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701). According to Huether and McCance, emphysema is characterized by the collapse ofalveoli through elastin breakdown within the septa by an imbalance between proteases and antiproteases, oxidative stress, and apoptosis of lung structural cells (2017, p. 702). Alveolar destruction produces large air spaces within the lung parenchyma (bullae) and air spaces adjacent to pleurae (blebs), which are neither effective in gas exchange (Huether & McCance, 2017, p. 702). Huether and McCance state the expiration becomes more difficult because of loss of elastic recoil reduces the volume of air that can be expired passively, and the air is trapped in the lungs (2017, p. 702). Air trapping will cause hyperexpansion of the chest, causing a barrel-like appearance over time. Accordingto Huether and McCance, the destruction of alveolar walls and pulmonary capillaries causes pulmonary artery hypertension and cor pulmonale (2017, p.702).
Week 3 Case Study Template3.Identify at least three subjective findings from the case which support the chosen diagnosis.Some subjective findings that support this patient's COPD diagnosis would include the patients' complaints of increasing dyspnea and fatigue over the past three months. The patient also reports he has a 35 pack-year history of smoking even though headmits to cutting down after his cardiac intervention. This patient also says having a dry, nonproductive cough that seems worse in the morning.4.Identify at least three objective findings from the case which support the chosen diagnosis.Some objective findings to support a COPD diagnosis would include the NP's assessment of noting bilateral wheezes with a forced exhalation with a prolonged expiratory phase. The patient also has a decreased SpO2 saturation of 93% along with a respiratory rate of 22. The chest x-ray noted hyperinflated lungs bilaterally with a flattened diaphragm.
Week 3 Case Study TemplateManagement of the Disease*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.