Week 3 Case Study Template
Pathophysiology & Clinical Findings of the Disease
1. Are the spirometry results consistent with obstructive or restrictive pulmonary disease?
What is the most likely pulmonary diagnosis for this patient?
According to the spirometry results the patient has an obstructive pulmonary
disease. The patients FEV1/FVC (%) Pre-bronchodilator is 56 which is less than
70 % and this indicates an obstructive issue. I believe the patient has Chronic
obstructive pulmonary disease (COPD). The chest x-ray shows lungs are hyper-
inflated bilaterally with a flattened diaphragm. No effusions or infiltrates which is
consistent with COPD which is an obstructive issue (Langan & Goodbred, 2020).
2. Explain the pathophysiology associated with the chosen pulmonary disease.
The major inducer of both lung cancer and chronic obstructive pulmonary disease
(COPD) is cigarette smoke (McCance & Huether, 2019). According to McCance
& Huether (2019), COPD is an airway obstruction disease that worsens with
expiration. Added force and the use of accessory muscles or added time to expire
the volume of air in the lungs, and the emptying of the lungs is slower with
patients of COPD (McCance & Huether, 2019). According to McCance &
Huether (2019), this disease is described as intrusion of the lung by incendiary
cells with the release of several cytokines that add to airway damage and mucus
production. According to Langan & Goodbred (2020), the symptoms these
patients have include dyspnea and wheezing bilaterally. They also have an
increased work of breathing, a “mismatching of the ventilation-perfusion ratio”,
and a decreased force of expiratory volume in one second (FEV1) (McCance &
Huether, 2019). According to Global Initiative for Chronic Obstructive Lung
Disease, Inc. (2018), inflammation and narrowing of peripheral airway can lead to
decreased number is FEV1. Parenchymal destruction due to emphysema can
contribute to airflow limitations which also leads to decreased gas transfer thus
leading to a COPD exacerbation (Global Initiative for Chronic Obstructive Lung
Disease, Inc., 2018).
3. Identify at least three subjective findings from the case which support the chosen
diagnosis.
Subjective findings or data is information from the patient’s point of view. Some
of the subjective findings from this case includes increased dyspnea,
breathlessness worsening with treatment, and a dry nonproductive cough in the
morning.
4. Identify at least three objective findings from the case which support the chosen
diagnosis.
The objective findings are measurable findings that are seen by the provider.
Some of the objective findings include + bilaterally wheezes noted with forced
exhalation along with a prolonged expiratory phase, lungs are hyper-inflated
, Week 3 Case Study Template
bilaterally with a flattened diaphragm, and Spirometry findings of FEV1/FVC (%)
of 56 with no change with the use of bronchodilator.
Pathophysiology & Clinical Findings of the Disease
1. Are the spirometry results consistent with obstructive or restrictive pulmonary disease?
What is the most likely pulmonary diagnosis for this patient?
According to the spirometry results the patient has an obstructive pulmonary
disease. The patients FEV1/FVC (%) Pre-bronchodilator is 56 which is less than
70 % and this indicates an obstructive issue. I believe the patient has Chronic
obstructive pulmonary disease (COPD). The chest x-ray shows lungs are hyper-
inflated bilaterally with a flattened diaphragm. No effusions or infiltrates which is
consistent with COPD which is an obstructive issue (Langan & Goodbred, 2020).
2. Explain the pathophysiology associated with the chosen pulmonary disease.
The major inducer of both lung cancer and chronic obstructive pulmonary disease
(COPD) is cigarette smoke (McCance & Huether, 2019). According to McCance
& Huether (2019), COPD is an airway obstruction disease that worsens with
expiration. Added force and the use of accessory muscles or added time to expire
the volume of air in the lungs, and the emptying of the lungs is slower with
patients of COPD (McCance & Huether, 2019). According to McCance &
Huether (2019), this disease is described as intrusion of the lung by incendiary
cells with the release of several cytokines that add to airway damage and mucus
production. According to Langan & Goodbred (2020), the symptoms these
patients have include dyspnea and wheezing bilaterally. They also have an
increased work of breathing, a “mismatching of the ventilation-perfusion ratio”,
and a decreased force of expiratory volume in one second (FEV1) (McCance &
Huether, 2019). According to Global Initiative for Chronic Obstructive Lung
Disease, Inc. (2018), inflammation and narrowing of peripheral airway can lead to
decreased number is FEV1. Parenchymal destruction due to emphysema can
contribute to airflow limitations which also leads to decreased gas transfer thus
leading to a COPD exacerbation (Global Initiative for Chronic Obstructive Lung
Disease, Inc., 2018).
3. Identify at least three subjective findings from the case which support the chosen
diagnosis.
Subjective findings or data is information from the patient’s point of view. Some
of the subjective findings from this case includes increased dyspnea,
breathlessness worsening with treatment, and a dry nonproductive cough in the
morning.
4. Identify at least three objective findings from the case which support the chosen
diagnosis.
The objective findings are measurable findings that are seen by the provider.
Some of the objective findings include + bilaterally wheezes noted with forced
exhalation along with a prolonged expiratory phase, lungs are hyper-inflated
, Week 3 Case Study Template
bilaterally with a flattened diaphragm, and Spirometry findings of FEV1/FVC (%)
of 56 with no change with the use of bronchodilator.
