Exam (elaborations) Nursing

Asthma - answerChronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles What are 5 s/s of asthma - answercoughing wheezing shortness of breath rapid breathing chest tightness Pathophysiology of asthma (5) - answer-airway inflammation, bronchial hyper-reactivity and smooth muscle spasm -excess mucus production and accumulation -hypertrophy of bronchial smooth muscle -airflow obstruction -decreased alveolar ventilation Bronchioles - answersmaller passageways that originate from the bronchi that become the alveoli 3 layers of the bronchioles - answerinnermost layer middle layer - lamina propria outermost layer lamina propria - answerthe middle layer of the bronchioles structure of the lamina propria - answerembedded with connective tissue cells and immune cells purpose of the lamina propria - answerwhite blood cells are present to help protect the airways How does the lamina propria effect the lungs in regards to asthma - answerthe WBCs protective feature goes into overdrive causing an inflammatory response that damages host tissue What does the innermost layer of the bronchioles contain - answercolumnar epithelial ells and mucus producing goblet cells What does the outermost layer of the bronchioles contain - answersmooth muscle cells what does the outermost layer of the bronchioles do - answercontrol the airways ability to constrict and dilate alveolar hyperinflation - answerWhen air is unable to move out of the alveolar like it should due to bronchial walls collapsing around possible mucus plug thus trapping air inside how does hyperinflation occur? - answerthe ongoing inflammatory process of asthma produces mucus and pus plug that the bronchial walls collapse around Effect of hyperinflation of the alveolar - answer-expanded thorax and hypercapnia (retention of CO2) - respiratory acidosis What are two anticholinergic drugs used for asthma - answertiotropium and ipratropium What do anticholinergics do in the lungs? - answerThese drugs block the effects of the parasympathetic nervous system - increasing bronchodilation MOA of anticholinergic drugs for asthma - answerthe parasympathetic system is stimulated by the vagal nerve to release acetylcholine which binds to the cholinergic receptors of the respiratory tract to cause bronchial constriction = decreased airflow - blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial constriction bronchitis - answerinflammation of the bronchial tubes 3 characteristics of bronchitis - answerbronchial inflammation hypersecretion of mucus chronic productive cough for at least 3 consecutive months for at least 2 successive years Perfusion - answerThe supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries. results of chronic bronchitis/ low perfusion - answercyanosis right to left shunting chronic hypoxemia Why is there cyanosis with chronic bronchitis - answerthere is hypoxia due to unfavorable conditions for gas exchange Right to left shunting - answerwhen blood passes from the right ventricle through the lungs and to the left ventricle without perfusion Causes of bronchitis - answer-long term exposure to environmental irritants -repeated episodes of acute infection (RSV infection in early infancy) -Factors affecting gestational childhood lung development (preterm birth) Pathogenesis of bronchitis - answer-Exposure to airborne irritants - Irritant activates bronchial smooth muscle constriction and mucus secretion - Triggers release of inflammatory mediators from immune cells located in the lamina propria most common irritant with bronchitis is? - answertobacco product smoke what does long term exposure to irritants promote in bronchitis? (5) - answer- smooth muscle hypertrophy - hypertrophy and hyperplasia of goblet cells - epithelial cell metaplasia - migration of more WBC to site - thickening and rigidity of bronchial basement membrane What does smooth muscle hypertrophy do in lungs? - answercauses increased bronchoconstriction Hypertrophy and hyperplasia of goblet cells do what in the bronchials - answerpromotes hypersecretion of mucus What are characteristics of epithelial cell metaplasia? - answersquamous cells become nonciliated and are less protective; allow passage of toxins and WBCs