NR 507 WEEK 3- ALTERATIONS IN PULMONARY
FUNCTION (EDAPT SLIDES WITH RATIONALS)
ADVANCED PATHOPHYSIOLOGY
(CHAMBERLAIN UNIVERSITY)
NR 507 WEEK 3- ALTERATIONS IN PULMONARY
FUNCTION (EDAPT SLIDES WITH RATIONALS)
ADVANCED PATHOPHYSIOLOGY
ALTERATIONS IN PULMONARY FUNCTION
OBSTRUCTIVE AND RESTRICTIVE LUNG FUNCTION
– PART 1 OF 4:
1. Obstructive Lung Function (The "Air Trap")
The problem is getting air OUT. The airways are narrowed or blocked, making exhalation slow and
difficult.
The Mechanism: Because air can't escape quickly, some stays trapped in the lungs after you
breathe out.
The Lung "Shape": Lungs often become over-inflated (hyperinflation).
Classic Examples: COPD (Chronic Bronchitis & Emphysema), Asthma, and Cystic Fibrosis.
The Metric: A low FEV1/FVC ratio (typically below 0.70).
2. Restrictive Lung Function (The "Stiff Sponge")
The problem is getting air IN. The lungs or chest wall cannot expand fully, meaning they hold less air
than normal.
The Mechanism: The lung tissue is either too stiff (fibrosis) or the chest wall is physically squeezed
(obesity/scoliosis), restricting total volume.
The Lung "Shape": Lungs appear smaller than average.
, Classic Examples: Pulmonary Fibrosis, Sarcoidosis, and Neuromuscular disorders like ALS.
The Metric: A low Total Lung Capacity (TLC), but usually a normal FEV1/FVC ratio.
Quick Comparison Table
Feature Obstructive Restrictive
Main Difficulty Exhaling (Out) Inhaling (In)
Airway Resistance High Normal
Total Lung Volume Normal or High Low
Analogy Breathing through a straw Breathing with a tight corset on
Introduction to Obstructive and
Restrictive Lung Diseases
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 anticipated based on the diagnosis of chronic bronchitis?
, 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
Blood Gas Normal Values Results Problem
pH 7.35–7.45 7.56 ↑ (alkalosis)
PaCO2 35–45 mmHg 30 ↓ (respiratory)
FUNCTION (EDAPT SLIDES WITH RATIONALS)
ADVANCED PATHOPHYSIOLOGY
(CHAMBERLAIN UNIVERSITY)
NR 507 WEEK 3- ALTERATIONS IN PULMONARY
FUNCTION (EDAPT SLIDES WITH RATIONALS)
ADVANCED PATHOPHYSIOLOGY
ALTERATIONS IN PULMONARY FUNCTION
OBSTRUCTIVE AND RESTRICTIVE LUNG FUNCTION
– PART 1 OF 4:
1. Obstructive Lung Function (The "Air Trap")
The problem is getting air OUT. The airways are narrowed or blocked, making exhalation slow and
difficult.
The Mechanism: Because air can't escape quickly, some stays trapped in the lungs after you
breathe out.
The Lung "Shape": Lungs often become over-inflated (hyperinflation).
Classic Examples: COPD (Chronic Bronchitis & Emphysema), Asthma, and Cystic Fibrosis.
The Metric: A low FEV1/FVC ratio (typically below 0.70).
2. Restrictive Lung Function (The "Stiff Sponge")
The problem is getting air IN. The lungs or chest wall cannot expand fully, meaning they hold less air
than normal.
The Mechanism: The lung tissue is either too stiff (fibrosis) or the chest wall is physically squeezed
(obesity/scoliosis), restricting total volume.
The Lung "Shape": Lungs appear smaller than average.
, Classic Examples: Pulmonary Fibrosis, Sarcoidosis, and Neuromuscular disorders like ALS.
The Metric: A low Total Lung Capacity (TLC), but usually a normal FEV1/FVC ratio.
Quick Comparison Table
Feature Obstructive Restrictive
Main Difficulty Exhaling (Out) Inhaling (In)
Airway Resistance High Normal
Total Lung Volume Normal or High Low
Analogy Breathing through a straw Breathing with a tight corset on
Introduction to Obstructive and
Restrictive Lung Diseases
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 anticipated based on the diagnosis of chronic bronchitis?
, 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
Blood Gas Normal Values Results Problem
pH 7.35–7.45 7.56 ↑ (alkalosis)
PaCO2 35–45 mmHg 30 ↓ (respiratory)
