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Assignment: Asthma
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. 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.To Prepare
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.
To CompleteWrite 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.
Quality of Work Submitted:
The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.--Excellent 27 (27%) - 30 (30%)
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.
Good 24 (24%) - 26 (26%)
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.
Fair 21 (21%) - 23 (23%)
Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.
Poor 0 (0%) - 20 (20%)
Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
Quality of Work Submitted:
The purpose of the paper is clear.--Excellent 5 (5%) - 5 (5%)
A clear and comprehensive purpose statement is provided which delineates all required criteria.
Good 4 (4%) - 4 (4%)
Purpose of the assignment is stated, yet is brief and not descriptive.
Fair 3.5 (3.5%) - 3.5 (3.5%)
Purpose of the assignment is vague or off topic.
Poor 0 (0%) - 3 (3%)
No purpose statement was provided.
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student's ability to:Understand and interpret the assignment's key concepts.--
Excellent 9 (9%) - 10 (10%)
Demonstrates the ability to critically appraise and intellectually explore key concepts.
Good 8 (8%) - 8 (8%)
Demonstrates a clear understanding of key concepts.
Fair 7 (7%) - 7 (7%)
Shows some degree of understanding of key concepts.
Poor 0 (0%) - 6 (6%)
Shows a lack of understanding of key concepts, deviates from topics.
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student's ability to:Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.--
Excellent 18 (18%) - 20 (20%)
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.
Good 16 (16%) - 17 (17%)
Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.
Fair 14 (14%) - 15 (15%)
Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.
Poor 0 (0%) - 13 (13%)
Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student's ability to:Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.--
Excellent 18 (18%) - 20 (20%)
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.
Good 16 (16%) - 17 (17%)
Summarizes information gleaned from sources to support major points, but does not synthesize.
Fair 14 (14%) - 15 (15%)
Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.
Poor 0 (0%) - 13 (13%)
Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.
Written Expression and FormattingParagraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused--neither long and rambling nor short and lacking substance.--
Excellent 5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity
Good 4 (4%) - 4 (4%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.
Fair 3.5 (3.5%) - 3.5 (3.5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.
Poor 0 (0%) - 3 (3%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.
Written Expression and FormattingEnglish writing standards: Correct grammar, mechanics, and proper punctuation--
Excellent 5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Good 4 (4%) - 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
Fair 3.5 (3.5%) - 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
Poor 0 (0%) - 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and FormattingThe paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.--
Excellent 5 (5%) - 5 (5%)
Uses correct APA format with no errors.
Good 4 (4%) - 4 (4%)
Contains a few (1-2) APA format errors.
Fair 3.5 (3.5%) - 3.5 (3.5%)
Contains several (3-4) APA format errors.
Poor 0 (0%) - 3 (3%)
Contains many (≥ 5) APA format errors.
| Subject | Nursing | Pages | 7 | Style | APA |
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Answer
The pathophysiological exacerbations of asthma lead to the development of an asthma attack on a person who has asthma. Asthma is a chronic condition that causes the inflammation of the airways which result in the narrowing of these airways (Dougherty & Fahy, 2009). The state of the airways in an asthmatic attack is narrowed and this affects the breathing of an individual. The asthmatic condition shows symptoms such as wheezing and coughing, chest tightness and shortness of breath. These are the signs to look out for when a pathological exacerbation of asthma has occurred (Dougherty & Fahy, 2009). Essentially, there are different causes of the condition which are observed an asthma exacerbation. The exacerbations are periodic are a resultant of various pathological or physiological factors. The pathophysiological mechanisms of the development of the asthmatic attack may be chronic or acute in manner. The exacerbation may be as a result of the exposure of an allergic person to an allergen or other environmental triggers resulting in the asthmatic attack (Kantor et.al., 2016). The result of the exposure may be immediate or the sensitization can occur several years after the initial onset of the symptoms. The mechanism of this is represented by the airway inflammation that results from specific allergens. The detection of the allergen in the airway results in a Th-2 mediated immunoglobulin E response that triggers an inflammatory reaction in the airways (Dougherty & Fahy, 2009). As a result of the inflammatory reaction, there is occlusion of the small airways with mucus and bronchial hyperactivity. The pathophysiology of the acute asthma exacerbation is represented by the swelling of the airways and the hyperactivity of the airway. Both of these factors result in the narrowed airways and bronchospasm. There are several triggers of this mechanisms and they include viral infections, allergens, medications and even environmental pollutants. Arterial blood gas patterns in an asthma exacerbation are measured to determine the lung function during an exacerbation. It is difficult to determine these rations in the children as compared to adults. The arterial blood gas analysis is determined by the blood gas analyzer and it determines the levels of oxygen and carbon IV oxide in the blood (Gardiner & Wilkinson, 2018). There is a difference between acute and chronic asthma in that there is a higher level of hypocapnoea in cases of chronic bronchial asthma and therefore the pH may be varied. In chronic asthma cases, the pH is within a narrow range and there may be no cases of acidosis.
Genetics and Asthma
The development of asthma is by a large part a genetic condition since it has been recorded that the gene by environment interactions are paramount to the expression of the asthma. The expression of the asthmatic attack is due to interactions of the genes and the environmental factors that include allergens (Hasegawa et al., 2015). Asthma is a multifactorial allergic disease and it has been established that there has to be an interaction between the environmental factors and the genetic factors such as the IL-4 and the other lists of inducers and inhibitors of asthma.
Diagnosis
The diagnosis of asthma is starts with the symptoms of the disease that include the coughing, the chest tightness, wheezing and difficulty in breathing. The impact of these symptoms is more if they worsen at night and improve after treatment. The diagnosis of the disease is based on the pulmonary function tests and peak expiatory flow measurements that show the forced expiratory volume and the forced vital capacity (Jolliffe et.al, 2017). In the cases of Asthma, there is a decline in the ratio of the FEV to FVC.
Management
The management of Asthma is basically classified into acute and long term steps. The acute management is through short acting means such as ipratropium bromide, bet agonists and oral corticosteroids (Kew, Quinn, Quon, & Ducharme, 2016). The long term management will include the inhaled corticosteroids, leukotriene modifiers, long acting beta agonists and theophylline.
Mind Maps
References
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Dougherty, R. H., & Fahy, J. V. (2009). Acute exacerbations of asthma: epidemiology, biology and the exacerbation‐prone phenotype. Clinical & Experimental Allergy, 39(2), 193-202. Gardiner, M. A., & Wilkinson, M. H. (2018). Randomized Clinical Trial Comparing Breath-Enhanced to Conventional Nebulizers in the Treatment of Children with Acute Asthma. The Journal of pediatrics. Hasegawa, K., Stoll, S. J., Ahn, J., Kysia, R. F., Sullivan, A. F., & Camargo Jr, C. A. (2016). Association of insurance status with severity and management in ED patients with asthma exacerbation. Western Journal of Emergency Medicine, 17(1), 22. Jolliffe, D. A., Greenberg, L., Hooper, R. L., Griffiths, C. J., Camargo Jr, C. A., Kerley, C. P., ... & Martineau, A. R. (2017). Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data. The Lancet Respiratory Medicine, 5(11), 881-890. Kantor, D. B., McDonald, M. C., Stenquist, N., Schultz, B. J., Smallwood, C. D., Nelson, K. A., ... & Hirschhorn, J. N. (2016). Omalizumab is associated with reduced acute severity of rhinovirus-triggered asthma exacerbation. American journal of respiratory and critical care medicine, 194(12), 1552-1555. Kew, K. M., Quinn, M., Quon, B. S., & Ducharme, F. M. (2016). Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. The Cochrane Library.
Appendix
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