A patient with emphysema is admitted to your unit. The patient is short of breath and purse lip breathing. The nurse identifies the cause as: Papa, K. (2021). Essential in-services for Long-term Care (2021st ed.). HCPro, a division of Simplify Compliance LLC. (Original work published 2021)
a. Bronchi spasms
b. An increase in lung vital capacity
c. Rapid expulsion of air
d. Air trapping and difficulty expelling air
e. All of the above
The correct answer and explanation is :
The correct answer is:
d. Air trapping and difficulty expelling air
Explanation:
Emphysema is a chronic obstructive pulmonary disease (COPD) characterized by damage to the alveoli (air sacs) in the lungs, resulting in reduced surface area for gas exchange. Over time, the alveolar walls break down, and the air sacs lose their elasticity, causing air to become trapped in the lungs. This leads to hyperinflation of the lungs, making it difficult for patients to exhale fully. The lungs stay partially inflated even after exhalation, which impairs the exchange of oxygen and carbon dioxide.
One of the hallmark signs of emphysema is pursed-lip breathing, a compensatory mechanism used by patients to keep the airways open longer during exhalation. By breathing out slowly through pursed lips, they create back pressure in the airways, preventing airway collapse and allowing more air to be expelled. This helps to reduce the amount of air that becomes trapped in the lungs.
Shortness of breath (dyspnea) in emphysema is primarily due to air trapping and difficulty expelling air. As more air becomes trapped, the lungs inflate more and more, placing the diaphragm in a flattened position. This mechanical disadvantage reduces the efficiency of breathing and contributes to the sensation of breathlessness.
The other options are incorrect:
- a. Bronchi spasms – more commonly associated with asthma, not emphysema.
- b. An increase in lung vital capacity – emphysema decreases vital capacity due to air trapping and hyperinflation.
- c. Rapid expulsion of air – emphysema impairs airflow and slows down exhalation, rather than speeding it up.
- e. All of the above – incorrect because not all listed options are true or relevant to emphysema.
Therefore, Option d accurately identifies the primary issue in emphysema: air trapping and difficulty expelling air. This understanding is crucial in guiding appropriate interventions, such as teaching pursed-lip breathing and optimizing oxygen therapy while avoiding over-oxygenation.