WEEK 3 STUDY GUIDE
Alterations IN Pulmonary Function
(Edapt slides with rationals)
, lOMoAR cPSD| 51648332
ALTERATIONS IN PULMONARY FUNCTION
OBSTRUCTIVE AND RESTRICTIVE LUNG
FUNCTION, PART 1 OF 4
Introduction to Obstructive and
Restrictive Lung Diseases
Obstructive and restrictive lung diseases disturb normal pathophysiological processes to
support normal cellular regulation and homeostasis. Lung diseases impair gas exchange due
to an inconsistent oxygen supply and subsequent removal of by-product waste (carbon
dioxide). Interdependent interactions between our neurological, respiratory, and
cardiovascular systems are also required to support gas exchange.
When gas exchange is compromised from pulmonary disease, oxygenation is reduced or
ceases, affecting the cells and triggering a cascade of physiological problems across and
between systems. There are also variations in client care needs based on context. For
example, is impaired gas exchange a result of a primary diagnosis of chronic obstructive
pulmonary disease (COPD) or secondary due to a myocardial infarction? Regardless of the
underlying cause, client care needs to support gas exchange are prioritized for ventilation,
oxygen transport, and perfusion of oxygen-rich blood throughout the circulatory system.
This learning module focuses on the disease process of obstructive and restrictive lung
diseases and enables you to meet the following course outcomes:
● CO 1: Analyze pathophysiologic mechanisms associated with selected disease states
across the lifespan.
● CO 2: Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through specific
therapeutic interventions across the lifespan.
● CO 3: Distinguish risk factors associated with selected disease states across the
lifespan.
● CO 4: Integrate advanced pathophysiological concepts in the diagnosis and treatment
of health problems in selected populations.
Chronic Bronchitis
The nurse practitioner (NP) is seeing a client with chronic bronchitis that needs spirometry on
today’s visit. What pulmonary function test (PFT) findings are anticipated based on the
diagnosis of chronic bronchitis?
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, lOMoAR cPSD| 51648332
Decreased diffusing capacity Decreased
total lung capacity (TLC)
Decreased lung compliance
Decreased forced expiratory flow (FEV1)
Chronic bronchitis is an obstructive disease. Therefore, the client will have decreased
expiratory flow rates. The FEV1 will be decreased.
Air trapping is also common in obstructive disease which will cause an increased TLC. A
decreased diffusing capacity typically only occurs in emphysema, not chronic bronchitis. In
chronic bronchitis, lung compliance is increased slightly, not decreased.
Arterial Blood Gas
The nurse practitioner (NP) assesses a client with a history of heart failure and
Arterial Blood Gas Results
pH 7.56
PaCO2 30 mmHg
HCO3‾ 24 mEq /L
PO2 82 mmHg
O2 saturation 87%
pulmonary edema. Based on the arterial blood gas (ABG) result below, which clinical condition
does the NP suspect?
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
The client has uncompensated respiratory alkalosis.
Arterial
Blood Gas Normal Values Results Problem
pH 7.35–7.45 7.56 ↑ (alkalosis)
PaCO2 35–45 mmHg 30 ↓ (respiratory)
HCO3– 22–26 mEq/L 24 24 (normal)
Downloaded by Benjamin Luca ()
, lOMoAR cPSD| 51648332
Arterial
Blood Gas Normal Values Results Problem
PO2 80–100 mmHg 82 82 (normal)
O2 saturation 95%–100% 87% 95 (normal)
---------------------
Characteristics of Lung Disease
Complete the following sentence by choosing from the list of options.
Lung diseases that have (increased lung volume\ increased lung capacity\ reduced lung
volume) are characterized as restrictive, whereas diseases with (increased airflow\ reduced
airflow\ normal airflow) are characterized as obstructive.
Risk Factors of Lung Disease
An individual is at risk based on age, individual factors, and underlying clinical conditions. Click
each section below to learn more about the risk factors of lung disease.
Age
● Infants and young children have less alveolar surface area for gas exchange; therefore,
airways can be easily obstructed by mucus, edema, or foreign objects.
● Older adults have anatomical and physiological changes expected with
advanced age.
● Loss of elastic recoil of the chest and decreased lung volume capacity (tidal
volume)
● Weaker respiratory muscles, reducing the effort to cough (risk for
aspiration)
● Dilation of alveoli, decreased surface area
Individual Factors
● Nonmodifiable: Age, congenital abnormalities, or environmental concerns (air pollution,
for example)
● Modifiable: Tobacco use (inhaled smoke) or second-hand exposure to air
pollutants; vaccinations to prevent pulmonary disease (COVID, influenza,
pneumococcal, Tdap)
● Other: Clients with altered levels of consciousness, neurological disorders, tracheal
intubation, bed rest, or immobilization
Acute or Chronic Disease
Downloaded by Benjamin Luca ()
Alterations IN Pulmonary Function
(Edapt slides with rationals)
, lOMoAR cPSD| 51648332
ALTERATIONS IN PULMONARY FUNCTION
OBSTRUCTIVE AND RESTRICTIVE LUNG
FUNCTION, PART 1 OF 4
Introduction to Obstructive and
Restrictive Lung Diseases
Obstructive and restrictive lung diseases disturb normal pathophysiological processes to
support normal cellular regulation and homeostasis. Lung diseases impair gas exchange due
to an inconsistent oxygen supply and subsequent removal of by-product waste (carbon
dioxide). Interdependent interactions between our neurological, respiratory, and
cardiovascular systems are also required to support gas exchange.
When gas exchange is compromised from pulmonary disease, oxygenation is reduced or
ceases, affecting the cells and triggering a cascade of physiological problems across and
between systems. There are also variations in client care needs based on context. For
example, is impaired gas exchange a result of a primary diagnosis of chronic obstructive
pulmonary disease (COPD) or secondary due to a myocardial infarction? Regardless of the
underlying cause, client care needs to support gas exchange are prioritized for ventilation,
oxygen transport, and perfusion of oxygen-rich blood throughout the circulatory system.
This learning module focuses on the disease process of obstructive and restrictive lung
diseases and enables you to meet the following course outcomes:
● CO 1: Analyze pathophysiologic mechanisms associated with selected disease states
across the lifespan.
● CO 2: Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through specific
therapeutic interventions across the lifespan.
● CO 3: Distinguish risk factors associated with selected disease states across the
lifespan.
● CO 4: Integrate advanced pathophysiological concepts in the diagnosis and treatment
of health problems in selected populations.
Chronic Bronchitis
The nurse practitioner (NP) is seeing a client with chronic bronchitis that needs spirometry on
today’s visit. What pulmonary function test (PFT) findings are anticipated based on the
diagnosis of chronic bronchitis?
Downloaded by Benjamin Luca ()
, lOMoAR cPSD| 51648332
Decreased diffusing capacity Decreased
total lung capacity (TLC)
Decreased lung compliance
Decreased forced expiratory flow (FEV1)
Chronic bronchitis is an obstructive disease. Therefore, the client will have decreased
expiratory flow rates. The FEV1 will be decreased.
Air trapping is also common in obstructive disease which will cause an increased TLC. A
decreased diffusing capacity typically only occurs in emphysema, not chronic bronchitis. In
chronic bronchitis, lung compliance is increased slightly, not decreased.
Arterial Blood Gas
The nurse practitioner (NP) assesses a client with a history of heart failure and
Arterial Blood Gas Results
pH 7.56
PaCO2 30 mmHg
HCO3‾ 24 mEq /L
PO2 82 mmHg
O2 saturation 87%
pulmonary edema. Based on the arterial blood gas (ABG) result below, which clinical condition
does the NP suspect?
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
The client has uncompensated respiratory alkalosis.
Arterial
Blood Gas Normal Values Results Problem
pH 7.35–7.45 7.56 ↑ (alkalosis)
PaCO2 35–45 mmHg 30 ↓ (respiratory)
HCO3– 22–26 mEq/L 24 24 (normal)
Downloaded by Benjamin Luca ()
, lOMoAR cPSD| 51648332
Arterial
Blood Gas Normal Values Results Problem
PO2 80–100 mmHg 82 82 (normal)
O2 saturation 95%–100% 87% 95 (normal)
---------------------
Characteristics of Lung Disease
Complete the following sentence by choosing from the list of options.
Lung diseases that have (increased lung volume\ increased lung capacity\ reduced lung
volume) are characterized as restrictive, whereas diseases with (increased airflow\ reduced
airflow\ normal airflow) are characterized as obstructive.
Risk Factors of Lung Disease
An individual is at risk based on age, individual factors, and underlying clinical conditions. Click
each section below to learn more about the risk factors of lung disease.
Age
● Infants and young children have less alveolar surface area for gas exchange; therefore,
airways can be easily obstructed by mucus, edema, or foreign objects.
● Older adults have anatomical and physiological changes expected with
advanced age.
● Loss of elastic recoil of the chest and decreased lung volume capacity (tidal
volume)
● Weaker respiratory muscles, reducing the effort to cough (risk for
aspiration)
● Dilation of alveoli, decreased surface area
Individual Factors
● Nonmodifiable: Age, congenital abnormalities, or environmental concerns (air pollution,
for example)
● Modifiable: Tobacco use (inhaled smoke) or second-hand exposure to air
pollutants; vaccinations to prevent pulmonary disease (COVID, influenza,
pneumococcal, Tdap)
● Other: Clients with altered levels of consciousness, neurological disorders, tracheal
intubation, bed rest, or immobilization
Acute or Chronic Disease
Downloaded by Benjamin Luca ()
