NR 507 - Mid Term Study Guide. Complete Solutions.
Mid Term Study Guide NR 507
Pulmonary
1. Concepts of anticholinergic drug and asthma:
Anticholinergic drugs: block acetylcholine binding (primarily in the lungs) -
...
NR 507 - Mid Term Study Guide. Complete Solutions.
Mid Term Study Guide NR 507
Pulmonary
1. Concepts of anticholinergic drug and asthma:
Anticholinergic drugs: block acetylcholine binding (primarily in the lungs) -promotes bronchiole
dilation through decrease in the parasympathetic response (tiotropium & ipratropium) is fast
acting
2. Bronchitis & associated pathogenesis:
Begins with an exposure to an irritant (tobacco smoke) – activates bronchiole smooth muscle
constriction- mucus secretion- release of inflammatory mediators(histamine, prostaglandins &
leukotrienes) normal response to occasional airborne site irritants- over bronchitis is over long
term 3 months for over 2 consecutive years- = smooth muscle hypertrophy = increase
bronchoconstriction, hypertrophy and hyperplasia of goblet cells= mucus hypersecretion,
epithelia cell metaplasia = non-ciliated squamous cells, migration of more WBCs to site =
inflammation and fibrosis in bronchial wall, thickening and rigidity of bronchial basement
membrane= narrowing of bronchial passageways : Increased mucus production- inflammation
process = weight loss, loss of appetite, muscle weakness (interleukin controls appetite) increases
protease activity= breakdown of elastin in the connective tissues of the lung= destruction of the
wall between the alveoli and lungs = large ineffective air sacs develop-elastic recoil of bronchial
wall -destroys bronchi and cant dilate and they stay constricted =air trapping : Chronic bronchitis
=Dyspnea- air trapping increased mucus, increase WOB r/t chronic bronchoconstriction
Cough- irritated and inflamed bronchial epithelia membrane Hypoxia & Hypercapnia -from
impaired gas exchange
3. Chronic bronchitis and related acid/base disturbance:
Hypercapnia (CO2 retention) = Respiratory acidosis
r/t anatomical changes ventilation is compromised esp. exhalation = alveolar hyperinflation)
expanded thorax) hypercapnia CO2 retention = respiratory acidosis\
4. Perfusion:
the actual exchange of O2 and CO2 in the bloodstream occurs via the alveoli and pulmonary
capillaries: the passage of fluid to an organ or a tissue usually referring to delivery of blood to an
area
5. Blood flow between the heart and lungs in chronic bronchitis:
Poor ventilation leads to r to l shunting to occur= deoxygenated blood passes from r ventricle to
the lungs to the l ventricle without adequate perfusion (gas exchange) the kidneys respond by
secreting erythropoietin increasing RBC production the increase in RBC increase O2 carrying
capacity -the increase blood volume increases the workload of the pulmonary and cardiovascular
systems increasing blood volume and vasoconstriction = pulmonary HTN= increase workload on
the R ventricle =cardiac hypertrophy= R side HF or Cor Pulmonale
6. Asthma signs and symptoms:
Coughing esp. at night, chest tightness, shortness of breath, wheezing on exhalation, and rapid
breathing: Characteristics: airway inflammation, bronchial hyperactivity, smooth muscle spasms, =
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