2018). The cascade of events includes exposure, immune activation, mast cell degranulation which produces vasoactive mediators, and chemotactic mediators which then cause vasodilation and cellular infiltration that promote bronchospasms, vascular congestion, mucus secretion and thickening of the airway walls that leads to airway obstruction (Huether and McCance, 2017).
3 In the article by, Jain, Singal, Jain, Clark, & Chauhan, (2003), lower airway the histopathological changes seen are: an increase in mucus secretion causing mucus plugging, desquamation or shedding of the epithelium, mucosal and submucosal edema, basement membrane thickening, smooth muscle hyperplasia, and inflammatory cell infiltration. Clinical Presentation Asthma in either chronic or exacerbated will present clinically similar with dyspnea, cough, and wheezing. However, the severity of the asthma “attack” can indicate an event that can be managed at home or a hospital admission as a life-threatening event. An acute exacerbation of asthma will present with the previous symptoms but more pronounced, and may include, increasing shortness of breath, accessory muscle use, intercostal retractions, hypoxia, cyanosis, agitation, tachycardia, tachypnea, and pulsus parodoxus (Papi et al., 2018). Exacerbations onset is usually rapid in children, but in adults can develop over a week or more. The pulmonary system is responsible for the exchange of gases such as oxygen (O2)and carbon dioxide (CO2) in the body. Gas exchange is done in the arterioles and if the upper airways are constricted less exchange of these gases occur (Huether and McCance, 2017). Arterial blood gases (ABGs) during an exacerbation will show changes in the percentage of O2 and CO2 values shown as PaO2: the partial pressure of oxygen in the alveoli and PaCO2: the partial pressure of CO2 in the alveoli (Jones, and Berry, 2015). During an acute asthma exacerbation and resulting airway compromise
You've reached the end of your free preview.
Want to read all 7 pages?
- Fall '17
- keisha lovence