Week 4: Alterations in the Cardiovascular and Respiratory Systems Assignment Solution

Week 4: Alterations in the Cardiovascular and Respiratory Systems

Week 4

Next week, you will examine the alterations in the cardiovascular and respiratory systems and the resultant disease processes through case study analysis. You will also consider patient characteristics, including racial and ethnic variables, which may impact altered physiology. 

Week 4: Alterations in the Cardiovascular and Respiratory Systems

Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

· Analyze processes related to cardiovascular and respiratory disorders

· Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes

· Analyze racial/ethnic variables that may impact physiological functioning

· Evaluate the impact of patient characteristics on disorders and altered physiology 

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REQUIRED READINGS

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

· Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review

· Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review

· Chapter 35: Structure and Function of the Pulmonary System; Summary Review

· Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review

NIH: National Library of Medicine

Alterations in the Cardiovascular and Respiratory Systems: Solution

Alterations in the Cardiovascular and Respiratory Systems

The symptoms presented by the patient are characteristic of chronic obstructive pulmonary disease (COPD). COPD primarily limits airflow, cannot be fully reversed and is usually progressive (McCance & Huether, 2019), suggesting that the client’s present symptoms are justifiably related to COPD. COPD consists of two phenotypes, including chronic bronchitis and emphysema, which causes the obstruction of airflow and impairs breathing (Centres for Disease Control and Prevention [CDC], 2020). In this case, the likely diagnosis is chronic bronchitis phenotype. Chronic bronchitis is characterized by chronic productive cough and hypersecretion of mucus for at least three months or two successive years (McCance & Huether, 2019). Chronic bronchitis results in a progressive inflammatory reaction to noxious gases or particles in the airways. As such, aggravating factors and comorbid conditions contribute to the overall severity of the disease.(Alterations in the Cardiovascular and Respiratory Systems)

Exposure to chronic irritants recruits lymphocytes, macrophages, and neutrophils to the lungs, leading to progressive damage from oxidative stress, autophagy and apoptotic cell death, and extracellular matrix proteolysis (McCance & Huether, 2019). The irritants promote bronchial inflammation, leading to bronchial edema, increased size of the bronchus, and increased number of mucous glands and goblet cells in the airway epithelium cells. Besides, irritants cause narrowing of the airways and smooth muscle hypertrophy with fibrosis. Consequently, the patient cannot clear the occurrence of hypersecretion of the thick tenacious mucus due to impaired ciliary function.(Alterations in the Cardiovascular and Respiratory Systems)

The inability to clear the mucus compromises the lungs’ defense mechanisms, increasing susceptibility to pulmonary infection. Pulmonary infection contributes to the injury of the airway and ineffectual repair. Consequently, aggravating conditions due to bacterial colonization of affected airways are complicated by the tightening of the bronchial muscles (bronchospasm) characterized by shortness of breath and productive cough presented by the case patient. The mucus and the enlarged bronchial smooth muscles narrow the airways, leading to obstruction during expiration. As a result, ventilation-perfusion mismatch occurs, i.e., low blood oxygenation (hypoxemia).(Alterations in the Cardiovascular and Respiratory Systems)

Few studies have been done to predict COPD’s racial and genetic variability. However, racial and ethnic variations are primarily related to risk factors, including genetics and lifestyles (Gilkes et al., 2017; Fuller-Thomson et al., 2016). Gilkes et al. (2017) found a lower risk of COPD among minority ethnic groups and higher risks among Hispanic and non-Hispanic whites associated with increased smoking intensity. Fuller-Thomson et al. (2016) found that females have higher risks of developing COPD than males due to biological factors, including poor lung function and structural factors such as air pollution and passive smoking. Moreover, Fuller-Thomson et al. (2016) argued that black men have lower COPD risks than white men. The high prevalence of COPD in white men is explained by genetic variant, antitrypsin deficiency, associated with higher COPD risks and consequently more prevalence among white males. Lastly, Lee et al. (2018) found that the prevalence of comorbidities determines COPD risks across racial and ethnic groups. For instance, COPD prevalence among non-Hispanic blacks is associated with stroke, diabetes mellitus, and hypertension. On the other hand, COPD prevalence among non-Hispanic whites is associated with coronary diseases and dyslipidemia.(Alterations in the Cardiovascular and Respiratory Systems)

Significantly, the physiological processes in chronic bronchitis, including oxidative stress, autophagy, apoptotic cell death, extracellular matrix proteolysis, and hypoxemia, could affect the patient. For instance, low airflow could result in the inability of the lungs to stretch and shrink back, destruction of the air sacs, swollen and irritated airways, and excessive mucus production (CDC, 2022). Consequently, the patient presents a nagging cough, tightness of the chest, and trouble with mental alertness. Depending on the duration and severity, hypoxemia can lead to mild symptoms such as headaches and dyspnea (Bhutta et al., 2022). Moreover, hypoxemia can limit the amount of oxygen available at the tissue level (hypoxia), affecting the heart and brain functions.(Alterations in the Cardiovascular and Respiratory Systems) 

References

Bhutta, B. S., Alghoula, F., & Berim, I. (2022). Hypoxia. In StatPearls [Internet]. StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK482316/ (Accessed 16 September 2022)

Centers for Diseases Control and Prevention (April 2020). Chronic Obstructive Pulmonary Disease (COPD). Available at: https://www.cdc.gov/tobacco/basic_information/health_effects/respiratory/index.htm#one (Accessed 16 September 2022)

Fuller-Thomson, E., Chisholm, R. S., & Brennenstuhl, S. (2016). COPD in a population-based sample of never-smokers: interactions among sex, gender, and race. International Journal of Chronic Diseases, 2016. https://doi.org/10.1155/2016/5862026  

Gilkes, A., Hull, S., Durbaba, S., Schofield, P., Ashworth, M., Mathur, R., & White, P. (2017). Ethnic differences in smoking intensity and COPD risk: an observational study in primary care. NPJ primary care respiratory medicine, 27(1), 1-6. https://doi.org/10.1038/s41533-017-0052-8

Lee, H., Shin, S. H., Gu, S., Zhao, D., Kang, D., Joi, Y. R., … & Park, H. Y. (2018). Racial differences in comorbidity profile among patients with chronic obstructive pulmonary disease. BMC medicine, 16(1), 1-8. https://doi.org/10.1186/s12916-018-1159-7

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Heart Failure: Diagnosis, Management and Utilization

Arati A. Inamdar and Ajinkya C. Inamdar

Salvatore De Rosa, Academic Editor

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961993/

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

Photo Credit: yodiyim / Adobe Stock

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.(Alterations in the Cardiovascular and Respiratory Systems)

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.(Alterations in the Cardiovascular and Respiratory Systems)

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

· The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.

· Any racial/ethnic variables that may impact physiological functioning.

· How these processes interact to affect the patient.

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