Understanding the pathophysiologic process of diseases is a critical component of being a nursing practitioner. It provides a better understanding of why symptoms occur in a certain manner, consequently providing a better understanding of how diseases progress. This constitutes a critical part of initiating early and effective treatment options to provide quality, safe and appropriate care. This paper aims to describe the pathophysiologic process behind cough and shortness of breath in a patient with COPD, highlighting any racial/ ethical factors that may be coming into play and understanding the interrelationship between these disease processes, resulting in the outcome observed.
The link between COPD and cardiovascular pathophysiologic processes primarily depends on hyperinflation and hypoxemia, among other processes. Hyperinflation is primarily a result of an increase in the residual gas in the alveoli after the process of breathing out. This hyperinflation can either be static or dynamic. Static entails the destruction of the lung parenchyma, resulting in the loss of the elastic recoil of the lung. The dynamic phase occurs on inhalation before full exhalation, consequently resulting in the retention of air molecules. This whole process greatly disrupts the muscles involved in respiration, resulting in the observed shortness of breath (McCance & Huether, 2019). Limitations in the airflow due to hyperinflation have been attributed to elevated pressures, right ventricular dysfunction, impaired left ventricular filling, and impaired cardiac output.
COPD results in excess mucus production by the lungs. The consequent impairment in the mucus-clearing mechanisms, in conjunction with the impairment of the ciliary structure, leads to the cough as a mechanism of clearing out the excess mucus (Radovanovic et al., 2018). The green sputum is due to an acute bacterial infection, most likely pneumonia. Elevated levels of myeloperoxidase enzyme during acute infections are the leading cause of the green color in the sputum. The fever is mostly a result of the upward surge of the set point of the thermoregulatory center as a result of cytokines (Santos et al., 2019). This is particularly common in infections and is believed to boost the immune system’s functioning while hindering the pathogen’s proliferation.
It is a common occurrence to experience cardiovascular complications and COPD coexisting. As highlighted earlier, the critical pathophysiological links between these two systems are lung hyperinflation, systemic inflammation, and exacerbations associated with COPD. This cardiovascular and cardiopulmonary interaction dramatically increases mortality rates and significantly affects the overall quality of life due to prolonged episodes of shortness of breath and exercise intolerance (Cheyne et al., 2020). Prolonged and frequent hospitalization as a result of COPD exacerbations dramatically reduces the patient’s productivity and increases the overall cost of healthcare.
Race is a crucial determinant in occupation types since most occupations are racially patterned (Wolf et al., 2020). In most instances, jobs, where there is exposure to smoke, dust, and other hazardous chemicals, tend to be reserved for certain racial groups. These factors greatly influence the disease process, consequently playing a significant role in the overall health of the individuals. Racially determined factors such as poverty and level of education determine an individual’s lifestyle, including physical exercise and diet. These are key to the overall physiologic functioning of an individual. These factors also influence health-seeking behaviors, which also affect normal physiologic functioning.
The cardiopulmonary and cardiovascular systems are greatly affected by conditions affecting either of these systems, with symptoms manifesting in relation to the pathophysiologic processes involved. Understanding these processes is critical to offering quality care to patients. Factors such as race and ethnicity should be taken into consideration as they greatly impact the normal physiologic functioning of the body and, consequently, the disease process.
Cheyne, W. S., Harper, M. I., Gelinas, J. C., Sasso, J. P., & Eves, N. D. (2020). Mechanical cardiopulmonary interactions during exercise in health and disease. Journal of Applied Physiology (Bethesda, Md.: 1985), 128(5), 1271–1279. https://doi.org/10.1152/japplphys
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