Asthma: Etiology and Pathology (Pediatric Nursing)

00:01 Now, we will cover asthma and status asthmaticus.

00:05 Asthma is a chronic disease in which there is swelling or inflammation on the inside of the smaller airways of the lungs.

00:11 In the United States, asthma affects an estimated 26 million people, many of whom may not be aware that they have it, especially if their symptoms aren't severe.

00:21 Asthma is classified as a reversible airway disease.

00:25 This means education is super important for the patient as something can actually be done to manage and reverse their symptoms.

00:32 You may hear people talking about an asthma attack or an asthma flare-up or an asthma episode.

00:38 These are all the same as an asthma exacerbation.

00:41 There's 2 main things that happen when asthma is acutely flaring.

00:45 The smooth muscles that are around the airway will tighten, and mucus will develop at the airway.

00:51 There's a huge variability regarding a patient's asthma severity.

00:55 It can range from mild, well-controlled, intermittent asthma, to severe, poorly-controlled, life-threatening asthma.

01:03 Although asthma is more common in the pediatric population, it can actually develop at any age.

01:09 So what causes asthma? No one really knows.

01:12 This means it has an unknown etiology.

01:15 Researchers are continuing to study asthma and possible causes, but we do know that there are certain risk factors and triggers.

01:22 These include your genetics.

01:24 Asthma tends to run in families.

01:26 If your mom or dad has asthma, then you're more likely to have asthma, too.

01:31 Allergies.

01:32 Certain allergic conditions are linked with asthma.

01:36 Respiratory infections.

01:37 As the lungs develop in infancy and early childhood, certain respiratory infections have been shown to cause inflammation and damage in the lung tissues.

01:45 The damage that is caused in infancy or early childhood, can impact the lung function long term, and can contribute to the development of asthma.

01:55 Certain environmental factors.

01:57 Contact with allergens and certain irritants can contribute.

02:01 Exposure to certain chemicals and dust in the workplace may also play a significant role in adult-onset asthma.

02:09 There are some inflammatory factors.

02:10 These are the respiratory infections, workplace triggers, and other allergens.

02:17 Now let's talk about irritant triggers.

02:19 These include exercise.

02:21 A lot of patients have exercise-induced asthma.

02:24 Cold air.

02:25 This can trigger a bronchospasm.

02:28 Stress and emotions, like shouting, crying, and laughing.

02:32 This can cause the bronchial tube to constrict, possibly provoking an attack.

02:36 Also, if a patient with asthma begins to panic, this can make it hard or impossible for them to relax and follow directions, which is essential during their asthma attack.

02:46 Strong odors.

02:47 These can also trigger a bronchospasm, and extreme temperature changes.

02:52 Other triggers include tobacco, and this is for obvious reasons because cigarette smoke is going to irritate the airway.

02:59 Gastric reflux.

03:00 This is heartburn.

03:02 Although the cause of the exact link between the 2 conditions is uncertain, they are linked.

03:07 Heartburn may worsen asthma symptoms, but asthma and asthma medications can, in turn, worsen the heartburn symptoms.

03:14 One theory is that the acid flow is going to cause injury to the lining of the throat, the airways, and the lungs, making inhalation difficult and causing a persistent cough.

03:24 Another is that when the acid enters the esophagus, a nerve reflex is triggered, causing the airways to narrow to prevent the acid from entering.

03:33 Pollutants.

03:34 This is exposure to smog and that will raise your risk for asthma.

03:38 Patients who grow up in an urban area have a higher risk for asthma.

03:42 Certain food additives and certain preservatives, including sulfites, can trigger asthma.

03:48 Medications, such as aspirin and other NSAIDs, beta blockers, the list is pretty long.

03:54 So the clinician needs to consider this before adding any new medications for your patients.

03:59 And obesity.

04:00 It's not clear why, but it's thought that maybe the chronic, low-grade inflammation occurs with extra weight.

04:07 Asthma is a disease that causes inflammation of the airways making them swollen.

04:12 Now, as you can see on the left in the normal airway, it's nice and relaxed.

04:16 It's free of constriction and free of mucus.

04:19 In the middle, you will see an asthmatic airway at baseline.

04:23 And this is like a ticking time bomb.

04:25 It's capable of making mucus and vasoconstricting in an instant.

04:29 It's easily irritated or reactive to triggers.

04:33 When the asthmatic airway is under attack, it will make more mucus and the capillaries will vasodilate and become permeable, allowing for swelling and tightening of the muscles that are going to squeeze the airway.

04:45 The airways get narrower, which make it difficult for the air to move in and out of the lungs, and gradually, the person will experience symptoms such as coughing, wheezing, shortness of breath, and chest tightness.