This document contains information about a COPD group assignment. The members of the group are listed. It then discusses the pathophysiologies of COPD including emphysema and chronic bronchitis. It notes that some lung damage from smoking is reversible after quitting but not all damage can be repaired. It discusses government smoking cessation programs in the Philippines and how student nurses can help implement education about these programs and the dangers of smoking.
This document contains information about a COPD group assignment. The members of the group are listed. It then discusses the pathophysiologies of COPD including emphysema and chronic bronchitis. It notes that some lung damage from smoking is reversible after quitting but not all damage can be repaired. It discusses government smoking cessation programs in the Philippines and how student nurses can help implement education about these programs and the dangers of smoking.
This document contains information about a COPD group assignment. The members of the group are listed. It then discusses the pathophysiologies of COPD including emphysema and chronic bronchitis. It notes that some lung damage from smoking is reversible after quitting but not all damage can be repaired. It discusses government smoking cessation programs in the Philippines and how student nurses can help implement education about these programs and the dangers of smoking.
This document contains information about a COPD group assignment. The members of the group are listed. It then discusses the pathophysiologies of COPD including emphysema and chronic bronchitis. It notes that some lung damage from smoking is reversible after quitting but not all damage can be repaired. It discusses government smoking cessation programs in the Philippines and how student nurses can help implement education about these programs and the dangers of smoking.
a. What are the pathophysiologies of chronic obstructive pulmonary disease (COPD)? Elaborate EMPHYSEMA: The “pink puffer” is a thin, cachetic person with marked shortness of breath. With emphysema, the blood remains relatively well-oxygenated because both ventilation and perfusion are reduced, leading to a matched V:Q defect. Loss of elastin fibers reduces structural support for alveoli and small airways, which makes them prone to collapse on expiration, leading to air trapping. Pursed-lip breathing allows maintenance of positive end-expiratory pressure (PEEP), which keeps the airways open. The decreased lung compliance leads to increased work of breathing and dyspnea.
Parenchymal Recurrent damage to the alveoli eventually leads to septal destruction along with destruction the capillary bed also.
Matched V/Q defect Since both the terminal bronchioles and alveoli along with the capillary bed have been destroyed, a matched defect exists between the ventilation and perfusion; areas of low ventilation also have poor perfusion.
Mild hypoxia Despite the “matched” V/Q defect, overtime hyperventilation develops and cardiac output (CO) drops which leads to areas of poor blood flow in relatively well oxygenated areas. Due to this poor CO, the rest of the body suffers from tissue hypoxia.
Cachexia At the pulmonary level, the low CO leads to pulmonary cachexia; which induces weight loss and muscle wasting. This gives these patients the characteristic “pink-puffer” appearance.
CHRONIC BRONCHITIS: The “blue bloater” is a large, edematous person with cyanotic and relatively little dyspnea. Airways obstruction leads to hypoxia, V:Q mismatch, and subsequently pulmonary vasoconstriction. High resistance in the pulmonary vasculature (pulmonary hypertension) causes (i) reduced circulating blood volume and (ii) rish-sided heart failure, which can progress to cor-pulmonale. V:Q mismatch leads to hypoxemia and polycythemia, which results in cyanosis.
Small airway Mechanisms discussed above lead to inflammation in the smaller bronchioles and inflammation mucus secretions further narrow the airway lumen. Despite this, the parenchyma are relatively less damaged.
V/Q mismatch The physiologic response leads to a drop in ventilation and compensation with the rise in CO. Increased perfusion in the areas of poor ventilation takes place eventually causing hypoxia and secondary polycythemia. Severe hypoxia and Chronic V/Q mismatch leads to decreased oxygenation/deoxygenation of the hypercarbia blood resulting in hypoxemia and increased CO2 retention (respiratory acidosis ensues).
Pulmonary Chronic hypercapnia and respiratory acidosis lead to arterial vasoconstriction in
hypertension and cor the lungs. With the retrograde pressure build-up, the right ventricular pressures pulmonale continue to rise and eventually causing RV failure. Otherwise, known as cor pulmonale.
b. Will the person's lungs return to normal once he quits smoking?
Tobacco smoke can have wide-running wellbeing consequences for the body, and the lungs and airways are two of the hardest-hit regions. In any case, fortunately after an individual stops smoking, the lungs can heal to a certain extent Generally speaking, some of the short-term inflammatory changes to the lungs can be reversed when people quit smoking. In the days to weeks after quitting, former smokers will notice that they have less shortness of breath when they exercise. It's not exactly clear why this happens, but part of it stems from getting carbon monoxide out of the blood. This gas found in cigarette smoke can interfere with the transport of oxygen because carbon monoxide binds to red blood cells in place of oxygen. This may account for the breathlessness some smokers experience. Another reason former smokers have improved breathing is that the inflammation decreases in the lining of their airways; this happens because the lining is no longer exposed to smoke's chemical irritants. This reduced swelling makes more room for air to flow through the passageways. Paradoxically, former smokers may cough more during the first few weeks after they quit than when they were smoking. But this is a good thing; it means the lung's cilia are active again, and these fine hairs can now move excess mucus secretions from the lungs into the airways and toward the throat, where they can be coughed up. Coughing is cleaning up the gunk in the lungs. But not all changes are reversible, the body is very good at repairing some of the damage to lung cells and tissues caused by smoking, but not all of the damage is reversible. Damage to the lungs and a deterioration in lung function are directly related to the number of packs of cigarettes a person typically smokes per day times the number of years the person has smoked, a measure known as pack years. The greater the pack years, the more likely the lungs will have irreversible damage. In summary, due to some of the irreversible changes in the lung smoking cessation does not completely return the lung to its normal status although it creates a deep impact towards the person’s functionality and overall health. Also, the longer the person is committed towards smoking cessation the more positive effects in the body he or she will experience overtime. According to an article from MedicalNewsToday, it takes at least 20 years after the risk of death from smoking-related causes, including both lung disease and cancer, drops to the level of a person who has never smoked in their life. Also, the risk of developing pancreatic cancer will be reduced to that of someone who has never smoked. It takes a long time to get to such a level but the health benefits are considerably worth it.
c. Write your thoughts, opinions on the mentioned government programs and how you could possibly help with its full implementation.
According to an article from Centers for Disease Control and Prevention, smoking accounts for 8 out of 10 COPD related deaths. According to the American Lung Association, about 85%-90% of COPD cases are caused by smoking which makes smoking the biggest risk factor. According to the Philippine College of Chest Physicians (PCCP), about 20% of Filipinos have COPD but only 3% are able to consult with a doctor, and 50% of those are not aware that they have COPD. A burning cigarette creates more than 7,000 chemicals, most of which are harmful, weakening the lungs, constricting airways, inflaming air passages and causing damage to air sacs, all of which are factors of COPD. In 2003, the Department of Health (DOH) implemented the Smoking Cessation Program in support of the National Tobacco Control and Healthy Lifestyle Program to reduce the prevalence of smoking and decrease the number of smoking related health risks. As it has been mentioned multiple times that smoking is a primary cause of COPD, the Smoking Cessation Program can greatly reduce the number of COPD cases by providing citizens an opportunity to cease smoking. The program offers several services which are covered in PhilHealth packages. This program also helps monitor the tobacco use, enforcing policies such as banning the advertisement of tobacco, and increasing the cost of tobacco products. As student nurses, health education is a part of our curriculum thus, we can help with the implementation of this program by spreading awareness on the dangers and risks of smoking through health teaching in communities and to patients. We understand that a chronic smoker may not be able to quit smoking immediately, therefore we can help by referring them to centers for rehabilitation, or informing them of the program by DOH, in order to give them the help they need to quit smoking. November is set as the National Lung Cancer Awareness Month. This year 2021 the DOH held it with the theme “Kaalaman sa Kanser sa Baga Palawakin, Pag iwas at Lunas Ating Alamin.” It focuses on encouraging the people to stop or even never start smoking as a study was conducted and proves that second-hand smoking is the leading cause of lung cancer. As student nurses, it is our duty to educate the people regarding the disease most especially that it weakens the immune system which makes the people susceptible to COVID-19. Our primary goal is to put up preventative measures so that people will be well-informed regarding the factors that lead to acquiring lung cancer such as smoking, secondhand smoke, and other substances found at workplaces like asbestos, arsenic, diesel exhaust, and some forms of silica and chromium. Also, family history, radiation therapy to the chest, diet, and lifestyle may also contribute to acquiring the disease. lung cancer is the most common cancer worldwide, affecting 2.2 million people in 2020, a study conducted by Global Cancer Statistics. The Philippines considers lung cancer to have the second rank when it comes to the percentage of mortality rate among the types of cancer that are noted to be acquired by Filipinos. In accordance with Republic Act No. 11215 or the National Integrated Cancer Control Act (NICCA), the Department of Health (DOH) is strict with the implementation of nationwide yearly observance of Lung Cancer Awareness Month every November. The DOH shall also closely coordinate with the World Health Organization and other partners in achieving the United Nations Sustainable Development Goal of reducing premature mortality from cancer by 30% in 2030. Further, the DOH established the Cancer Assistance Fund to support those who are diagnosed with any type of cancer to ease their financial constraints as well as to give hope.
The programs regarding the improvement of lung health are the National Tobacco Control and Healthy Lifestyle Program and the National Lung Cancer Awareness Month. To be implemented by student nurses, health education is key in spreading awareness in controlling the person’s behavior. I would advocate the dangers of COPD, its signs and symptoms, risk factors, and interventions to prevent any complications of COPD. Active participation and effective communication are the factors that would help the people in question change their behavior, habits, and lifestyles towards a healthier future.
