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Med Surge 4th exam > Asthma > Flashcards

Flashcards in Asthma Deck (59)
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1

A chronic inflammatory lung disease that results in variable episodes of airflow obstruction that's usually reversible is defined as:

asthma

2

What is the curent prevalence of asthma:

children, boys, women

3

What ethnicity has the highest asthma morbidity and mortality:

African Americans

4

What are the types of episodes experienced in asthma attacks:

recurrent episodes of wheezing, breathlessness, chest tightness, cough all happening typically at night or early in the morning

5

What is the genetic influence in relation to asthma:

Atopy which is the body producing an antibody, immunoglobulin- E, that responds to common allergens

6

What can immunoglobulin E trigger in a pt:

allergic rhinitis, asthma, hay fever, eczema

7

How does the immune response affect asthma:

hygiene hypothesis suggest that baby's need to be exposed to things that cause allergies in order to not be allergic or have asthmatic episodes

8

How do allergens affect asthma:

House mites, dander

9

How does exercise affect asthma:

Exercise induced asthma occurs AFTER vigorous activity and usually in the cold

10

How does air pollutants trigger asthma:

Ozone, pollution, and smoking trigger asthma

11

How does occupational factors trigger asthma:

agricultural workers, painters, plastic mechanics, cleaning work

12

How do respiratory infections trigger asthma:

VIRAL infections such as RSV (respiratory syncytial virus in children) and the rhinovirus are two major factors in the development of asthma d/t causing the bronchial system to be hyperresponsive

13

How do nose and sinus problems affect asthma:

Allergic rhinitis is a major predictor in adult asthma; sinusitis must be treated and nasal polyps removed for asthma to be better controlled

14

How do drugs and food additives affect asthma:

Pts with sinusitis and lrg nasal polyps are sensitive to specific drugs. Asthma triad (nasal polyps, asthma, and sensitivity)are sensitive to ASA and NSAIDs; Beta blockers 2 may trigger asthma d/t bronchospasm; ACE inhibitors trigger cough; Food dye tartrazine (Yellow color)

15

How does gastroesophageal reflux disease (GERD) affect asthma:

Typically causes nocturnal asthma (can occur in the day) by stomach acid being aspirated into the lungs triggering vagal stimulation and bronchoconstriction

16

How do psychological factors affect asthma:

Strong emotions (stress, laughter) can cause hyperventilation or hypocapnia which can lead to airway narrowing

17

What are the characteristics of asthma:

recurring variable S/S; airflow obstruction; bronchial hyper-responsiveness

18

What is the key feature of asthma:

inflammation which will lead to cough, chest tightness, wheeze, dyspnea

19

In the pathophysiology of asthma, what occurs, after exposure to allergens or irritants:

Mast cells, epithelial cells, and IgE bodies are released

20

During the inflammatory cascade response, what do the mast cells and epithelial cells produce:

mast cells degranulate to release leukotrienes, histamine, cytokines, PGs, and nitric oxide=vasodilation/cap permeability and cellular infiltration; epithelial cells produce cytokines too

21

What is the resulting inflammatory process result in:

vascular congestion, airway edema, thick tenacious mucus, bronchial muscle spasm, thickening of airway walls, increased bronchial hyper-responsiveness

22

What is the response to increased lung volume from trapped air and airflow limitation:

hyperventilation

23

Hyperventilation will cause:

decrease perfusion and ventilation of the alveoli; early hypoxemia w/decreased CO2 and increased pH (low CO2 and high ph = respiratory alkalosis)

24

What will occur if respiratory alkalosis isn't resolved:

CO2 will normalize as the pt tires and then will increase to produce respiratory acidosis (an OMINOUS sign of RESPIRATORY FAILURE)

25

In the pathophysiology of asthma, what occurs after the mast cells have degranulated their contents, IGE have been activated, and epithelial cells produce their cytokins:

inflammatory mediators cause vasodilation and cellular infiltration (neutorphils, lymphocytes, eosinophils)

26

What occurs after cellular infiltration:

activation of neutrophils and eosinophils will release more chemical mediators and neuropeptides (effects nervous system) that will prolong the asthma occurrence for 24 hrs or more

27

What occurs after inflammatory mediators cause vasodilation:

increased cap permeability causing bronchospasm, vascular congestion, edema formation, mucous secretion, impaired mucociliary function, thickening of airway walls=bronchial hyper-responsiveness and airway obstruction

28

What do the sympathetic nervous system regulate in asthmatic pts:

contain beta-adrenergic receptors that mediate the bronchial dilation and diminish mucus secretion (epinephrine can relax the bronchial muscles)

29

What do the parasympathetic system regulate in asthmatic pts:

regulates airway smooth muscle tone; contain Cholinergic receptors that respond to acetylcholine (released d/t airway nerve ending stimulation) to make the muscles contract

30

Structural changes ( smooth muscles hypertrophy, mucus hypersecretion, fibrosis of epithelium) in the bronchial wall causing a progressive loss of lung function if no prevention is initiated is defined as:

remodeling