3. Explain the differences between the etiology, clinical manifestations and pathophysiology of asthma, chronic bronchitis, and emphysema and describe how this affects your practice as a nurse practitioner. 9
- Status asthmaticus: if spasm not reversed; life-threatening: silent chest and Paco2 >70 are s/s of impending death Pathophysiology Epithelial exposure to antigen causing persistent inflammation of bronchial mucosa/hyperresponsiveness of airways Early: - Activation of dendritic cells to present antigen to CD4+ cells - IgE released - Eosinophils proliferated and cause increased hyperresponsiveness, fibroblast prolif, epithelial inj, airway scarring Late: - 4-8 hours after early response - prolonged smooth muscle contraction - plugs formed in airways - can lead to airway remodeling - air trapping in alveoli respiratory acidosis, which leads to resp. failure Clinical Implications dx- history of allergies and recurrent episodes of wheezing/dyspnea/cough/exercise intolerance - spirometry, ABG, peak flow, underlying triggers tx- bronchodilator, corticosteroids management- avoid allergens, inhalers, anti-inflammatory meds, inhaled corticosteroids - leukotriene antagonists -
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- Fall '15
- Pathophysiology 5315