NUR 315 Discussion: Cellular Adaptation: Cellular injury “leads to injury of tissues and organs ultimately determining the structural patterns of disease” according to McCance and Huether (2019, p.49). Injury can be caused by numerous things including hypoxia, toxicity, immune reactions, or even genetics. When a cell is injured it can either recover, which would be reversible injury, or it can die which is irreversible injury (McCance and Huether).
An example cellular injury that can start as reversible but ultimately lead to irreversible damage is, of course, hypoxia. McCance and Huether explain hypoxia as the lack of oxygen needed for the cell and is the most common form of cellular injury caused by many things including decreased hemoglobin, respiratory disease, or simply lack of oxygen in the air. For example, a patient experiencing a NSTEMI in in the stage where cellular injury can be reversible. There is still a blockage to some extent, which intermittently causes ischemia to the cells, but hasn’t yet evolved into a full-blown heart attack. A STEMI has now progressed to a fully blocked artery causing death to cells as they have no blood flow. If left to long untreated to much heart muscle may become permanently ischemic resulting in cell death and ultimately patient death. It only takes 1 minute of interrupted flow to the heart for it to weaken and become less efficient and 3-5 minutes for the affected area of the heart to no longer work (McCance and Huether). NUR 315 Discussion: Cellular Adaptation
Another example of cellular injury that can lead to irreversible damage is caused by chemicals. Being from NH where we have cold winters I was intrigued by McCance and Huether’s section regarding indoor air pollution from solid fuels like wood for open fires. If homes aren’t well ventilated it can cause an increased risk for particles and carbon monoxide poisoning. According to McCance and Huether, “several studies have found that long-term particulate matter air pollution exposure is associated with cardiovascular disease (CVD) morbidity and mortality (p61). It would make sense that repeat exposure to harsh chemicals eventually cause cell damage and then death as exposure continues.
Reference: NUR 315 Discussion: Cellular Adaptation
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th Ed.). St. Louis, MO: Elsevier.
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