45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. Patient has history of COPD with chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals flattened diaphragm and increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.

 45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. Patient has history of COPD with chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals flattened diaphragm and increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.

 45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. Patient has history of COPD with chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals flattened diaphragm and increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.

Case Study

This paper is an analysis of a case study involving a 45-year-old woman that present with a 3-day duration of shortness of breath, fevers, and cough with thick green sputum. The patient has history of COPD with chronic cough. She states that the cough has worsened and interferes with her sleep. Sputum is thicker and harder for her to expectorate. There is flattened diaphragm on chest x-ray and increased AP diameters. The paper analyzes pathophysiologic processes contributing to the problem, racial or ethnic variables, and processes interaction.

Cardiovascular and Cardiopulmonary Pathophysiologic Processes

The patient in the case study suffers from COPD exacerbated by a bacterial infection. The production of thick green sputum with fevers indicates an underlying infection. COPD is a chronic disease that develops following prolonged exposure to irritants such as smoke. The exposure to the irritants produces inflammatory processes that damage the alveoli and alveoli sacs. During inflammation, there is the release of inflammatory cells such as cytokines, neutrophils, and macrophages. Neutrophils and macrophages stimulate mucus production. Prolonged inflammation cause airway narrowing, which impedes normal gaseous exchange. The inflammatory mediators also cause alveoli destruction. The alveoli become non-responsive, which cause air trapping in them. Patients suffer from respiratory acidosis since too much carbon dioxide accumulate in the blood with the impaired respiratory processes (Leap et al., 2021). In addition, air trapping within the alveoli causes increased lung volume and flattening of the diaphragm. Severe or persistent exacerbation of COPD may result in pulmonary edema.

Racial/Ethnic Variables

Considerable variations exist in the rate of COPD due to race and ethnicity in America. According to evidence, the rate of COPD among American Whites is high as compared to other ethnicities. The high rate of COPD seen in this population is attributed to their increased exposure to risks such as cigarette smoking. Black Americans come second after American Whites in terms of the rate of COPD. However, the risk of poor outcomes in COPD treatment is high among Black Americans as compared to American Whites. The difference is attributable to the role of factors such as lack of medical insurance coverage, which makes it hard for them to access the healthcare services that they need for COPD (Stellefson et al., 2021). Black Americans also suffer the most from the effect of social determinants of health such as unemployment, low income levels, and low educational attainment. A study conducted by Assari et al., (2019) demonstrated the existence of an inverse relationship between the level of education and COPD risk and prevalence. The rate of COPD was lowest among individuals with higher education level as compared to those who had low educational attainment.

Processes Interaction

The above processes interact to influence the symptoms the client presented to the hospital. As noted initially, factors such as exposure to smoke, dust, and viral and bacterial infections trigger the development of COPD in patients with a history of the disease. The inflammatory processes destroy alveoli and narrow airways, leading to dyspnea and air trapping. The potential exacerbating factor, which is an infection contributed to fevers and production of thick sputum (Leap et al., 2021). Racial and ethnic factors such as increased smoking and poor access to healthcare for individuals from ethnic minority groups increase the risk of poor outcomes among the affected patients.

Conclusion

In summary, the patient in the case study suffers from acute exacerbation of COPD. COPD is a disorder characterized by alveolar destruction and air trapping. Racial and ethnic disparities exist in the rate of COPD. The racial, ethnic, and pathophysiologic processes interact to cause symptoms of COPD.

References

Assari, S., Chalian, H., & Bazargan, M. (2019). High Education Level Protects European Americans but Not African Americans Against Chronic Obstructive Pulmonary Disease: National Health Interview Survey. International Journal of Biomedical Engineering and Clinical Science, 5(2), 16–23. https://doi.org/10.11648/j.ijbecs.20190502.12

Leap, J., Arshad, O., Cheema, T., & Balaan, M. (2021). Pathophysiology of COPD. Critical Care Nursing Quarterly, 44(1), 2. https://doi.org/10.1097/CNQ.0000000000000334

Stellefson, M., Wang, M.-Q., & Kinder, C. (2021). Racial Disparities in Health Risk Indicators Reported by Alabamians Diagnosed with COPD. International Journal of Environmental Research and Public Health, 18(18), Article 18. https://doi.org/10.3390/ijerph18189662

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In your Case Study Analysis related to the scenario provided, explain the following

• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.