Asthma sample essay assignment
Complications of asthma can be sudden. Consider the case of Bradley Wilson, a young boy who had several medical conditions. He appeared in good health when he went to school, returned home, and ate dinner. However, when he later went outside to play, he came back inside wheezing. An ambulance took him to the hospital where he was pronounced dead (Briscoe, 2012). In another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the middle of the night and ran to her grandfather’s bedroom to tell him she couldn’t breathe. By the time paramedics arrived, she had passed out and was pronounced dead at the hospital (Glissman, 2012). These situations continue to outline the importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms Asthma sample essay assignment. Since these symptoms and attacks are often induced by a trigger, as an advanced practice nurse, you must be able to help patients identify their triggers and recommend appropriate treatment options. For this reason, you need to understand the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation.
Review “Asthma” in Chapter 27 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of both disorders. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Consider the epidemiology and clinical presentation of both chronic asthma and acute asthma exacerbation Asthma sample essay assignment.
Write a 2- to 3-page paper that addresses the following:
Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.
Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.
Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting Asthma sample essay assignment.
Paper must include a purpose statement.
References must be 5 years or less
Please follow the rubric that will be uploaded.
Asthma is a chronic inflammatory disease of the airway that is characterized by bronchial hypersensitivity and hyper-responsiveness to otherwise innocuous stimuli, resulting in reversible narrowing of the airway. Worldwide, it is estimated to occur in 334 million people (Asher, I, 2014). Asher’s study also lists Asthma as one of the top 10 causes of mortality in mid-childhood children.
In this paper I will elucidate the pathophysiological mechanisms of chronic asthma and severe acute asthma and outline the management of these conditions with emphasis on symptomatic relief, preventing future attacks, and improving survival rates among asthmatics
The primary event that underlies the restructuring of the airway in chronic asthma is inflammation of the airway in response to commonly inhaled allergens such as those in dust, house mites, pollen or excrement from insects (Kudo, M, 2013.) This inflammation occurs in childhood and triggers type 2 T helper cells to secrete cytokines that mediate the inflammation. There is resultant mucosal edema, bronchial smooth muscle hypertrophy and mucous gland hypertrophy. These changes in the structure of the airway make it very responsive to subsequent stimuli with an exaggerated response.
The diagnosis of asthma is pegged on a high index of suspicion after taking a comprehensive history and physical examination. A history of cough, wheezing and chest tightness that are often triggered by cold, dust or exercise is very characteristic for asthma. These symptoms are usually reversible and the patient experiences period of normal respiration in between the attacks. Typically there is no fever accompanying the symptoms. The physical exam is often unremarkable unless there is an ongoing attack. A polyphonic wheeze may be heard on auscultation. The test of choice is assessment of lung function by spirometry Asthma sample essay assignment. A bronchial challenge test is used to diagnose asthma in a patient with normal lung function. The patient breathes increasing doses of nebulized methacholine with FEV1 measurement. A normal subject is not expected to show significant dip in their FEV1 unlike a patient with asthma. Lung inflation can also be demonstrated on a chest radiograph.
Acute asthma exacerbation
Severe acute asthma exacerbation, also referred to as status asthmaticus or near-fatal asthma, refers to the occurrence of bronchial obstruction that does not respond to the institution of standard bronchodilator therapy causing life threatening respiratory failure with marked hypoxemia and hypercapnia due to hampered ventilation (Nievas, I, 2013).
During the attack, there is marked mucosal edema. The remodeled airway has a relatively higher number of mucous producing cells and hypertrophied smooth muscles. The production of a lot of mucous and exaggerated active bronchoconstriction by the hypertrophied smooth muscles results in a very narrow airway that is plugged by mucous. A lot of energy is expended in an attempt to sustain adequate respiration. Air is trapped within the respiratory system with each inspiration. The patient will present with profound breathlessness, unable to complete sentences. On physical examination there will be tachypnea of more than 25 breaths per minute, tachycardia of more than 110 beats per minute and a pulmonary ejection fraction of less than 50%. The patient may have bradycardia, hypotension, cyanosis, confusion and may even go into a coma. Prompt reversal of this condition is necessary to prevent respiratory failure. Arterial blood gas analysis will demonstrate profound hypoxemia with hypocapnia because there is hyperventilation early on. After fatigue sets in, the PaC02 normalizes heralding impending respiratory failure (Nievas, I, 2013) Asthma sample essay assignment.
Patient behavior is a critical predisposing factor to the development of acute asthma exacerbation. Asthmatic patients on follow up are usually put on both steroid and beta 2 agonist inhalers. The steroid component is prescribed to be taken on a daily basis to prevent airway remodeling by reducing the inflammatory response that goes on in the hypersensitive airway of the asthmatic patient. Lack of adherence to this management by patients allows the airway to remodel and ‘ready itself’ for an acute exacerbation (Taylor, A, 2014).
Emergency management of acute asthma exacerbation involves the administration of high flow oxygen if the saturation is below 92% and nebulization with a Beta 2 agonist. This is followed by the administration of intravenous then oral steroids. The patients are also often dehydrated therefore fluid resuscitation is necessary. There is a role for intravenous magnesium sulphate, ipratropium bromide, xanthines and antibiotics where there is concomitant infection. If the patient is still unresponsive to the treatment or develops a silent chest, ICU care will be necessary to provide ventilatory support Asthma sample essay assignment. In a patient with poor adherent behaviour, I will include a counselling session to their management to sensitize them on the need to be compliant with their medication so as to prevent future attacks.
The management of asthma remains to be a big challenge to nurse practitioners and physicians all over the world. Patient behavior compounds this problem when the patients show poor compliance to their preventive medication. It is imperative that patients become part of the management team by being adherent to their preventive medication hence reducing the incidence of acute asthma exacerbation. Asthma sample essay assignment.
Asher, I. Pearce, N. (2014) Global burden of asthma among children. The International Journal of Tuberculosis and Lung Disease, Volume 18, Number 11, 1 November 2014, pp. 1269-1278(10)
Kudo, M., Ishigatsubo, Y., & Aoki, I. (2013). Pathology of asthma. Frontiers in Microbiology, 4, 263. http://doi.org/10.3389/fmicb.2013.00263
Nievas, I. F. F., & Anand, K. J. S. (2013). Severe Acute Asthma Exacerbation in Children: A Stepwise Approach for Escalating Therapy in a Pediatric Intensive Care Unit. The Journal of Pediatric Pharmacology and Therapeutics : JPPT, 18(2), 88–104. http://doi.org/10.5863/1551-6776-18.2.88
Taylor, A., Chen, L.-C., & Smith, M. D. (2014). Adherence to inhaled corticosteroids by asthmatic patients: measurement and modelling. International Journal of Clinical Pharmacy, 36(1), 112–119. http://doi.org/10.1007/s11096-013-9862-0 Asthma sample essay assignment.