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1. Describe the Pathophysiology of an Acute

1. Describe the Pathophysiology of an Acute

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Published by: shij_02 on Feb 25, 2010
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11/08/2012

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1. describe the pathophysiology of an acute asthma attack in BJ followingexposure to cats
 The allergic person forms an abnormally large amount of IgE antibodies and theseantibodies cause allergic reactions when they react with their specific antigen, andin this case, fur from cats. These antibodies are mainly attached to mast cells that lie in the lung interstitium inclose association with the bronchioles and small bronchi. Once JB breathes in fur, towhich he is sensitive to (that is to which he has developed IgE antibodies), thepollen reacts with the mast cell-attached antibodies and causes these cells torelease several different substances. Among them are
histamine, slow reactingsubstance of anaphylaxis
(which is a mixture of leukotrienes),
eosinophilicchemotactic factor 
, and
bradykinin
. The combined effects of all these factors,especially of the slow-reacting substance of anaphylaxis, are to produce (1)localized edema in the walls of the small bronchioles as well as secretion of thickmucus into the bronchiolar lumens and (2) spasm of the bronchiolar smooth muscle. Therefore the airway resistance increases greatly. The bronchiolar diameter becomes more reduced during expiration than duringinspiration in asthma because the increased intrapulmonary pressure duringexpiratory effort compresses the outsides of the bronchioles. Because thebronchioles are already partially occluded, further occlusion resulting from theexternal pressure creates especially severe obstruction during expiration. (anasthmatic person usually can inspire quite adequately but has great difficultyexpiring and this results in dyspnea or “air hunger” ) The functional residual capacity and the residual volume of the lung become greatlyincreased during the asthmatic attack because of the difficulty in expiring air fromthe lungs. Also, over a period of years, the chest cage becomes permanentlyenlarged causing a “barrel chest” and the functional residual capacity and residualvolume become permanently increased.
How Airways Narrow
 
During an asthma attack, the smooth muscle layer goes into spasm, narrowing the airway. Themiddle layer swells because of inflammation, and more mucus is produced. In some segments of the airway, mucus forms plugs that nearly or completely block the airway.
2. describe the early signs of an acute asthma attack and relate each of these tothe changes taking place in the lungs
 The symptoms of severe asthma are persistent coughing and the inability to speakfull sentences or walk without shortness of breath. Your chest may feel closed, andyour lips may have a bluish tint. In addition, you may feel agitation, confusion, or aninability to concentrate. You may hunch your shoulders, sit or stand up to breathemore easily, and strain your abdominal and neck muscles. These are signs of animpending respiratory system failure. At this point, it is unlikely that inhaledmedications will reverse this process. A mechanical ventilator may be needed toassist the lungs and respiratory muscles. A face mask or a breathing tube isinserted in the nose or mouth for this treatment. These breathing aids aretemporary and are removed once the attack has subsided and the lungs haverecovered sufficiently to resume the work of breathing on their own. A short hospitalstay in an intensive-care unit may be a result of a severe attack that has not beenpromptly treated.
3. if you were updating a medical and drug history for BJ, list severalsignificant questions that should be asked.
(1) are you taking corticosteroids as a treatment for your asthma? If yes, for howlong?(2) are you taking aspirins or other NSAIDS?(3) are you taking Theophylline(Theodur, Theoair, Slo-bid, Uniphyl, Theo-24) and/oraminophyllineIf yes, what dosage?(4) Aside from Theophylline(Theodur, Theoair, Slo-bid, Uniphyl, Theo-24) and/oraminophylline are you taking other drugs such ascimetidine(Tagamet),calcium channel blockers(Procardia),quinolones(Cipro), andallopurinol(Xyloprim)?
(Dosage levels of theophylline or aminophylline are closely monitored. Excessivelevels can lead to nausea, vomiting, heart-rhythm problems, and evenseizures. Incertain medical conditions, such asheart failureor cirrhosis, dosages of  methylxanthines are lowered to avoid excessive blood levels. Drug interactions withother medications, such ascimetidine(Tagamet),calcium channel blockers  (Procardia),quinolones(Cipro), and allopurinol(Xyloprim) can further affect drug blood levels.)
 
4. Describe what precautions you would take if you were treating or dealing withBJ and include your reasons. Describe your actions if BJ had an attack while hewas with you
Know the Triggers
One of the best precautions you can take to reduce asthma attacks is to know whattriggers an attack. Once you recognize the triggers, you can avoid them.1. Cigarette Smoke. If you smoke or anyone in your home smokes, you will have toask them to do it outside. Even the presence of the smoke in the house can triggeran attack, so it is not enough that they smoke in a separate room. Of course, if youare the smoker, you need to quit.2. Pets. Pet dander can cause asthma attacks. You will have to find a new home foryour cat or dog and look into getting an animal that doesn't produce any petdander, such as a fish or an iguana.3. Pollen. In some cases, pollen cannot be avoided. When the pollen count is high,you might want to stay indoors. Also make sure that all surfaces are wiped down, sothat any pollen that may have gotten into the house is removed.4. Mold. Mold can be removed with bleach. Don't dilute the bleach: Use 100 percentof it on anything that has mold on it.5. Dust. You may have to dust your house more often than usual to lessen thechances of having an asthma attack.6. Exercise. Take it easy and don't over-exert yourself. A lot of physical activity cancause an asthma attack.
Know the Symptoms
 Taking precautions includes knowing thesymptomsof an asthma attack. That way,you are ready when one occurs. The most common asthma symptoms include:wheezing that can be heard by others, or by a doctor with a stethoscope; coughingthat doesn't go away and seems to occur when physical activity is performed;shortness of breath; rapid breathing; chest discomfort; and chest tightening.
Consult a Physician
If you suffer from asthma, you need to keep regular appointments with your doctor.He may be your family doctor or a specialist to whom your family doctor referredyou. As a precaution, this doctor can monitor your symptoms and the number andseverity of attacks. He can keep you informed of any new drugs or treatments thathave become available. The doctor may want to change your inhaler or nebulizertreatments, based on your progress or the worsening of your symptoms.
Create an Action Plan

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