NR-507 Mid-Term Study Guide simultaneous responsive (A GUARANTEED)

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NR-507 Mid-Term Study Guide simultaneous responsive (A GUARANTEED) This study guide is for the 50 question multiple choice Mid-Term exam that will be given during Week 4. It will cover the followin... g concepts: PULMONARY: review concepts related to anticholinergic drugs and the treatment for asthmaAsthma is a chronic disease characterized by airway inflammation bronchial hyper reactivity and smooth muscle spasm intermittent reversible airflow obstruction. Asthma is caused by complex interaction of genetic and environmental factors. As a matter of fact over 100 different genetic mutations have been implicated as possible links to the development of asthma. Asthma results in excess mucus production and accumulation hypertrophy of bronchial smooth muscle airflow obstruction decreased alveolar ventilation. • bronchitis and associated pathogenesis; smooth muscle hypertrophy à increased bronchoconstriction • hypertrophy and hyperplasia of goblet cells à mucus hypersecretion • epithelial cell metaplasia à non-ciliated squamous cells • migration of more WBCs to site à inflammation & fibrosis in bronchial wall • thickening and rigidity of bronchial basement membrane à narrowing of bronchial passageways chronic bronchitis and related acid/base disturbances- air being trapped in alveoli results in hypercapnia (CO2) retention and respiratory acidosis perfusion- High CO2 creastes unfavorable conditions for gas exchange so there is decreased O2 exchange via ventilation/perfusion mismatch. Decreased perfusion of pulmonary capillaries with oxygenated blood results in chronic pulmonary hypoxia and cyanosis. Perfusion is gas exchange or the actual exchange of O2 andCO2 in the bloodstreat and occurs via the alveoli and pulmonary capillaries. Without effective ventilation we cannot have effective perfusion. Air has to get to the alveoli and pulmonary capillaries in order for perfusion to occur. blood flow between the heart and lungsasthma signs and symptoms- Symptoms- coughing, wheezing shortness of breath rapid breathing chest tightness bronchioles,- The bronchioles are a three layer tube like structure surrounding the lumen or air passageway. The innermost layer, closest to the lumen, is composed of columnar epithelial cells and mucus producing goblet cells. The outermost layer is composed of smooth muscle cells, responsible for the ability of the airways to constrict and dilate. The middle layer, called the lamina propria, is embedded with connective tissue cells, as well as immune cells. These immune cells include a number of different kinds of white blood cells located here to help protect the airways. However, in the case of asthma, this protective feature goes into overdrive, causing an inflammatory response that damages host tisse. alveolar hyperinflation with asthma - The plugs of mucus and pus from this inflammatory process can block alveolar passageways, leading to air-trapping and hyperinflation more signs and symptoms consistent with the diagnosis of asthma. This process is illustrated in this image which shows the airway pathology in its entirety mast cell degranulation triggered by the excessive amounts of IGE that have airingly formed this individual that will bind that allergen as it enters the airway that mast cell degranulation releases chemicals that releases mucus production and accumulation as well as chemicals that contribute to smooth muscle constriction that smooth muscle constriction along with mucus plugs that form result in hyperinflation of the alveoli and eventual erosion of airway tissue polycythemia vera; Poor ventilation, leading to decreased perfusion, causes Right to Left “shunting” to occur. This is the phenomenon where deoxygenated blood passes from the RV to lungs to the LV without adequate perfusion (gas exchange). In response to the chronic low level of oxygen in the blood, the kidneys compensate by increasing secretion of erythropoietin, the primary hormone responsible for stimulating red blood cell production. As a result of increased RBC production, clients with chronic bronchitis exhibit an elevated hematocrit and can develop a condition known as secondary polycythemia vera. mechanism of action of anticholinergic drugs to treat asthma CARDIOVASCULAR: review concepts related to cardiac output, [Show More]

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