Exam 2 MS 1

Alterations in Gas Exchange, Alterations in Hematologic System, Alterations in Cardiovascular Function and Perfusion

What part of the respiratory system is affected by asthma?

The lungs in the lower respiratory tract.

What are the components of the upper respiratory tract?

The nasopharynx, oropharynx, laryngopharynx, and epiglottis.

What structures are included in the lower respiratory tract?

The bronchi, bronchioles, and alveoli.

What physiological changes occur in asthma?

Inflammation leads to airway constriction.

How many people in the U.S. are affected by asthma?

Approximately 24.9 million people.

What symptoms are commonly associated with asthma?

Wheezing, breathlessness, chest tightness, and coughing.

Is asthma curable?

No, asthma is a chronic condition that can be controlled but not cured.

What triggers asthma exacerbations?

Exercise, allergens, and viral respiratory infections.

What is the role of the respiratory system?

To control breathing through the airways, lungs, and blood vessels.

What are the functions of the nasal cavity?

To trap dust and particles, warm, and moisten the air.

What are conchae?

Lobes in the walls of the nasal cavity that increase air turbulence.

What is the pharynx and its function?

A tube-like passageway connecting the nasal cavities to the larynx, facilitating respiratory and digestive functions.

What is the major function of the larynx?

Speech.

What is the structure of the trachea?

Made up of smooth muscle and C-shaped rings to prevent collapse.

What is the mediastinum?

The area between the lungs that encloses the heart, bronchi, and esophagus.

What are the pleura?

The pleural sac made up of two layers of membrane surrounding the lungs.

What is the difference between parietal and visceral pleura?

Parietal pleura attaches to the chest wall; visceral pleura covers the lungs.

What is the role of cilia in the respiratory system?

To move mucus along the membrane and remove foreign substances.

What is the function of alveoli?

Where the exchange of oxygen and carbon dioxide occurs.

What is a key feature of asthma pathophysiology?

Airway inflammation leading to bronchospasm and obstruction.

What cells are involved in the inflammatory response in asthma?

Mast cells, eosinophils, neutrophils, macrophages, epithelial cells, and lymphocytes.

What antibody is central to allergic reactions in asthma?

Immunoglobulin E (IgE).

What are bronchioles?

Narrow airways in the lungs that branch from the bronchi.

What is the role of goblet cells in the nasal mucosa?

To secrete mucus that traps particles.

What is the glottis?

The passageway that creates the opening between the vocal cords.

What are the three portions of the pharynx?

Nasopharynx, oropharynx, and laryngopharynx.

What is the significance of the hilus in the lungs?

It allows for blood drainage from the trachea into the lungs.

What is the role of Immunoglobulin E (IgE) in allergic reactions?

IgE is the antibody that activates allergic reactions and is important in the pathology of allergic conditions like asthma.

How do IgE antibodies interact with mast cells?

IgE antibodies bind to mast cells and basophils, activating them when an allergen is inhaled.

What mediators are released by mast cells during an allergic reaction?

Mediators include histamine, leukotrienes, and prostaglandins, which cause airway tightening.

What is the function of eosinophils in asthma?

Eosinophils migrate to the lungs during inflammation and release leukotrienes, contributing to airway inflammation.

What are the consequences of airway inflammation in asthma?

Chronic airway inflammation can lead to airway remodeling, which includes thickening of the airway wall and chronic breathing difficulties.

What is bronchospasm?

Bronchospasm is the narrowing of bronchi in response to a stimulus, commonly seen in asthma or bronchitis.

What role do lymphocytes play in asthma?

Lymphocytes produce interleukins that facilitate communication between cells and sustain airway inflammation.

What is airway remodeling?

Airway remodeling refers to long-term structural changes in the bronchial walls that lead to persistent airflow limitation.

What is the prevalence of asthma in the U.S. adult population?

Asthma affects approximately 8% of the U.S. adult population.

How does asthma prevalence differ between genders before and after puberty?

Asthma is more common in males before puberty, but after puberty, prevalence is higher in females.

What are the common phenotypes of asthma?

Common phenotypes include allergic asthma, nonallergic asthma, aspirin-sensitive asthma, and exercise-induced asthma.

What is allergic asthma?

Allergic asthma is the most common phenotype, often beginning in childhood with a family history of allergic disorders.

What characterizes nonallergic asthma?

Nonallergic asthma is less common, usually found in adults, and does not involve hypersensitivity to allergens.

What triggers aspirin-sensitive asthma?

Aspirin-sensitive asthma is triggered by taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).

What is exercise-induced asthma?

Exercise-induced asthma is characterized by asthma flare-ups that occur during physical activity.

What is hyperventilation?

Hyperventilation is rapid breathing that causes reduced carbon dioxide levels in the arterial blood.

What are leukotrienes?

Leukotrienes are lipid mediators involved in acute and chronic inflammation and allergic reactions.

What is the role of macrophages in the immune response?

Macrophages stimulate immune cells, kill microorganisms, and remove dead cells.

What are the characteristics of eosinophils?

Eosinophils are white blood cells involved in the inflammatory response and host defense against parasites and allergies.

What is the function of basophils?

Basophils are white blood cells that release histamine and heparin, playing a role in the inflammatory response.

What is histamine and its role in allergic reactions?

Histamine is a mediator released during inflammation that can cause allergic reactions, such as anaphylaxis.

What is the significance of cytokines in asthma?

Cytokines help in the communication between cells and facilitate the migration of eosinophils into the airway.

What is the impact of social determinants on asthma prevalence?

Social determinants, such as living conditions and age, significantly influence asthma prevalence and morbidity.

What is the relationship between eczema and asthma?

Eczema is associated with asthma and can manifest as itchiness, redness, or weeping skin.

What is rhinitis?

Rhinitis is characterized by nasal congestion, runny nose, sneezing, and itching, often associated with asthma.

What factors contribute to how asthma presents in a client?

Both genetic factors (like allergic conditions and family history) and environmental exposures (like allergens and pollution).

What are common triggers of asthma?

Allergens, infections, irritants, and continual exposure to triggers like pets or second-hand smoke.

What role do irritants play in asthma?

Irritants such as air pollution, household chemicals, and changing weather conditions can trigger asthma attacks.

How does obesity affect asthma?

Obesity is linked to a higher likelihood of developing asthma and poorer health outcomes for those with asthma.

What are some common indoor allergens associated with asthma?

Dust mites, cockroaches, mice, and pet dander.

What are outdoor allergens that can trigger asthma?

Pollen and air pollution.

What is vocal cord dysfunction (VCD)?

A condition where the vocal cords do not open correctly, sometimes confused with asthma.

What are the physiological manifestations of asthma?

Airway narrowing leading to coughing, wheezing, chest tightness, and shortness of breath.

How can psychosocial factors affect asthma management?

Stress and depression can lead to increased asthma episodes and poor adherence to treatment.

What are common clinical manifestations of asthma?

Wheezing, coughing, chest tightness, and dyspnea, often worsening at night or in the morning.

What defines intermittent asthma?

Manifestations occur less than two days per week, with fewer than two nighttime awakenings per month.

What characterizes mild asthma?

Episodes occur more than two days per week, with three to four nighttime awakenings per month.

What indicates moderate asthma?

Daily episodes of asthma symptoms and nighttime awakenings more than once a week.

What is severe asthma?

Episodes occur daily or more than seven times per week.

What is involved in diagnosing asthma?

Client history, physical examination, pulmonary function testing, and laboratory values.

What is the purpose of pulse oximetry in asthma management?

To determine the severity of an asthma attack and monitor for deterioration.

What does spirometry reveal in asthma patients?

An obstructive pattern that responds favorably to short-acting bronchodilators like albuterol.

What lab values are important in asthma management?

Assessment of urea and electrolytes for kidney function, arterial blood gas values for hypoxemia, and ECG for sinus tachycardia.

What is the impact of aging on asthma?

Older clients often have more comorbidities and may experience physiological changes that mimic airway obstruction.

What are some comorbidities associated with asthma?

Rhinitis, vocal cord dysfunction, gastroesophageal reflux disease, obesity, and obstructive sleep apnea.

How does asthma affect quality of life?

Asthma can lead to increased fatigue, missed workdays, and challenges in communication between clients and providers.

What is the relationship between asthma and psychiatric conditions?

Psychiatric conditions can lead to risk-taking behaviors that exacerbate asthma, such as smoking.

What is the significance of family history in asthma?

A child with parents who have asthma has a higher risk of inheriting the condition.

What is the purpose of reviewing arterial blood gas (ABG) values?

To determine hypoxemia and respiratory acidosis.

What does an electrocardiogram (ECG) assess in asthma patients?

It assesses for sinus tachycardia, which may be due to asthma or prescribed medications.

What imaging is ordered to assess for infection or foreign bodies in asthma patients?

A chest x-ray.

What is the significance of a chest CT scan in asthma management?

It is used for clients who do not respond favorably to treatment.

What does pH measure in arterial blood gas values?

The hydrogen ion concentration in the blood, indicating its acidity or alkalinity.

What does PaCO2 represent in arterial blood gas values?

The partial pressure of carbon dioxide in the blood, indicating the respiratory component of acid-base balance.

What does PaO2 indicate in arterial blood gas values?

The partial pressure of oxygen dissolved in the blood, reflecting the body's ability to absorb oxygen from the lungs.

What does HCO3- represent in arterial blood gas values?

The metabolic parameter reflecting the kidneys' ability to retain and excrete bicarbonate.

What is the desired range for pH in arterial blood gas values?

7.35 to 7.45.

What is the desired range for PaCO2 in arterial blood gas values?

35 to 45 mm Hg.

What is the desired range for PaO2 in arterial blood gas values?

80 to 100 mm Hg.

What is the desired range for HCO3- in arterial blood gas values?

21 to 28 mEq/L.

What is the role of ventilation (V) in gas exchange?

It is the flow of air in and out of the alveoli.

What is the role of perfusion (Q) in gas exchange?

It is the flow of blood to alveolar capillaries.

What does a high V/Q ratio indicate?

It indicates alveolar dead space, where alveoli are not ventilated.

What neurological manifestations can occur with hypoxia?

Poor judgment, memory loss, inattentiveness, and decreased muscle coordination.

How do the lungs and kidneys interact in maintaining acid-base balance?

The respiratory system regulates carbon dioxide levels, while the renal system manages bicarbonate concentration.

What are common environmental triggers for asthma symptoms?

Air pollution, dust mites, mold, pet dander, chemical irritants, and tobacco smoke.

What are key nursing responsibilities in asthma management?

Helping clients identify and avoid triggers, promoting medication adherence, and ensuring access to rescue inhalers.

What should client education for asthma management focus on?

Recognizing symptoms, using medications correctly, avoiding triggers, and following an asthma action plan.

What is the importance of peak flow meters in asthma management?

They help monitor airflow and detect early declines in lung function.

What individual factors can influence asthma symptom control?

Anxiety, comorbidities, and barriers to self-management such as health literacy.

What is the desired oxygen saturation range in arterial blood gas values?

95 to 100%.

What does base excess (BE) indicate in arterial blood gas values?

The amount of acid or base needed to return pH to 7.40, indicating metabolic deviations from normal acid-base status.

What symptoms should be gathered during an asthma assessment?

Wheezing, coughing, frequency of exacerbations, and triggers.