Week 3 Case Study Template
NR507 Week3 Case Study questions and answers with
solutions
Pathophysiology & Clinical Findings of the Disease
1. Are the spirometry results consistent with obstructive or restrictive pulmonary disease?
What is the most likely pulmonary diagnosis for this patient?
The spirometry results are consistent with obstructive lung disease since the patient has
forced expiratory volume in one second (FEV1) is reduced, as seen in obstructive
pulmonary disease, and the normal range is >80% (Global Initiative for Chronic
Obstructive Lung Disease, 2021). In addition, the patient's FEV1/FVC ratio is less than
70%, with a 69% pre-bronchodilator prediction and a 64% post-bronchodilator forecast.
The TLC is 125, and the TLC range for the obstructive pulmonary disease is >120%,
which is deemed normal. Chronic Obstructive Pulmonary Disease (COPD) is the most
likely pulmonary diagnosis for this patient. The patient has been experiencing difficulties
for nearly three months and attempts to alleviate some of his problems have been
unsuccessful. In addition, the patient had a 35-pack-year smoking history. Dyspnea with
exertion is a classic symptom of COPD, and his chest x-ray shows hyperinflated lungs
with a flattened diaphragm.
2. Explain the pathophysiology associated with the chosen pulmonary disease. Shortness of
breath is a sign of chronic obstructive pulmonary disease (COPD) when patients have
trouble expelling all of the air from their lungs. COPD is an inflammatory condition that
involves airway thickness, increased mucus production, and probable lung structural
.
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Week 3 Case Study Template
alterations (McCance et al., 2019). COPD affects the lungs by causing fibrosis of the tiny
airways and a loss of elasticity due to the deconstruction of the lung parenchyma,
including the air sacs. When the lungs' structure is deconstructed, it leads to airflow
resistance, air trapping, hyperinflation, dyspnea, coughing, and additional mucus
production (McCance et al., 2019). COPD increases neutrophils, activated macrophages,
and CD8 T lymphocytes when the lungs become inflamed (McCance et al., 2019). COPD
is a group of small airway illnesses that includes obstructive bronchiolitis and
emphysema. Patients' symptoms vary depending on their medical history, risk factors,
and pollution exposure. Chronic inflammation leads to anatomical abnormalities in the
airways, limiting airflow and producing mucociliary dysfunction.
3. Identify at least three subjective findings from the case which support the chosen
diagnosis.
The patient had a 35-pack-year smoking history, which is a subjective finding supporting
COPD diagnosis. The patient complains of dyspnea with exertion, nonproductive dry
cough, fatigue, and chest tightness/mid-sternal chest pain. With these subjective findings
and a request for a second opinion from the cardiologist, the lungs would be the next
system to be examined for pulmonary illness.
4. Identify at least three objective findings from the case which support the chosen
diagnosis
Bilateral wheeze with forceful exhalation and a protracted expiratory phase,
hyperinflated lugs with a flattened diaphragm on the chest x-ray, and aberrant spirometry
results of a normal FVC, decreased FEV1, a decreased FEV1/FVC, and an increased
TLC implies an obstructive lung disease diagnosis.
.