A nurse is teaching a client who has multiple sclerosis about factors that can worsen their manifestations. Which of the following factors should the nurse include in the teaching?

Choice A Reason:

Epithelial cells is correct. Epithelial cells lining the airways play a role in initiating the inflammatory response in asthma by releasing cytokines and other inflammatory mediators. These cells can contribute to the circulatory surge of inflammatory cells and cytokines seen in status asthmaticus.

Choice B Reason:

OT lymphocytes is incorrect. There is no specific cell type known as "OT lymphocytes." It's possible this may refer to T lymphocytes (T cells), which are involved in the immune response in asthma but are not typically associated with a circulatory surge in status asthmaticus.

Choice C Reason:

Hyperreactivity is incorrect. Hyperreactivity refers to the exaggerated response of the airways to various stimuli, leading to bronchoconstriction and inflammation. While hyperreactivity is a characteristic feature of asthma, it does not directly contribute to a circulatory surge of inflammatory cells and cytokines.

Choice D Reason:

Mast cells is correct. Mast cells are key players in the pathophysiology of asthma. They release various inflammatory mediators, including histamine and leukotrienes, which contribute to airway inflammation, bronchoconstriction, and mucus production. Mast cells can participate in the circulatory surge of inflammatory cells and cytokines in status asthmaticus.

Choice E Reason:

Inflammation is correct. Inflammation is a hallmark feature of asthma and plays a central role in the pathogenesis of status asthmaticus. The inflammatory response involves the recruitment and activation of various inflammatory cells, release of cytokines, and other mediators that contribute to airway obstruction and systemic effects.

Choice A Reason:

Typical pneumonia is correct. Streptococcus pneumoniae is a common bacterial pathogen that causes typical pneumonia, also known as community-acquired pneumonia (CAP). Typical pneumonia is characterized by an acute onset of symptoms such as fever, productive cough with purulent sputum, chest pain, and difficulty breathing. Streptococcus pneumoniae is one of the most common causes of typical pneumonia, especially in community settings.

Choice B Reason:

Chemical pneumonitis is incorrect. chemical pneumonitis, refers to inflammation of the lung tissue caused by inhalation or aspiration of toxic chemicals, gases, or gastric contents. It is not caused by Streptococcus pneumoniae.

Choice C Reason:

Atypical pneumonia is incorrect. Atypical pneumonia, refers to pneumonia caused by atypical pathogens such as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Atypical pneumonia typically presents with milder symptoms compared to typical pneumonia and may not respond to traditional antibiotics used for typical bacterial pneumonia.

Choice D Reason:

Aspiration pneumonia. Aspiration pneumonia, occurs when foreign material, such as food, saliva, or gastric contents, is aspirated into the lungs, leading to inflammation and infection. While Streptococcus pneumoniae can cause pneumonia in the context of aspiration, it is more commonly associated with typical pneumonia acquired through inhalation of respiratory droplets containing the bacteria.