Week 4: Mid-term Study guide NUR507-NP

Week 4: Mid-term Study guide
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NUR507-NP
Pulmonary Il`




Review concepts related to
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• Anticholinergic drugs o Anticholinergic agents – block acetylcholine
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binding
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Primarily in lung bronchodilation through ( Decreased parasympathetic Il` Il` Il` Il` Il` Il` Il`




response) Il` Il`




• Tiotropium, ipratropium Il` Il`




• Asthma Il`




Is a chronic inflammatory disorder of the bronchial mucosa that causes
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bronchial hyperresponsiveness, constriction of the airways, and variable
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airflow obstruction that is reversible Il` Il` Il` Il` Il` Il`




o chronic disease characterized by Il` Il` Il` Il`




airway inflammation Il` Il`




bronchial hyperreactivity and smooth muscle spasm Il` Il` Il` Il` Il` Il`




intermittent, reversible airflow obstruction Il` Il` Il` Il`




o caused by Il`




complex interaction of genetic and environmental factors o Il` Il` Il` Il` Il` Il` Il`




resulting in Il` Il` Il`




excess mucus production and accumulation Il` Il` Il` Il` Il`




hypertrophy of bronchial smooth muscle Il` Il` Il` Il` Il`




airflow obstruction o asthma can take two forms Il` Il` Il` Il` Il` Il` Il` Il`




extrinsic asthma Il` Il` Il`




• triggered by a chronic allergic reaction o (mold, pollen, dust Il` Il` Il` Il` Il` Il` Il` Il` Il`




mites, pet dander) Il` Il` Il` Il`




• Elevated IgE level is diagnostic Il` Il` Il` Il` Il`




• More common especially in children (males: females = 2:1) Il` Il` Il` Il` Il` Il` Il` Il` Il`




Intrinsic asthma Il` Il`




• Triggered by a variety of non-allergic factors o (chemicals, Il` Il` Il` Il` Il` Il` Il` Il`




airborne irritants, infections- viral, exercise, stress, anxiety, Il` Il` Il` Il` Il` Il` Il`




GERD, obesity) o No initial elevation in IgE level Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




o Typically seen in adults (<40yrs) – slightly more common in females
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o Most common symptoms of extrinsic and intrinsic asthma
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Coughing, wheezing, SOB Il` Il`




Rapid breathing, chest tightness o Treatment Il` Il` Il` Il` Il` Il`




Immediate administration of oxygen and inhaled beta-agonist Il` Il` Il` Il` Il` Il`




bronchodilators Il` Il`




Inhaled corticosteroids should be administered early in the course of Il` Il` Il` Il` Il` Il` Il` Il` Il`




management. Il` Il`

, Week 4: Mid-term Study guide
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NUR507-NP
Avoidance of allergens and irritants, control of symptoms and prevention of
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exacerbations
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Severe asthma- long-acting beta agonists can be used to control persistent
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bronchospasm o Signs and symptoms
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Chest constriction, expiratory wheezing, dyspnea, nonproductive
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coughing, prolonged expiration, tachycardia, tachypnea
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• Bronchitis and associated pathogenesis o A chronic disease Il` Il` Il` Il` Il` Il` Il`




characterized by Il` Il` Il`




Bronchial inflammation Il` Il`




Hypersecretion of mucus Il` Il` Il`




Chronic productive cough, persisting for at least 3 consecutive months for
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at least 2 successive years
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o Caused by
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Long-term exposure to environmental irritants Il` Il` Il` Il` Il`




Repeated episodes of acute bronchitis (infection) Il` Il` Il` Il` Il` Il`




Factors affecting gestational or childhood lung Il` Il` Il` Il` Il`




development o Resulting in Il` Il` Il` Il` Il`




Excess mucus production and accumulation Il` Il` Il` Il` Il`




Hypertrophy of bronchial smooth muscle Il` Il` Il` Il` Il`




Hypertrophy and hyperplasia of bronchial mucus Il` Il` Il` Il` Il`




producing cells Il` Il` Il`




Airflow obstruction Il` Il`




Decreased alveolar ventilation o the lung damage Il` Il` Il` Il` Il` Il`




from chronic bronchitis is typically considered irreversible o Il` Il` Il` Il` Il` Il` Il` Il`




most common symptoms of chronic bronchitis are Il` Il` Il` Il` Il` Il` Il` Il`




productive, purulent cough Il` Il` Il`




copious sputum production Il` Il` Il`




shortness of breath Il` Il` Il`




wheezing, rhonchi Il`




cyanosis, peripheral edema o pathogenesis of Il` Il` Il` Il` Il`




chronic bronchitis Il` Il` Il`




1. Exposure to airborne irritants activated bronchial Il` Il` Il` Il` Il` Il` Il`




• Smooth muscle constriction Il` Il` Il`




• Mucus secretion Il` Il`




• Release of inflammatory mediators from immune cells in the Il` Il` Il` Il` Il` Il` Il` Il`




lamina propria o (histamine, prostaglandins, leukotrienes,
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interleukins) Il` Il`




2. Long term exposure to airborne irritants promotes
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• Smooth muscle hypertrophy - increased bronchoconstriction Il` Il` Il` Il` Il` Il`