs) practice EBP by adhering to recommended guidelines, for example, the GOLD (Global Initiative for Chronic Obstructive Lung Disease). When there is no evidence or research regarding certain situations, NPs draw upon ongoing research and consensus, as well as patient-centered models and techniques for safe healthcare (Agustí et al., 2023).
References
Agarwal, A. K., Raja, A., & Brown, B. D. (2023, August 7). Chronic obstructive pulmonary disease. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559281/
Agustí, A., Celli, B. R., Criner, G. J., Halpin, D., Anzueto, A., Barnes, P., Bourbeau, J., Han, M. K., Martinez, F. J., De Oca, M. M., Mortimer, K., Papi, A., Pavord, I., Roche, N., Salvi, S., Sin, D. D., Singh, D., Stockley, R., Varela, M. V. L., . . . Vogelmeier, C. F. (2023). Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. American Journal of Respiratory and Critical Care Medicine, 207(7), 819–837. https://doi.org/10.1164/rccm.202301-0106pp
National Heart, Lung, and Blood Institute. (2024, November 8). What is COPD? NHLBI, NIH. https://www.nhlbi.nih.gov/health/copd
Powers, K. A., & Dhamoon, A. S. (2023, January 23). Physiology, pulmonary ventilation and perfusion. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK539907/
Vogelmeier, C. F., Román-Rodríguez, M., Singh, D., Han, M. K., Rodríguez-Roisin, R., & Ferguson, G. T. (2020). Goals of COPD treatment: Focus on symptoms and exacerbations. Respiratory Medicine, 166, 105938. https://doi.org/10.1016/j.rmed.2020.105938
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Pulmonary Disorders – Chronic Obstructive Pulmonary Disease (COPD)
Choose a pulmonary condition from the text.
Define the condition. Identify the disorder of ventilation and its impact on gas exchange.
Chronic Obstructive Pulmonary Disease
Address key points of pathophysiology, clinical manifestation and evaluation toward diagnosis and treatment. Use appropriate physiological terms in your response.
How can the NP ensure that evidence based practice guides diagnostic decisions when addressing pulmonary conditions?
How can one incorporate innovations into practice when evidence is not available?
Provide 3 evidence-based references to support your content.
1 page
3 references after every paragraph
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