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NURS 3122 Final: Chronic Lung Disease
NURS 3122 Final: Chronic Lung Disease

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Mount Royal University
NURS 3122
Robert Catena

Chronic Lung Disease Asthma - Asthma is a chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness, and an underlying inflammation . - Asthma is one of the most common chronic disorders affecting children, and the prevalence (the percentage of the population that has a condition at a specific point in time) of asthma remains at historic high levels since the late 1990s. - Boys more commonly have asthma than girls, but during adolescence the prevalence of asthma in girls is similar to that of boys. - Asthma has a significant impact on children and their families. Etiology and Pathophysiology - Asthma is a chronic inflammatory disease of the lungs in children who are genetically susceptible. - It is caused by the interplay of multiple factors, including indoor air contaminants (e.g., tobacco smoke, pet dander, and cockroach feces), outdoor air pollutants, recurrent respiratory viral infections, and allergic disease (e.g., atopic eczema, hay fever, and food allergies). - Protective factors that reduce the risk for asthma include a large family size, later birth order, childcare attendance, dog in the family, and living on a farm. - According to the hygiene hypothesis, these protective factors increase exposure to infections in early life that enable the child’s immune system to develop along a nonallergic pathway. - Inflammation causes the normal protective mechanisms of the lungs (mucous formation, mucosal swelling, and airway muscle contraction) to overreact in response to a stimulus and cause an acute asthma episode (sudden onset of breathing difficulty with cough, wheeze, or breathlessness) and airway obstruction. - The trigger, a stimulus initiating an acute asthma episode, can be inflammatory or noninflammatory. - Triggers increase the frequency and severity of smooth muscle contraction (bronchospasm), and airway responsiveness is enhanced through inflammatory mechanisms. - Asthma triggers include exercise, viral or bacterial agents, allergens (mold, dust, pollen, furry pets, birds), fragrances, food additives, pollutants, weather changes (humidity and temperature), and emotions or stress. - With exposure to a trigger, IgE and sensitized mast cells may be activated, leading to the release of many inflammatory mediators (e.g., histamines, prostaglandins, and leukotrienes). - The inflammatory mediators release pro-inflammatory cytokines, causing chronic airway inflammation that may be associated with airway remodeling (permanent airway damage that involves thickening of the sub basement membrane, subepithelial fibrosis, airway smooth muscle hypertrophy and hyperplasia, blood vessel proliferation and dilation, and mucous gland hyperplasia and hypersecretion). - This results in decreased airway elasticity and decreased lung function. These permanent alterations are not prevented by or fully responsive to currently available treatments. The reactive airway responses to stimu
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