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CH is an elderly man who suffers from emphysema that was caused by the patient’s prolonged history of smoking. It is important to note that smoking is usually discussed as the main cause of such chronic pulmonary disease as emphysema that is characterized by damaging alveoli in lungs. The walls of alveoli can lose their elasticity, and they become destroyed. As a result, the volume of air in lungs increases, causing the shortness of breath because of the presence of a lot of old air (Grassino, Fracchia, Rampulla, & Zocchi, 2013). Therefore, it is possible to speak about the further development of the “barrel” chest configuration as a consequence of emphysema.
The pathological process behind the “barrel” chest configuration is the increase in the lungs’ volume because of their constant hyperinflation as a result of emphysema. The chest becomes rounded due to the augmented lungs in which the volume of air increases significantly. Thus, it is also possible to notice the larger capacity of lungs (Grassino et al., 2013). The “barrel” chest configuration caused by the increased residual volume of lungs is observed because the diaphragm stays in the inspiratory position all the time, and this process can develop gradually (Linton, 2015; Shan et al., 2014).
Patients with emphysema are expected to have rather normal arterial gases analysis if emphysema is only developing. The reason is that the abnormal level of oxygen in the blood is compensated with other processes such as the secondary polycythemia because the body reacts to hypoxemia and tries to address it while producing more red cells to increase the level of oxygen. Nevertheless, it is possible to notice hypoxemia that is a result of the inadequate functioning of lungs and the low level of received oxygen. Hypoxemia can be identified with the help of arterial gases analysis when emphysema only develops (Shan et al., 2014). The pathology associated with this process is the chronic inadequate respiration because of the damaged alveoli that leads to decreasing oxygen levels in the individual’s blood.
However, CH suffers from emphysema for many years, and it is possible to expect such abnormal changes in arterial blood gases as both hypoxemia and hypercapnia. It is important to note that the inadequate functioning of lungs in CH can lead to increasing levels of carbon dioxide in the patient’s blood (Grassino et al., 2013). The relationship between the development of emphysema and the level of arterial gases in the blood is often discussed as significant to assess the patient’s state effectively only when emphysema is advanced or progressive.
The further development of emphysema in CH can lead to such complications caused by described pathological processes as pneumothorax that is associated with the air surrounding the lungs. The air becomes concentrated between the person’s lungs, and this process can cause the further collapse of the lung (Linton, 2015). Another complication is the development of heart problems. It is possible to observe the failure of the heart’s right side associated with the advanced emphysema when arteries serving to connect the lungs and the heart cannot work effectively, and the heart weakens while coping with the pressure.
From this perspective, CH needs the effective monitoring of his emphysema in order to prevent possible complications. It is important to note that healthcare providers should control not only CH’s lung function but also his heart function and levels of red cells in the blood.
References
Grassino, A., Fracchia, C., Rampulla, C., & Zocchi, L. (2013). Respiratory muscles in chronic obstructive pulmonary disease. New York, NY: Springer Science.
Linton, A. D. (2015). Introduction to medical-surgical nursing. New York, NY: Elsevier Health Sciences.
Shan, M., You, R., Yuan, X., Frazier, M. V., Porter, P., Seryshev, A.,… & Whitehead, L. (2014). Agonistic induction of PPARγ reverses cigarette smoke–induced emphysema. The Journal of Clinical Investigation, 124(3), 1371-1381.
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