CASE STUDY

EMPHYSEMA
DEFINITION
Emphysema is a pathologic
term that describes an
abnormal distention of the air
spaces beyond the terminal
bronchioles and destruction of
the walls of alveoli.
 DEFINITION
Emphysema is a lung condition that causes
shortness of breath. In people with emphysema, the
air sacs in the lungs (alveoli) are damaged. Over
time, the inner walls of the air sacs weaken and
rupture — creating larger air spaces instead of many
small ones. This reduces the surface area of the
lungs and, in turn, the amount of oxygen that
reaches your bloodstream.
 TYPES OF EMPHYSEMA
Centriacinar emphysema
is characterized by focal destruction limited to the respiratory
bronchioles and the central portions of the acini. This form of
emphysema is associated with cigarette smoking and is
typically most severe in the upper lobes.
Panacinar emphysema
involves the entire alveolus distal to the terminal bronchiole.
The panacinar type is typically most severe in the lower lung
zones and generally develops in patients with homozygous
alpha1-antitrypsin (AAT) deficiency.
 TYPES OF EMPHYSEMA
Distal acinar emphysema, or paraseptal emphysema
is the least common form and involves distal airway
structures, alveolar ducts, and sacs. This form of emphysema
is localized to fibrous septa or to the pleura and leads to
formation of bullae

Paraseptal emphysema is not associated with airflow

obstruction.
 CAUSES
The main cause is exposure to airborne irritants, which include
tobacco smoke, marijuana smoke, air pollutants, and manufacturing
smoke.
Very rarely, emphysema is caused by heredity, wherein a person
has a shortage of a protein that guards the elastic structure in the
lungs
Close relatives of people with emphysema are more likely to
develop the disease themselves. This is probably because the tissue
sensitivity or response to smoke and other irritants may be
inherited. The role of genetics in the development of emphysema,
however, remains unclear.
Abnormal airway reactivity, such as bronchial asthma, has been
shown to be a risk factor for the development of emphysema.
 SIGNS & SYMPTOMS
IF YOU OR SOMEONE YOU KNOW IS EXHIBITING SYMPTOMS OF
EMPHYSEMA, SEEK MEDICAL ATTENTION IMMEDIATELY.

Symptoms start gradually and

include:
Shortness of breath, even
with routine activities of
walking, climbing stairs etc.
Long lasting cough which can
be dry or with mucus
Wheezing


Fatigue
Frequent respiratory infections
Nails and lips turning blue even with the slightest of exertion
Chest tightness or pain
You can have emphysema for many years without noticing any
signs or symptoms. The main symptom of emphysema is
SHORTNESS OF BREATHING which usually begins gradually.

Emphysema eventually causes shortness of breath even while

you're at rest.
You may start avoiding activities that cause you to be short of
breath, so the symptom doesn't become a problem until it starts
interfering with daily tasks.
 DIAGNOSTIC PROCEDURES

In making a diagnosis of emphysema, your doctor will start by

conducting a thorough medical examination, recording your
medical history and asking about any symptoms you are
experiencing.
PULMONARY FUNCTION
TESTING (PFT)

This test involves a series of

breathing maneuvers that measure
the airflow and volume of air in your
lungs. This allows your doctor to
objectively assess the function of
your lungs.
CHEST X-RAY

Can help confirm a diagnosis of

emphysema and rule out other lung
conditions.
HIGH RESOLUTION COMPUTED
TOMOGRAPHY (HRCT

This is a special type of CT scan

that provides your doctor with high-
resolution images of your lungs.
Having a HRCT is no different than
having a regular CT scan; they both
are performed on an open-air table
and take only a few minutes
ARTERIAL BLOOD GASES
ANALYSIS

These blood tests measure how well

your lungs transfer oxygen to your
bloodstream and remove carbon
dioxide.
TREATMENT/ MEDICAL

INTERVENTION
PHARMACOLOGICAL TREATMENT
Bronchodilators - These drugs can help relieve coughing, shortness of breath and
breathing problems by relaxing constricted airways.

Inhaled steroids - Corticosteroid drugs inhaled as aerosol sprays reduce

inflammation and may help relieve shortness of breath.

Antibiotics - If you have a bacterial infection, like acute bronchitis or pneumonia,

antibiotics are appropriate.
THERAPY
Pulmonary rehabilitation - A pulmonary rehabilitation program providing
exercises and techniques that may help reduce breathlessness and improve ability
to exercise.

Nutrition therapy - a therapy about proper nutrition. In the early stages of

emphysema, many people need to lose weight, while people with late-stage
emphysema often need to gain weight.

Supplemental oxygen - for severe emphysema with low blood oxygen levels,
using oxygen regularly at home and when you exercise may provide some relief.
Many people use oxygen 24 hours a day. It's usually administered via narrow
tubing that fits into your nostrils.
SURGERY

Lung volume reduction surgery - In the procedure, surgeons remove small

wedges of damaged lung tissue. Removing the diseased tissue helps the
remaining lung tissue expand and work more efficiently and helps improve
breathing.

Lung transplant - Lung transplantation is an option if you have severe lung

damage and other options have failed.
 NURSING INTERVENTION
Maintaining a patent airway is a priority. Use a humidifier at night to
help the patient mobilize secretions in the morning.
Encourage the patient to use controlled coughing to clear secretions
that might have collected in the lungs during sleep.
Instruct the patient to sit at the bedside or in a comfortable chair, hug a
pillow, bend the head downward a little, take several deep breaths,
and cough strongly.
Place patients who are experiencing dyspnea in a high Fowler position
to improve lung expansion. Placing pillows on the overhead table and
having the patient lean over in the orthopneic position may also be
helpful. Teach the patient pursed-lip and diaphragmatic breathing.
 NURSING INTERVENTION
To avoid infection, screen visitors for contagious diseases and instruct
the patient to avoid crowds.
Conserve the patient’s energy in every possible way. Plan activities to
allow for rest periods, eliminating nonessential procedures until the
patient is stronger.
Refer the patient to a pulmonary rehabilitation program if one is
available in the community.
Patient education is vital to long-term management. Teach the patient
about the disease and its implications for lifestyle changes, such as
avoidance of cigarette smoke and other irritants, activity alterations,
and any necessary occupational changes.
 HEALTH TEACHING
Stop smoking
This is the most important measure you can take for your overall health
and the only one that might halt the progression of emphysema. Join a
smoking cessation program if you need help giving up smoking. As much
as possible, avoid secondhand smoke.
Avoid other respiratory irritants
These include fumes from paint and automobile exhaust, some cooking
odors, certain perfumes, even burning candles and incense. Change
furnace and air conditioner filters regularly to limit pollutants.
Exercise regularly.
Try not to let your breathing problems keep you from getting regular
exercise, which can significantly increase your lung capacity.
 Protect yourself from cold air
Cold air can cause spasms of the bronchial passages, making it even
more difficult to breathe. During cold weather, wear a soft scarf or a cold-
air mask — available from a pharmacy — over your mouth and nose
before going outside, to warm the air entering your lungs.
Get recommended vaccinations
Be sure to get an annual flu shot and
pneumonia vaccinations as advised
by your doctor.
Prevent respiratory infections
Do your best to avoid direct contact with people who have a cold or the
flu. If you have to mingle with large groups of people during cold and flu
season, wear a face mask, wash your hands frequently and carry a small
bottle of alcohol-based hand sanitizer to use when needed.

THANK
YOU!
 REPORTERS

BERMAL, MARIANELLA FABELLARE, KYRA MAE ESPINOSA, CEDRICK

TRIXIE S
 REPORTERS

ALANIS, JEWELLE ANN ARCILLA, JESSA MAE