NURS 6501 Module 2 Assignment: cardiopulmonary and cardiovascular physiologic mechanisms Case Study Analysis Paper

NURS 6501 Module 2 Assignment: cardiopulmonary and cardiovascular physiologic mechanisms Case Study Analysis Paper

Case Study Analysis

The provided case study depicts the circumstance of an 11-year-old child who complains of wheezing and trouble “getting enough breath.” While he is playing baseball, he notices it more, and symptoms become better when exercise is discontinued. He claims that the problems are worsening and that they are even occurring when he is sleeping. The child’s mother claims that he is allergic to cat dander, and their apartment complex’s neighbor next door has begun harboring cats for the local humane society. Auscultation reveals wheezes in all lung areas during forced expiration. This discussion covers the racial/ethnic determinants, circulatory and cardiopulmonary pathophysiologic mechanisms, and how these processes interconnect to affect the patient.

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Cardiovascular and Cardiopulmonary Pathophysiologic Processes

Asthma pathophysiology is comprised of three major components. Airway inflammation is one of the pathophysiologic processes. Airflow obstruction and bronchial reactivity are also made possible by mucus production and airway edema in addition to acute, subacute, or chronic inflammation. Eosinophil infiltration and other mononuclear cells are also present (Bush, 2019). Mucus hypersecretion, smooth muscle hyperplasia, epithelium desquamation, and airway remodeling are other causes of airway inflammation.

The second factor is sporadic airflow blockage brought on by numerous alterations, including airway metamorphosis, acute bronchoconstriction, airway edema, and chronic mucous plug formation. Reduced expiratory flow rates and higher airflow resistance are caused by airway obstruction. The modifications lead to a decreased ability to exhale and may result in hyperinflation. Over distention hence aids in keeping an open airway, enabling increased expiratory flow. Yet excessive distention also modifies pulmonary processes and elevates the burden of breathing (Huether & McCance, 2019). Normally, hyperinflation is used to compensate for airflow blockage; yet, when the tidal volume reaches the pulmonary dead space volume, alveolar hypoventilation occurs. Airflow resistance variations that are out of balance lead to uneven ventilation and perfusion. Moreover, it happens as a result of the corresponding uneven air distribution and circulation alterations brought on by elevated interalveolar pressure as a result of hyperinflation (Bush, 2019). Vasoconstriction brought on by alveolar hypoxia contributes to unevenness.

The last pathogenic process is bronchial hyperresponsiveness. Early in the course of the illness, hypoxia is brought on by uneven breathing and perfusion. Hypercarbia is avoided, however, thanks to the simple passage of carbon dioxide over alveolar capillary membranes. In the early phases of acute asthma without carbon dioxide retention, asthma patients have hypoxemia. The hypoxic drive produces hyperventilation and; consequently, a decreased PaCO2. Because of the obstruction and the expanding ventilation-perfusion mismatch, carbon dioxide is retained. Early-stage hyperventilation leads to the development of respiratory alkalosis (Huether & McCance, 2019). Due to difficult breathing, increased oxygen demand, and increased cardiac output, metabolic acidosis develops.

Racial/Ethnic Variables

             Asthma is more common, more severe, and more morbid in children from certain ethnic origins. The histories of these kids are consistent with a poor socioeconomic position. Asthma in children is currently 8.7% prevalent in the US. Nevertheless, it differs mostly due to ethnic origins, with non-Hispanic whites and other minority groups falling in the center, making up 4-5% of Asian Indians and Chinese and 19% of Puerto Ricans (Huether & McCance, 2019). People from certain ethnic groups, such as Black Americans and Puerto Ricans, have more severe asthma. According to studies, Black Americans experience more hospital admissions, ER visits, and deaths than White Americans.

Processes Interact To Affect The Patient

             Race and ethnicity complicate the determination of asthma drug response biomarkers even further. Gene-drug links can exist in one group but not in another due to variations in the mechanisms of asthma, “allele” rates, and genetic correlations, as well as different sociocultural perspectives on and approaches to the use of asthma medications (Zhang et al., 2019).

The ancestral history at that locus may have an impact on a genetic marker’s projected value since Hispanics and African Americans may be populations from other continents (Gray et al., 2018). As a result, genetic factors affecting asthma and how well people respond to therapy tend to vary amongst groups.

Conclusion

Childhood asthma is a significant chronic respiratory disease that impacts everyday living and is characterized by wheezing, cough, breathlessness, and airflow restriction. Complex interactions between physics, chemistry, pharmacology, and immunology all contribute to the pathophysiology of pediatric asthma, which causes increased mucus production, bronchial edema, and spasms, as well as scar remodeling. Even though inhaled corticosteroids can reduce asthma symptoms, some kids with chronic asthma nonetheless have serious consequences including lung dysfunction.

References

Bush, A. (2019). Pathophysiological Mechanisms of Asthma. Frontiers in Pediatrics, 7(68). https://doi.org/10.3389/fped.2019.00068

Gray, W. N., Netz, M., McConville, A., Fedele, D., Wagoner, S. T., & Schaefer, M. R. (2018). Medication adherence in pediatric asthma: A systematic review of the literature. Pediatric Pulmonology, 53(5), 668–684. https://doi.org/10.1002/ppul.23966

Huether, S. E., & McCance, K. L. (2019). Understanding Pathophysiology – E-Book. Mosby.

Zhang, E., Levin, A. M., & Williams, L. K. (2019). How do race and ethnicity affect the precision treatment of asthma? Expert Review of Precision Medicine and Drug Development, 4(6), 337–356. https://doi.org/10.1080/23808993.2019.1690396

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To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

The Assignment

In your Case Study Analysis related to the scenario provided, explain the following

• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

Scenario 3: 11-year-old boy complains of wheezing and difficulty “getting enough air.” Notices it more when he is playing baseball and symptoms improve when exercise activity stops. He says that the symptoms are getting worse and the symptoms are even occurring at rest. Mother says the child is allergic to cat dander and his next-door neighbor in their apartment building recently began sheltering cats for the local humane society. Auscultation demonstrates wheezes on forced expiration throughout all lung fields.