WEEK 3 STUDY GUIDE
Alterations IN Pulmonary Function
(Edapt slides with rationals)
, lOMoARcPSD|51648332
ALTERATIONS IN PULMONARY FUNCTION
OBSTRUCTIVE AND RESTRICTIVE LUNG
FUNCTION, PART 1 OF 4
Introduction to Obstructive and Restrictive L
Obstructive and restrictive lung diseases disturb normal pathophysiological
processes to support normal cellular regulation and homeostasis. Lung diseases
impair gas exchange due to an inconsistent oxygen supply and subsequent
removal of by-product waste (carbon dioxide). Interdependent interactions
between our neurological, respiratory, and cardiovascular systems are also
required to support gas exchange.
When gas exchange is compromised from pulmonary disease, oxygenation is
reduced or ceases, affecting the cells and triggering a cascade of physiological
problems across and between systems. There are also variations in client care
needs based on context. For example, is impaired gas exchange a result of a
primary diagnosis of chronic obstructive pulmonary disease (COPD) or secondary
due to a myocardial infarction? Regardless of the underlying cause, client care
needs to support gas exchange are prioritized for ventilation, oxygen transport,
and perfusion of oxygen-rich blood throughout the circulatory system.
This learning module focuses on the disease process of obstructive and restrictive
lung diseases and enables you to meet the following course outcomes:
● CO 1: Analyze pathophysiologic mechanisms associated with selected
disease states across the lifespan.
● CO 2: Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through specific
therapeutic interventions across the lifespan.
● CO 3: Distinguish risk factors associated with selected disease states
across the lifespan.
● CO 4: Integrate advanced pathophysiological concepts in the diagnosis and
treatment of health problems in selected populations.
Chronic Bronchitis
The nurse practitioner (NP) is seeing a client with chronic bronchitis that needs
spirometry on today’s visit. What pulmonary function test (PFT) findings are
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
anticipated based on the diagnosis of chronic bronchitis?
, lOMoARcPSD|51648332
Decreased diffusing capacity
Decreased total lung capacity (TLC)
Decreased lung compliance
Decreased forced expiratory flow (FEV1)
Chronic bronchitis is an obstructive disease. Therefore, the client will have
decreased expiratory flow rates. The FEV1 will be decreased.
Air trapping is also common in obstructive disease which will cause an increased
TLC. A decreased diffusing capacity typically only occurs in emphysema, not
chronic bronchitis. In chronic bronchitis, lung compliance is increased slightly, not
decreased.
Arterial Blood Gas
The nurse practitioner (NP) assesses a client with a history of heart failure and
Arterial Blood Gas Results
pH 7.56
PaCO2 30 mmHg
HCO3‾ 24 mEq /L
PO2 82 mmHg
O2 saturation 87%
pulmonary edema. Based on the arterial blood gas (ABG) result below, which
clinical condition does the NP suspect?
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
The client has uncompensated respiratory alkalosis.
Arterial
Normal Values Results Problem
Blood Gas
pH 7.35–7.45 7.56 ↑ (alkalosis)
PaCO2 35–45 mmHg 30 ↓ (respiratory)
Downloaded by Benjamin Luca ()
Alterations IN Pulmonary Function
(Edapt slides with rationals)
, lOMoARcPSD|51648332
ALTERATIONS IN PULMONARY FUNCTION
OBSTRUCTIVE AND RESTRICTIVE LUNG
FUNCTION, PART 1 OF 4
Introduction to Obstructive and Restrictive L
Obstructive and restrictive lung diseases disturb normal pathophysiological
processes to support normal cellular regulation and homeostasis. Lung diseases
impair gas exchange due to an inconsistent oxygen supply and subsequent
removal of by-product waste (carbon dioxide). Interdependent interactions
between our neurological, respiratory, and cardiovascular systems are also
required to support gas exchange.
When gas exchange is compromised from pulmonary disease, oxygenation is
reduced or ceases, affecting the cells and triggering a cascade of physiological
problems across and between systems. There are also variations in client care
needs based on context. For example, is impaired gas exchange a result of a
primary diagnosis of chronic obstructive pulmonary disease (COPD) or secondary
due to a myocardial infarction? Regardless of the underlying cause, client care
needs to support gas exchange are prioritized for ventilation, oxygen transport,
and perfusion of oxygen-rich blood throughout the circulatory system.
This learning module focuses on the disease process of obstructive and restrictive
lung diseases and enables you to meet the following course outcomes:
● CO 1: Analyze pathophysiologic mechanisms associated with selected
disease states across the lifespan.
● CO 2: Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through specific
therapeutic interventions across the lifespan.
● CO 3: Distinguish risk factors associated with selected disease states
across the lifespan.
● CO 4: Integrate advanced pathophysiological concepts in the diagnosis and
treatment of health problems in selected populations.
Chronic Bronchitis
The nurse practitioner (NP) is seeing a client with chronic bronchitis that needs
spirometry on today’s visit. What pulmonary function test (PFT) findings are
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
anticipated based on the diagnosis of chronic bronchitis?
, lOMoARcPSD|51648332
Decreased diffusing capacity
Decreased total lung capacity (TLC)
Decreased lung compliance
Decreased forced expiratory flow (FEV1)
Chronic bronchitis is an obstructive disease. Therefore, the client will have
decreased expiratory flow rates. The FEV1 will be decreased.
Air trapping is also common in obstructive disease which will cause an increased
TLC. A decreased diffusing capacity typically only occurs in emphysema, not
chronic bronchitis. In chronic bronchitis, lung compliance is increased slightly, not
decreased.
Arterial Blood Gas
The nurse practitioner (NP) assesses a client with a history of heart failure and
Arterial Blood Gas Results
pH 7.56
PaCO2 30 mmHg
HCO3‾ 24 mEq /L
PO2 82 mmHg
O2 saturation 87%
pulmonary edema. Based on the arterial blood gas (ABG) result below, which
clinical condition does the NP suspect?
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
The client has uncompensated respiratory alkalosis.
Arterial
Normal Values Results Problem
Blood Gas
pH 7.35–7.45 7.56 ↑ (alkalosis)
PaCO2 35–45 mmHg 30 ↓ (respiratory)
Downloaded by Benjamin Luca ()
