NURS 3380 MODULE 5 RESPIRATORY CASE STUDY
Bree Lively
Module 5 – NURS 3380 Respiratory Case Study
June 30, 2019
Scenario: RS has smoked for many years and has developed chronic bronchitis, a chronic
obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and
peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH, 7.32; PaCO2, 60
mm Hg; PaO2, 50 mm Hg; and HCO3-, 30 mEq/L. His hematocrit is 52% with normal red blood
cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory
disease. At this clinic visit, it is noted on a chest x-ray examination that RS has an area of
consolidation in his right lower lobe that is thought to be consistent with pneumonia.
1. What clinical findings are likely in RS as a consequence of his COPD? How would
these differ from those of emphysematous COPD?
According to Stephens and Yew (2008), common findings among patients with COPD are a
chronic productive cough for a minimum of three months, shortness of breath, ausculatory
wheezing, use of accessory muscles when breathing, pursed lips, increased expiratory time,
cyanotic, increased mucous production, and weak. Furthermore, research has shown a link
between a higher risk for developing obesity in COPD patients due to the lack of physical
activity and the limitations due to COPD symptoms (Franssen, Goosen, O’Donnell, and Schols,
2008). Emphysematous COPD consists of damaged air sacs within the lungs. These air sacs
lose their elasticity, and therefore, hold onto trapped air, making exhaling very difficult and the
patient feeling short of breath (Columbia Surgery, 2019). Studies have shown emphysematous
Bree Lively
Module 5 – NURS 3380 Respiratory Case Study
June 30, 2019
Scenario: RS has smoked for many years and has developed chronic bronchitis, a chronic
obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and
peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH, 7.32; PaCO2, 60
mm Hg; PaO2, 50 mm Hg; and HCO3-, 30 mEq/L. His hematocrit is 52% with normal red blood
cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory
disease. At this clinic visit, it is noted on a chest x-ray examination that RS has an area of
consolidation in his right lower lobe that is thought to be consistent with pneumonia.
1. What clinical findings are likely in RS as a consequence of his COPD? How would
these differ from those of emphysematous COPD?
According to Stephens and Yew (2008), common findings among patients with COPD are a
chronic productive cough for a minimum of three months, shortness of breath, ausculatory
wheezing, use of accessory muscles when breathing, pursed lips, increased expiratory time,
cyanotic, increased mucous production, and weak. Furthermore, research has shown a link
between a higher risk for developing obesity in COPD patients due to the lack of physical
activity and the limitations due to COPD symptoms (Franssen, Goosen, O’Donnell, and Schols,
2008). Emphysematous COPD consists of damaged air sacs within the lungs. These air sacs
lose their elasticity, and therefore, hold onto trapped air, making exhaling very difficult and the
patient feeling short of breath (Columbia Surgery, 2019). Studies have shown emphysematous
