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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 Complete
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.
By Day 7
This Assignment is due.
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.
Reference
Briscoe, K. (2012, May 12). Thetford: mother of Bradley Wilson, who died of asthma attack, told there was nothing she could have done. East Anglian Daily Times. Retrieved fromhttp://www.eadt.co.uk/news/thetford_mother_of_bradley_wilson_who_died_of_asthma_attack_told_there_was_nothing_she_could_have_done_1_1375128Glissman, B. (2012, May 21). Girl's death puts focus on asthma's broader grip. Omaha World-Herald. Retrieved from http://www.omaha.com/article/20120521/LIVEWELL01/305219975
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| Subject | Nursing | Pages | 5 | Style | APA |
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Answer
Pathophysiological mechanisms of Exacerbating Acute and Chronic Asthma
Asthma refers to a medical state where the pulmonary conditions that lead to the acute inflammation of the respiratory ducts together with tightening of the muscles within the respiratory tract. There are varied cases of the Asthmatic attacks that can be experienced. In some cases, however, the constriction of the bronchi will accompany the above mentioned symptoms. It is therefore important to determine the pathophysiological mechanism relevant to each case of the Asthmatic complications as a key to determine its exacerbation, diagnosis criteria and prescription of treatment for the patient.
Closely tied to the pathophysiological exacerbation of Asthma is the etiological aspects relating to chlamydia and other persistent viruses. Different virus and other microbial organisms present in the host body play a huge role in the provision of the conditions necessary for Asthma to thrive. In exacerbation of Asthma, the key mechanism considered is the chain reaction from the viral replication within the epithelial cells in the respiratory tract that trigger the body to release the enzyme cytokine. The enzyme then leads to inflammation and the eventual production of mucus in larger quantities.
According to research, the Chlamydia and viral load do not however result in sporadic changes within the blood patterns or the arteries. The Asthma manifestation takes time. The blood normal recordings of the blood PaO2 of 100m Hg is slightly affected resulting to a fall in the recording to about 85 mm Hg. However, there is a slight increase in the PH levels from an initial recording of about 7.40 to 7.45, (Casale, 2016). Under these conditions the body is still able to sustain and aid in the clearance of the viral load. Despite this, the additional inflammatory condition within the airway tract helps to ignite the display of the symptoms of Asthma. During this period, the immune system is also impaired making it difficult for the body to defend itself against the viruses. The end result is the infiltration of the pulmonary vein which exacerbates asthmatic inflammation.
Increased exacerbation of an Asthmatic condition is severely propelled by dehydration within the body of a patient. According to studies, the highway epithelial cells are water reliant. As a result, water levels in the body and Asthma have a close correlation with regard to the airway where the epithelial cells are situated. Lack of adequate water in the body results in the fraction of the epithelial cells combine with elevated levels of responsiveness. This reaction is however not observed in cases where it is an exercise –induced Asthma, (Gelb, 2016). According to Walsh et al., (2017), an Asthma attack due to dehydration has the following effects on the body. The arterial blood PH patterns change sharply and could rise to about 7.60 while the paCO2 sharply rises while the paO2 may reduce to a low of about 40 mm Hg.
Other aspects of the mental well-being of an individual can lead to the Exacerbation of Asthma. Researchers say that acute Asthma can be triggered by cases of emotional strain, sorrow or general stress. Alarmingly, there have hire case of anxiety reported among Asthma patients as compared to patients with Hepatitis B. oxygen levels and levels of carbon (iv) oxide fluctuate sharply as the PH levels rise in an almost equal ratio to that of carbon (iv) oxide. In a study conducted on about 230 patients, (Gelb, 2016), a whopping 45% of the patients recorded high depression levels. it was determined that intense emotions trigger Asthma symptoms such as the reactivity of the airway, reduced performance on the expiratory flow rate, incidences of elevate respiratory resistance and shortness of breath.
Researchers indicate that despite Asthma being a predominantly multifactorial medical condition, allergies remain some of its most pressing factors. For patients suffering from chronic Asthma, prior family history of allergic reactions plays a major role in boosting the velocity of the Asthma exacerbation. Basically, the immune response to the allergy acts as the trigger factor in the symptomatology of Asthma. Among individuals constantly exposed to inhalant antigens, the resultant disruptive effect on the epithelial cells acts as the trigger to the responses due to exposure from these agents.
Another major factor that leads to the exacerbation of chronic Asthma is the repeated exposure to toxic metals in the respiratory tracts. Such metallic compounds include but not limited to copper, Aluminum, Zinc and cadmium. Exposure to excessive metal toxicity leads to two major consequences, the acute self-limiting neutrophil alveolitis and the chronic obstructive lung disease Morris (2016). The neutrophil alveolitis progressively develop into pulmonary fibrosis. Additionally, due to the agents’ potential to initiate change, it damages the functional impairment. Some of the radical effects of metals in the body range from the erratic increase in the PH levels and the amount of CO2 in the blood as the oxygen levels are significantly depressed.
The fore mentioned factors play a major role in the increased pathophysiological disorders present in Asthma. The viruses main provide an ample environment through which the epithelial cells are attacked. The action is as a result of the release of cytokine that leads to large mucus production and inflammation. In addition, exposure to toxic metals results in the manifestation of the chronic lung disease and the self-inhibiting neutrophil which is directly linked to the pulmonary fibrosis. The extent of the effect of toxic metals is consequently based on the damaging extent of the metal agent that a patient is exposed to. Another major factor that leads to the exacerbation of chronic Asthma is the exposure to emotional stress and dehydration. These factors predispose the Asthma patient to irregular PH levels, decreased oxygen levels, increased amounts of CO2, decreased blood flow rate and the shortness of breath combined with increased respiratory resistance.
There are different approaches to the diagnosis of Asthma. However, these approaches follow a specific approach. For example, in the case where the Asthmatic exacerbation is caused by an allergy, the doctor performs an allergy test. The patient’s lungs are also tested to determine their functionality and the medical history of the patient is also taken into consideration. Despite there being no cure for Asthma, the allergist will prescribe medications that will help prevent asthma triggers. For dehydration cases the prescription is relatively easy. The patient is advised to take a lot of water and replenish more often. Dehydration tests are carried out by testing the water levels of the patients. Cases that involve toxicity, body fluids and solids are subjects to tests for presence of any toxic substances. Consequently, if the results are positive, heavy detoxification is recommended. Lastly, epistemological tests are carried out to test for virus and chlamydia by a qualified doctor. Upon detection, the doctor prescribes appropriate antibiotics to reduce the risk of Asthma.
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References
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Casale, T. B., Tashkin, D. P., Lühmann, R., Engel, M., Moroni-Zentgraf, P., & Kerstjens, H. A. (2016). Therapy Demonstrates Reduced Risk of Severe Asthma Exacerbation and Asthma Worsening in Symptomatic Asthma, Independent of IgE or Blood Eosinophil Levels. Journal of Allergy and Clinical Immunology, 137(2), AB214. Gelb, A. F., Christenson, S. A., & Nadel, J. A. (2016). Understanding the pathophysiology of the asthma–chronic obstructive pulmonary disease overlap syndrome. Current opinion in pulmonary medicine, 22(2), 100-105. Morris, M. (2016). Drugs and Diseases: Pulmonology. Medscape. Retrieved from: emedicine.medscape.com/article/296301-overview Walsh, C. G., Sills, M. R., & Arnold, D. H. (2017). Time-dependent severity changes during treatment of pediatric patients hospitalized for acute asthma exacerbations. Annals of Allergy, Asthma & Immunology, 118(2), 226-227.
Appendix
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