| Course | NSG 120 Nursing Pathophysiology |
|---|---|
| Unit | Unit 4 |
| Paper type | Body system comparison paper |
| Length | About 860 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 120 Unit 4
Stiff Lungs and Floppy Lungs: Pulmonary Fibrosis and Emphysema Held to the Same Four Questions in Two Composite Patients
Student Name
Department of Nursing, Herzing University
NSG 120: Nursing Pathophysiology
Instructor Name
February 6, 2026
Stiff Lungs and Floppy Lungs: Pulmonary Fibrosis and Emphysema Held to the Same Four Questions in Two Composite Patients
Why These Two
Two composite patients sit in neighboring beds on a respiratory floor. Mr. A, aged 71, spent his working life as a machinist and has idiopathic pulmonary fibrosis. Mr. B is a 68-year-old retired truck driver with emphysema after 45 years of smoking. Both are short of breath when they walk, both have low oxygen saturation on exertion, and both have a dry or mild cough. A student reading only those findings could not tell them apart. The comparison is worth making because the two processes damage the lung in opposite ways: fibrosis makes the lung stiff and small, emphysema makes it loose and overinflated. Holding both to the same questions shows where the overlapping findings come from and where the two finally look different.
The Grid
The same four rows are applied to both columns.
| Question | Pulmonary fibrosis (Mr. A) | Emphysema (Mr. B) |
|---|---|---|
| Where the problem sits | The interstitium: the thin tissue between the air sacs (alveoli) and the capillaries, which fills with scar tissue | The alveolar walls themselves, which are destroyed, merging small air sacs into large, floppy spaces |
| What it does to air movement | The lung becomes stiff and hard to expand, so breathing in takes more effort and each breath is smaller; air flows out easily | The lung loses its elastic recoil and the small airways collapse when breathing out, so air is trapped; breathing out is the hard part |
| What it does to the blood | Oxygen must cross a thickened, scarred barrier to reach the blood, so it diffuses slowly, especially when blood moves fast during exercise | Destroyed walls mean less surface area and fewer capillaries, so less oxygen can cross; ventilation and blood flow are mismatched |
| What the patient shows | Rapid, shallow breathing; fine, dry crackles at the lung bases that sound like Velcro; clubbed fingertips in many patients; a small chest | Slow breathing out through pursed lips; a barrel-shaped chest; distant breath sounds; use of neck muscles; leaning forward on the arms |
Where the Problem Sits
In fibrosis, injury to the cells lining the alveoli is followed by abnormal repair: cells called fibroblasts lay down collagen in the interstitium instead of restoring normal tissue, and the scarring spreads over years (Lederer & Martinez, 2018). The alveoli are still present, but their walls are thick and stiff. In emphysema, the irritants in cigarette smoke draw in inflammatory cells that release enzymes, which break down the elastic fibers of the alveolar walls faster than the lung can repair them (Rogers, 2023). The walls disappear rather than thickening. So one disease adds tissue, and the other removes it.
What Each Does to Air Movement
This row is where the two columns diverge most, and it is the row that explains most of the findings. A fibrotic lung behaves like a stiff balloon. It takes more work to inflate, so Mr. A takes small, fast breaths, which cost him less effort than deep ones. His lung volumes are reduced, which is why fibrosis is called a restrictive disease. Breathing out is not a problem; the stiff lung springs back quickly.
An emphysematous lung behaves like an old, stretched balloon. It inflates easily but does not spring back, and the small airways, which depend on the pull of surrounding elastic tissue to stay open, collapse as Mr. B breathes out. Air is trapped behind them. His lung volumes are large, his chest becomes barrel-shaped over time, and each breath starts from a lung that is already too full. That is why emphysema is part of chronic obstructive pulmonary disease: the obstruction is to airflow out of the lung (Agustí et al., 2023). Pursed-lip breathing helps him because it keeps a little pressure in the airways and stops them from collapsing so early.
What Each Does to the Blood
Both men have trouble getting oxygen into the blood, but for different reasons. In Mr. A, the barrier is thicker. At rest, blood spends enough time in the lung capillaries for oxygen to cross even a thickened wall, so his saturation at rest may be near normal. With exercise, blood moves faster and there is not enough time, so his saturation drops sharply when he walks. In Mr. B, the barrier is not thicker but there is less of it, and some areas of lung receive air but little blood while others receive blood but little air. His low oxygen comes from that mismatch as well as from the lost surface. Over time Mr. B may also retain carbon dioxide, because trapped air makes it hard to breathe it out, which is uncommon in fibrosis until very late.
The Overlapping Findings, Where the Two Are Confused
Breathlessness on walking, low saturation during exertion, a cough, and fatigue appear in both men. Each has a different source. Mr. A's breathlessness comes from the work of expanding a stiff lung and from oxygen crossing slowly at speed. Mr. B's comes from trapped air and a lung that starts each breath overfilled. Crackles are a particular source of confusion: Mr. A's fine, dry crackles at the bases come from stiff alveoli snapping open, and they are a key finding in fibrosis (Lederer & Martinez, 2018). Mr. B usually has quiet breath sounds instead, but if he also has mucus in his airways he may have coarser crackles that shift after coughing. The word "crackles" in a record is not enough to tell them apart; the description matters.
What a Nurse Would Record Differently
For Mr. A: breathing rate and depth; saturation at rest and after a measured walk, since the drop with exertion is the key finding; the character of the crackles, fine and dry, and where they are heard; and clubbing of the fingers.
For Mr. B: the length of breathing out compared with breathing in; pursed-lip breathing and use of neck muscles; chest shape; saturation, recorded against his own target range; and signs of carbon dioxide retention, such as new drowsiness, headache, or confusion.
Sources: the mechanisms of fibrosis follow Lederer and Martinez (2018); those of emphysema follow Rogers (2023) and the GOLD summary (Agustí et al., 2023). Target oxygen ranges vary between patients and facilities and were checked against course materials.
References
Agustí, A., Celli, B. R., Criner, G. J., Halpin, D., Anzueto, A., Barnes, P., Bourbeau, J., Han, M. K., Martinez, F. J., Montes de Oca, M., Mortimer, K., Papi, A., Pavord, I., Roche, N., Salvi, S., Sin, D. D., Singh, D., Stockley, R., López Varela, M. V., ... Vogelmeier, C. F. (2023). Global Initiative for Chronic Obstructive Lung Disease 2023 report: GOLD executive summary. European Respiratory Journal, 61(4), Article 2300239. https://doi.org/10.1183/13993003.00239-2023
Lederer, D. J., & Martinez, F. J. (2018). Idiopathic pulmonary fibrosis. New England Journal of Medicine, 378(19), 1811-1823. https://doi.org/10.1056/NEJMra1705751
Rogers, J. L. (Ed.). (2023). McCance & Huether's pathophysiology: The biologic basis for disease in adults and children (9th ed.). Elsevier.
What the NSG 120 Unit 4 instructions ask for
Unit 4 asks you to compare two conditions in the same body system using a consistent set of questions. Expect to introduce two patients or conditions, apply the same rows to each, explain where they differ and overlap and describe what a nurse would record differently. Many versions ask whether one patient can be used instead of two and how detailed the mechanism should be. Check whether your section expects a grid. Two contrasting conditions, such as restrictive and obstructive lung disease, make the comparison clear. Use the same questions for both so differences stand out. Overlapping findings matter because they are where mistakes happen. Cite current guidelines for each condition. Keep both patients composite. Explain mechanisms in plain language with key terms defined.
How the NSG 120 Unit 4 example is put together
The paper opens with two patients and why they are worth comparing. The grid applies four rows to both columns. Each row section then explains the difference in plain language, such as stiff lungs that resist expansion versus floppy lungs that trap air. The air movement row is the most detailed, because it explains most of the findings. The blood row explains different reasons for low oxygen. The overlap section shows how breathlessness and low saturation can lead to confusion between the two. The recording section lists what to document for each patient, such as saturation after a measured walk for fibrosis. The comparison is balanced, with equal depth for both conditions.
Reading the NSG 120 Unit 4 rubric
Herzing's rubric for a body system comparison typically covers the choice of conditions, consistent application of questions, accuracy of mechanisms, analysis of differences and overlaps, nursing implications and writing. Accuracy and consistent application are read together, since graders want both conditions held to the same rows with correct mechanisms. Choice points reward a contrast that teaches something. Difference and overlap criteria look for clear explanation of each. Nursing implications earn credit for distinct recording. A grid helps presentation. Graders also check that the nurse's recording differs for each patient, since identical recording suggests the mechanisms were not used. Cite Lederer and Martinez's review and the GOLD report in APA 7.
NSG 120 Unit 4 help before you submit
A Unit 4 comparison often falls short by describing each condition separately without using the same questions. Another frequent problem is giving one condition far more depth than the other. Students often miss overlapping findings. Mechanisms are described at the level of the whole lung rather than the alveolus. Nursing implications are the same for both. The grid is missing. Guidelines are outdated. Terms such as compliance and recoil are used without explanation. Finally, explain where the two are confused, because graders reward a comparison that shows how similar findings can come from opposite mechanisms. Another gap is forgetting smoking history and occupational exposure, which explain why each patient developed his condition.
Get a NSG 120 Unit 4 example written to your instructions
Send the Unit 4 instructions and the rubric from your NSG 120 classroom, and name the two processes the assignment pairs. We write a custom example that runs both through identical rows, settles the location first, marks the findings the two share, and carries each difference through to what the patient shows. First custom sample free, returned in 24 to 48 hours.
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NSG 120 Unit 4 questions, answered
Can the comparison use one patient instead of two?
Either works, and your instructions usually decide. A single composite patient in whom both possibilities are open makes the overlapping findings easier to show, while two patients make the divergence cleaner. If you use two, keep their ages and backgrounds close enough that the differences you report come from the processes rather than from the people.
How detailed should the mechanism be here?
Only as detailed as the comparison uses. A row that never produces a difference between the columns is background, and background is what crowds out the divergence paragraphs where the marks sit. Keep the depth even across both columns as well, since a reader notices immediately when one process was understood better than the other.
What if the two processes look identical at the bedside?
Then write that, because it is a real finding and a defensible one. Say which findings genuinely overlap, name whatever does separate them even slightly, and note what a nurse would record to keep the picture accurate. A comparison that manufactures a clean difference reads as less careful than one reporting honestly where the two cannot be told apart.
Where can I find a free NSG 120 Unit 4 sample paper?
The complete NSG 120 Unit 4 fibrosis and emphysema comparison is posted here free, four questions applied to both with the overlaps and recording differences. A comparison of another pair of conditions can be prepared on request.
What is the difference between pulmonary fibrosis and emphysema?
Fibrosis makes the lungs stiff, so they resist filling; emphysema destroys alveolar walls and elastic recoil, so air is trapped on exhaling. This sample compares both in two patients using the same four questions.