Can also comprise: peripheral airway disease and asthmatic bronchitis

Responses to classmates must consist of at least @75 words (not including the greeting and the references), do NOT repeat the same thing your classmate is saying, try to add something of value like a resource, educational information to give to patients, possible bad outcomes associated with the medicines discussed in the case, try to include a sample case you’ve seen at work and discuss how you feel about how that case was handled. Try to use supportive information such as current Tx guidelines, current research related to the treatment, anything that will enhance learning in the online classroom. COPD primarily includes: 1) Chronic Bronchitis 2) Emphysema 3) Can also comprise: peripheral airway disease and asthmatic bronchitis (Woo & Robinson, 2016, p.935). Chronic bronchitis is defined as a chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough have been excluded Emphysema is defined as an abnormal and permanent enlargement of the airspaces distal to the terminal bronchioles that is accompanied by destruction of the airspace walls, without obvious fibrosis (Global Initiative for Chronic Obstructive Lung Disease [GOLD], 2019). The CDC states that in 2012 over 3 million people died from COPD (CDC). In small airway obstruction a rapid ventilatory rate, small tidal volume, increased effort, prolonged expiration, and wheezing are often present (McCance, & Huether, 2015, p.1249). PATHOPHYSIOLOGY There is both change in cellular proliferation, causing tissue destruction, loss of structural ciliated columnar cells, squamous and goblet cell metaplasia, glandular and smooth muscle hypertrophy, and scarring. Obstruction worsen, hyperinflation of lungs, increased sputum production, recurrent respiratory infections, and altered gas exchange (Woo & Robinson, 2016, p.932). Airway collapse is due to the loss of tethering caused by alveolar wall destruction in emphysemais characterized by both acute and chronic inflammation (GOLD, 2019). EPIDEMIOLOGY The main cause is cigarette smoking, second hand smoke, occupational dust and chemicals, and exposure to pollutants. Genetic factors may influence who could develop COPD (Woo & Robinson, 2016, p.932). CLINICAL FEATURES Wheezing Chest tightness Weight loss Respiratory infections (GOLD, 2019). Dyspnea is reported in up to 4 million all-cause emergency room visits annually (Anzueto, & Miravitlles, 2017, p.367). Warm Regards, Morrisa Gibson Works Cited Anzueto, A., & Miravitlles, M. (2017). Pathophysiology of dyspnea in COPD. Postgraduate Medicine, 129(3), 366-374. doi:10.1080/00325481.2017.1301190 Global Initiative for Chronic Obstructive Lung Disease [GOLD]. (2016, April 5). Global initiative for chronic obstructive lung disease. Retrieved from https://goldcopd.org/ Heron, M., Division of Vital Statistics, & Centers for Disease Control and Prevention [CDC]. (2019). Deaths: Leading causes for 2017. National Vital Statistics Reports, 68(6), 1-76. Retrieved from https://www.cdc.gov/nchs/nvss/index.htm McCance, K. L., & Huether, S. E. (2015). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Elsevier Health Sciences. Woo, T. M., & Robinson, M.V. (2016). Pharmacotherapeutics for nurse practitioner prescribers (4th ed.). Philadelphia: F.A. Davis. Retrieved from https://fadavisreader.vitalsource.com/#/books/ 9780803658110/cfi/6/2!/4/2@0:0.00

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