Chronic Obstructive Pulmonary Disease (COPD)

This assignment will explain the pathophysiology of the disease process chronic obstructive pulmonary disease (COPD). It will examine how this disease affects an individual looking at the biological, psychological and social aspects. It will accomplish this by referring to a patient who was admitted to a medical ward with an exacerbation of COPD. Furthermore with assistance of Gibbs model of reflection (as cited in Bulman & Schutz, 2004) it will demonstrate how an experience altered an attitude. In accordance with the Nursing and Midwifery Council, (NMC) Code of Professional Conduct (NMC, 2005) regarding safeguarding patient information no names or places will be divulged. Therefore throughout the assignment the patient will be referred to as John. John is a 57 year old gentleman who has been married to Mavis for two years. John was admitted to the ward with severe breathlessness cough and excessive sputum production. By looking through John's notes it was discovered this was an exacerbation of COPD.

To understand John's condition it is useful to look at how the normal respiratory system works. The function of the respiratory System is to supply the body with oxygen and remove carbon dioxide (Marieb, 2004). According to Waugh and Grant (2004) it also helps maintain body temperature and eliminate excess water from the body. The Respiratory system consists of the mouth, nasal cavity, pharynx, larynx, trachea, bronchi and the lungs (Seeley, Stephens & Tate, 2000). Air enters through either the mouth or nose which humidifies and cleans the air. (Cohen & Wood, 2000) merging into a common chamber called the oropharynx (Watson, 2000). Air then leaves to the pharynx, a short, funnel-shaped tube that transports air to the larynx (Waugh & Grant, 2004). The air enters the larynx which is lined with mucous membrane and proceeds to the trachea, which is formed of semi-circular cartilage rings. The inner membrane of the trachea contains hair cells and mucous cells which trap particles and sweeps them toward the bronchi. The bronchi are also lined with mucous membrane and ringed with cartilage (Marieb, 2004). Each bronchus is lined with mucous membrane. (Martini, 2000) and extends into a lung where it subdivides forming smaller bronchioles (Watson, 2000). Bronchioles terminate with the alveoli which are the functional units for gas exchange and are thin, moist and surrounded by capillaries (Clancy & McVicar 2001). Inhaled air travels through these airways to the alveoli. Blood is pumped out of the heart through the pulmonary arteries to the capillaries surrounding the alveoli. (Shaw, 2005) The oxygen of the inhaled air diffuses out of the alveoli into the blood, while carbon dioxide in the blood moves into the alveoli to be exhaled (Tortora & Grabowskie, 2003). The oxygen-rich blood is returned to the heart through the pulmonary veins. The lungs can expand and contract without friction during breathing due to the pleura, a thin membranous structure (Tamir, 2002). The visceral pleura surround the lungs, while the parietal pleura line the wall of the thoracic cavity. These pleura are ...