COPD - According to the Centers for Disease Control (CDC), chronic obstructive pulmonary disease (COPD) is a group of diseases where airflow is blocked leading to respiratory complications (2015). Diseases associated with COPD include emphysema, chronic bronchitis, and sometimes asthma which are described as chronic lower respiratory diseases. In 2011, COPD was the third leading cause of death in the U. S., with over 15 million Americans diagnosed. However, many people are undiagnosed and it is estimated that the number is much higher. Higher prevalence exist among older adults (65-74 years), current or former smokers, with a history of asthma, less than a high school education, lower income levels, and are divorced, widow, or separated (CDC, …show more content…
Cigarette smoke is the primary cause of the inflammatory response which increases mucous secretions (chronic bronchitis), promotes tissue damage (emphysema), disrupts normal defense mechanisms, and inevitably causes small airway inflammation and fibrosis (bronchiolitis). In turn, these pathological changes manifest with chronic cough and wheeze, dyspnea upon exertion due to increase work of breathing, air trapping, and progressive airflow obstruction (MacNee, 2006). Respiratory fatigue and alveolar hypoventilation decreases oxygenation leading to hypoxemia, hypercapnia, and respiratory acidosis which are usually late signs of disease progression (see Fig. 1). Respiratory failure and death may occur with increased hypoxia due to increased pulmonary vasoconstriction and pulmonary hypertension. Cor pumonale may also result with disease progression by increasing the load on the right ventricle (Grossman & Porth,