COPD Group Assignment

Members:
Burgos Canlas
Fernandez Ginson
Jallorina Matulac
BSN 3-G

a. What are the pathophysiologies of chronic obstructive pulmonary disease (COPD)? Elaborate
 EMPHYSEMA: The “pink puffer” is a thin, cachetic person with marked shortness of breath.
With emphysema, the blood remains relatively well-oxygenated because both ventilation and
perfusion are reduced, leading to a matched V:Q defect. Loss of elastin fibers reduces structural
support for alveoli and small airways, which makes them prone to collapse on expiration, leading to
air trapping. Pursed-lip breathing allows maintenance of positive end-expiratory pressure (PEEP),
which keeps the airways open. The decreased lung compliance leads to increased work of
breathing and dyspnea.

Parenchymal Recurrent damage to the alveoli eventually leads to septal destruction along with
destruction the capillary bed also.

Matched V/Q defect Since both the terminal bronchioles and alveoli along with the capillary bed have
been destroyed, a matched defect exists between the ventilation and perfusion;
areas of low ventilation also have poor perfusion.

Mild hypoxia Despite the “matched” V/Q defect, overtime hyperventilation develops and
cardiac output (CO) drops which leads to areas of poor blood flow in relatively
well oxygenated areas. Due to this poor CO, the rest of the body suffers from
tissue hypoxia.

Cachexia At the pulmonary level, the low CO leads to pulmonary cachexia; which induces
weight loss and muscle wasting. This gives these patients the characteristic
“pink-puffer” appearance.

CHRONIC BRONCHITIS: The “blue bloater” is a large, edematous person with cyanotic and
relatively little dyspnea. Airways obstruction leads to hypoxia, V:Q mismatch, and subsequently
pulmonary vasoconstriction. High resistance in the pulmonary vasculature (pulmonary
hypertension) causes (i) reduced circulating blood volume and (ii) rish-sided heart failure, which
can progress to cor-pulmonale. V:Q mismatch leads to hypoxemia and polycythemia, which results
in cyanosis.

Small airway Mechanisms discussed above lead to inflammation in the smaller bronchioles and
inflammation mucus secretions further narrow the airway lumen. Despite this, the parenchyma
are relatively less damaged.

V/Q mismatch The physiologic response leads to a drop in ventilation and compensation with the
rise in CO. Increased perfusion in the areas of poor ventilation takes place
eventually causing hypoxia and secondary polycythemia.
Severe hypoxia and Chronic V/Q mismatch leads to decreased oxygenation/deoxygenation of the
hypercarbia blood resulting in hypoxemia and increased CO2 retention (respiratory acidosis
ensues).

Pulmonary Chronic hypercapnia and respiratory acidosis lead to arterial vasoconstriction in

hypertension and cor the lungs. With the retrograde pressure build-up, the right ventricular pressures
pulmonale continue to rise and eventually causing RV failure. Otherwise, known as cor
pulmonale.

b. Will the person's lungs return to normal once he quits smoking?

Tobacco smoke can have wide-running wellbeing consequences for the body, and the lungs
and airways are two of the hardest-hit regions. In any case, fortunately after an individual stops
smoking, the lungs can heal to a certain extent
Generally speaking, some of the short-term inflammatory changes to the lungs can be
reversed when people quit smoking. In the days to weeks after quitting, former smokers will notice
that they have less shortness of breath when they exercise. It's not exactly clear why this happens,
but part of it stems from getting carbon monoxide out of the blood. This gas found in cigarette
smoke can interfere with the transport of oxygen because carbon monoxide binds to red blood
cells in place of oxygen. This may account for the breathlessness some smokers experience.
Another reason former smokers have improved breathing is that the inflammation decreases in
the lining of their airways; this happens because the lining is no longer exposed to smoke's
chemical irritants. This reduced swelling makes more room for air to flow through the
passageways.
Paradoxically, former smokers may cough more during the first few weeks after they quit
than when they were smoking. But this is a good thing; it means the lung's cilia are active again,
and these fine hairs can now move excess mucus secretions from the lungs into the airways and
toward the throat, where they can be coughed up. Coughing is cleaning up the gunk in the lungs.
But not all changes are reversible, the body is very good at repairing some of the damage to lung
cells and tissues caused by smoking, but not all of the damage is reversible.
Damage to the lungs and a deterioration in lung function are directly related to the number
of packs of cigarettes a person typically smokes per day times the number of years the person has
smoked, a measure known as pack years. The greater the pack years, the more likely the lungs will
have irreversible damage.
In summary, due to some of the irreversible changes in the lung smoking cessation does not
completely return the lung to its normal status although it creates a deep impact towards the
person’s functionality and overall health. Also, the longer the person is committed towards
smoking cessation the more positive effects in the body he or she will experience overtime.
According to an article from MedicalNewsToday, it takes at least 20 years after the risk of death
from smoking-related causes, including both lung disease and cancer, drops to the level of a person
who has never smoked in their life. Also, the risk of developing pancreatic cancer will be reduced
to that of someone who has never smoked. It takes a long time to get to such a level but the health
benefits are considerably worth it.

c. Write your thoughts, opinions on the mentioned government programs and how you could
possibly help with its full implementation.

According to an article from Centers for Disease Control and Prevention, smoking
accounts for 8 out of 10 COPD related deaths. According to the American Lung Association, about
85%-90% of COPD cases are caused by smoking which makes smoking the biggest risk factor.
According to the Philippine College of Chest Physicians (PCCP), about 20% of Filipinos have
COPD but only 3% are able to consult with a doctor, and 50% of those are not aware that they
have COPD. A burning cigarette creates more than 7,000 chemicals, most of which are harmful,
weakening the lungs, constricting airways, inflaming air passages and causing damage to air sacs,
all of which are factors of COPD.
In 2003, the Department of Health (DOH) implemented the Smoking Cessation Program in
support of the National Tobacco Control and Healthy Lifestyle Program to reduce the prevalence
of smoking and decrease the number of smoking related health risks. As it has been mentioned
multiple times that smoking is a primary cause of COPD, the Smoking Cessation Program can
greatly reduce the number of COPD cases by providing citizens an opportunity to cease smoking.
The program offers several services which are covered in PhilHealth packages. This program also
helps monitor the tobacco use, enforcing policies such as banning the advertisement of tobacco,
and increasing the cost of tobacco products. As student nurses, health education is a part of our
curriculum thus, we can help with the implementation of this program by spreading awareness on
the dangers and risks of smoking through health teaching in communities and to patients. We
understand that a chronic smoker may not be able to quit smoking immediately, therefore we can
help by referring them to centers for rehabilitation, or informing them of the program by DOH, in
order to give them the help they need to quit smoking.
November is set as the National Lung Cancer Awareness Month. This year 2021 the DOH
held it with the theme “Kaalaman sa Kanser sa Baga Palawakin, Pag iwas at Lunas Ating Alamin.” It
focuses on encouraging the people to stop or even never start smoking as a study was conducted
and proves that second-hand smoking is the leading cause of lung cancer. As student nurses, it is
our duty to educate the people regarding the disease most especially that it weakens the immune
system which makes the people susceptible to COVID-19. Our primary goal is to put up
preventative measures so that people will be well-informed regarding the factors that lead to
acquiring lung cancer such as smoking, secondhand smoke, and other substances found at
workplaces like asbestos, arsenic, diesel exhaust, and some forms of silica and chromium. Also,
family history, radiation therapy to the chest, diet, and lifestyle may also contribute to acquiring
the disease. lung cancer is the most common cancer worldwide, affecting 2.2 million people in
2020, a study conducted by Global Cancer Statistics. The Philippines considers lung cancer to have
the second rank when it comes to the percentage of mortality rate among the types of cancer that
are noted to be acquired by Filipinos. In accordance with Republic Act No. 11215 or the National
Integrated Cancer Control Act (NICCA), the Department of Health (DOH) is strict with the
implementation of nationwide yearly observance of Lung Cancer Awareness Month every
November. The DOH shall also closely coordinate with the World Health Organization and other
partners in achieving the United Nations Sustainable Development Goal of reducing premature
mortality from cancer by 30% in 2030. Further, the DOH established the Cancer Assistance Fund
to support those who are diagnosed with any type of cancer to ease their financial constraints as
well as to give hope.

The programs regarding the improvement of lung health are the National Tobacco Control and
Healthy Lifestyle Program and the National Lung Cancer Awareness Month. To be implemented by
student nurses, health education is key in spreading awareness in controlling the person’s
behavior. I would advocate the dangers of COPD, its signs and symptoms, risk factors, and
interventions to prevent any complications of COPD. Active participation and effective
communication are the factors that would help the people in question change their behavior,
habits, and lifestyles towards a healthier future.