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Asthma is a chronic inflammatory disease of the airway and makes the lumens more difficult to breathe through. In asthma, there are lots of eosinophils, which are white blood cells responsible for inflammation, just below the epithelial surface of the bronchiole tubes. Reduced oxygen in arterial blood (hypoxemia) occurs as hyperventilation increases, because the respiratory center is stimulated by these phenomena. This causes PaCO2 (arterial carbon dioxide)to decrease, and pH (hydrogen ions) to increases causing respiratory alkalosis (Huether & McCance, 2017, p. 699)Pathophysiology of Acute Asthma ExacerbationWhen factors such as viruses, bacteria, environmental allergens, or pollutants enter the airways from, they may trigger an exacerbated response of the patient with asthma. With asthma exacerbation, the muscle layer (smooth muscle), of the airway thickens and constricts, making the airway lumen smaller (Fan, 2014). The mucosal layer of the lumen swells, and the glands in the airways overproduce with mucus and secret into the already constricted lumen and filling it up with fluid (Fan, 2014). The sound of wheezing is from the constriction of narrowing of the airway lumen, and the overproduction of mucus causes a cough (Fan, 2014).
4When an allergen or foreign substances enter the body, the immune response reacts with antibodies (IgE), and every time you get exposed, the body produces more antibodies allowing the immune system to hyper respond. The antibodies are there to recognize and pick up foreign objects. Mast cells carry molecules called histamines, bradykinins, prostaglandins, leukotrienes, platelet-activating factor, and interleukins. Immunoglobulin-E antibodies attach to the foreign substance, go to look for a mast cell, then attach to (Fan, 2014). The mast cells then open, releasing all its substances, including histamine, into the bloodstream, causing allergic reactions everywhere, including the lungs. The release of these inflammatory mediators causes vasodilation, increase capillary permeability, mucosal edema, bronchial smooth muscle contractions (bronchospasm), and mucus secretion from goblet cells (Huether & McCance, 2017,p. 698). Ethical Disparities in AsthmaEthnical disparities in asthma remain an issue in the United States. African Americans and Puerto Ricans Children are three times more likely to die from asthma than whites, and in 2015 African American children have a death rate ten times that of white children (U.S. Department of Health and Human Services [HHS], 2018, para. 1). HHS (2018) goes on to mention that children living below the poverty level are more likely to have high levels of nicotine in the blood than those living in higher-income homes. The authors also mention that children exposed to secondhand smoke are at increased risk for acute lower respiratory tract infections.