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Summary C155 Revision 1.docx C155 Pathopharmacological Foundations for Advanced Nursing Practice College of Health Professions, Western Governors University Contents Investigated Disease Process............................................................. $7.49   Add to cart

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Summary C155 Revision 1.docx C155 Pathopharmacological Foundations for Advanced Nursing Practice College of Health Professions, Western Governors University Contents Investigated Disease Process.............................................................

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C155 Revision C155 Pathopharmacological Foundations for Advanced Nursing Practice College of Health Professions, Western Governors University Contents Investigated Disease Process...........................................................................................................3 P...

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  • May 26, 2021
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C155
Pathopharmacological Foundations for Advanced Nursing Practice


College of Health Professions, Western Governors University




Contents

Investigated Disease Process...........................................................................................................3

Pathophysiology..............................................................................................................................3

Standard of Practice.........................................................................................................................6

Pharmacologic Treatments...............................................................................................................8

Clinical Guidelines........................................................................................................................16

Standard of Practice Disease Management....................................................................................20

Managed Disease Characteristics and Resources..........................................................................22

International and National Disparities...........................................................................................24

Managed Disease Factors..............................................................................................................26

Unmanaged Disease Characteristics..............................................................................................30

Patients, Families, and Community...............................................................................................31

Costs..............................................................................................................................................34

Best Practices.................................................................................................................................36

Plan Implementation......................................................................................................................37

Plan Evaluation..............................................................................................................................39

References......................................................................................................................................42

, Investigated Disease Process

The disease process I have selected to investigate is asthma. Asthma is a respiratory

condition that can range from mild to life-threatening with chronic inflammation of the

bronchioles, bronchoconstriction and the lining of the lungs. This causes airway restriction.

Acute exacerbation of asthma is caused by triggers such as infections, allergens, exercise, and

other irritants, or noncompliance with treatment regimens. In the United States in 2018 more

than 24 million people were diagnosed with asthma. Roughly 19 million adults, which is 7.7

percent of the US adult population have asthma. In 2018 over 3 thousand people's underlying

cause of death was asthma [ CITATION Natnd \l 1033 ].

The reason I selected this topic is that it is a disease the affects me both personally and

professionally. Professionally, I am a pediatric nurse, and this is a disease that affects both adults

and children. The information and knowledge I gain from this assignment I will be able to

directly apply to my practice. I developed asthma as an adult, so the knowledge I gain from this

assignment will help me better understand how this disease impacts my body, overall health, and

if not controlled how it could alter my quality of life and life expectancy. In the current climate

with the COVID-19 pandemic, I am more aware of the impact having asthma could have on my

overall health. That the disease places me in a higher risk category for COVID-19 and that I must

take additional safety precautions to stay virus-free.

Pathophysiology

Asthma is described as a chronic inflammatory disease of the pulmonary airways and bronchial

hyperresponsiveness which causes an obstruction of the lower airways that is usually reversible.

The inflammation causes a narrowing of the airways disrupting airways. However, asthma does

just affect the respiratory system, it affects several key areas of the body. During an asthma

,attack, your bronchial passageways in the lungs narrow. This causes an increased load on the

heart to supply the body with oxygen. During a severe asthma attack, the amount of oxygen

being supplied to the brain can be greatly reduced. What happens in the respiratory system

directly affects the neurological system and the circulatory system, therefore the whole body.

Acute exacerbation of asthma is caused by bronchial smooth muscle contracting which

narrows the airways. This is usually in response to stimulants such as allergens and irritants. To

understand the pathophysiology of asthma, knowledge of the anatomical structures of the

respiratory and the pulmonary system is essential. The respiratory system is comprised of two

tracts: the upper respiratory tract which is made up of the nose and nasal passages, mouth, and

oropharynx, pharynx, and larynx. The lower respiratory tracts are made of the trachea and within

the lungs the bronchi, and alveoli. The blood vessels which I have included because they are

responsible for oxygen distribution and gas exchange throughout the body. The lungs are

considered the main component of the respiratory system whose functions include air inspiration,

oxygen extraction, and exhalation, expelling carbon dioxide. The lungs and lower respiratory

tract are significantly affected by Asthma. The trachea works as a passageway for air to be

transported through the bronchi into the lungs. The alveoli are tiny sacs of air within the lungs

that are responsible for the exchange of oxygen and carbon dioxide [ CITATION McC14 \l

1033 ]. The understanding of the anatomical structures of the respiratory system can assist and

enhance the understanding of the pulmonary system. According to McCance and Huether in

2014, “the pulmonary system functions to (1) ventilate the alveoli, (2) diffuse gases into and out

of the blood, and (3) perfuse the lungs so that the organs and tissues of the body receive blood

that is rich in oxygen and low in CO2.”

, Asthma is a chronic inflammatory disorder of the airways that involves many cells and

cellular elements such as mast cells, eosinophils, T lymphocytes, macrophages, neutrophils, and

epithelial cells. Bronchoprovocation triggers such respiratory infections, allergens, smoke, cold

air, and exercise can cause these cells and mediators to be released[ CITATION Exp07 \l

1033 ]. Exposure to these triggers can cause a response in the airways known as

bronchoconstriction. The airway smooth muscles contract as a direct result of allergen-induced

acute bronchoconstriction, due to immunoglobulin-E (IgE) dependent release of a mediator

from mast cells. These mast cells consist of histamine, tryptase, leukotrienes, and prostaglandin

D2

[ CITATION Exp07 \l 1033 ]. The T-lymphocytes that affect the airway can be T helper1 or T

helper 2 (Th1, Th2) cells and are activated at the start of the inflammation process by leukocytes

in the bloodstream. The leukocytes also signal the release of other inflammatory mediators, mast

cells, and eosinophils. Mast cells in the airway smooth muscle in large quantities can contribute

to airway hyper-responsiveness, and a large number of eosinophils in the airway can exacerbate

asthma [CITATION Sec07 \l 1033 ]. These inflammatory mediators, then generate the cytokines

that contribute to the airway inflammation process [ CITATION Exp07 \l 1033 ].

If asthma becomes more advanced, edema of the airway hypersecretion of mucus, and the

formation of mucus plugs can limit airflow further. These symptoms can be reversible with

treatment. However, structural changes that may not respond well to traditional treatment include

hypertrophy and hyperplasia of the airway smooth muscle[ CITATION Sec07 \l 1033 ]. In

individuals with asthma, the inflammation can cause wheezing, breathlessness, chest tightness,

and coughing and are usually associated with airflow obstruction. The inflammation also causes

an increase in the existing bronchial hyperresponsiveness to a variety of stimuli. If the loss of

lung function is not treated or prevented it can result in structural changes in the airway that

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