the Treatment of Asthma Discussion
Sample Answer for the Treatment of Asthma Discussion Included After Question
the Treatment of Asthma Discussion
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Robin Stuckey posted Aug 13, 2020 8:53 AM
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The patient is an 18-year-old that has a history of shortness of breath, dry cough and wheezing for 5 years. The primary care has diagnosed her with asthma. Her father smokes in the home.
A Sample Answer For the Assignment: the Treatment of Asthma Discussion
Title: the Treatment of Asthma Discussion
Asthma is a chronic inflammatory disorder of the bronchial mucosa that causes hyperresponsiveness, constriction of the airways, and airflow obstruction that can be reversible (McCance and Huether, 2019). With bronchial asthma, thick mucus, edema and smooth muscle spasm cause obstruction in small airways (McCance and Huether, 2019). Thus, the condition is both restriction and obstructive. Asthma has many cellular elements that contribute to inflammation of the bronchial mucosa and further hyperresponsiveness of airways to include dendritic cells, lymphocytes, mast cells, neutrophils, eosinophils and basophils (McCance & Huether, 2019). Antigen exposure to the mucosa activates dendritic cells to present the antigen to T helper cells which release inflammatory cytokines (McCance & Huether, 2019).
The diagnosis of asthma is made by a few assessments, one would be a history which would include occurrences of wheezing, cough, and any exertion intolerance. Also, a family history in addition to questions regarding their work and home environment. In addition to the history of illness, a spirometry test can also be performed. Spirometry assesses lung function by measuring how much air is inhaled and exhaled. Management and treatment of asthma is first to avoid irritants, control symptoms, and prevention of exacerbation (McCance & Huether, 2019). Anti-inflammatory medications are needed along with corticosteroids and leukotriene antagonists (McCance & Huether, 2019). In more severe cases, immunotherapy has been shown to reduce exacerbations.
Secondhand smoke can exacerbate asthma symptoms and the majority of patients who had been exposed to second hand smoke whether at home or in a public place complained of severe asthma symptoms (Lima, Cruz, Fernandez, Pinheiro, Souza-Machado, Lima, Mello, & Cruz, 2020).
The patients father smokes in the home. The research shows that the majority of patients with severe or recurrent asthma attacks are exposed to secondhand smoke. This exposure can be from home, work or in a public setting. The patient and family members, especially the father should be educated on the effects of secondhand smoke and how it would benefit the patient not having this exposure.
References:
Lima, L.L., Cruz, C.M.S., Fernandes, A.G.O., Pinheiro, G.P., Souza-Machado, C. de, Lima, V.B., Mello, L.M. de, & Cruz, A.A. (2020). Exposure to secondhand smoke among patients with asthma: a cross-sectional study. Einstein (Sa Paulo, Brazil), 18, eA04781. https://doi-org.su.idm.oclc.og/10.31744/einstein_journal/2020AO4781
McCance, K.L. & Huether, S.E. (2019). Pathophysiology, 8th Edition. [South University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/9780323583473/
Sheena John posted Aug 14, 2020 11:40 PM
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Lung disease can be restrictive or obstructive in nature. Restrictive lung diseases disrupts an individual’s ability to inhale air, as in cystic fibrosis (Leader, 2020). Obstructive lung diseases impacts the lungs ability to exhale air, as in asthma (Leader, 2020).
Asthma is the process by which the lungs react to an irritant causing broncospasms along bronchiolar inflammation and constriction leading to edema thereby limiting the lungs ability to clear mucus (Lynn & Kushto-Reese, 2015). Mucus-secreting cells, in asthma, can create an increase in mucus production, resulting in thick mucus plugs that obstruct the airway (Lynn & Kushto-Reese, 2015). Furthermore, with this disease process the epithelial peeling can occur and allow the invasion of allergens that activates hyperresponsiveness (Lynn & Kushto-Reese, 2015).
Individuals with asthma presents with shortness of breath, wheezing, coughing, and chest tightness (Centers for Disease Control and Prevention [CDC], 2019). The development of asthma can be genetic, environmental, or occupational (CDC, 2019) to list a few.
When allergic asthma is related to a genetic influence it is typically referred to as “Atopy” (CDC, 2019). Environmental induced asthma can be triggered on by secondhand smoke, mold or dampness, and air pollution (CDC, 2019).
When evaluating a client for an asthma diagnosis pulmonary function tests (PFT) such as spirometry, lung plethysmography, and diffusing capacity should be evaluated (Leader, 2020). Spirometry helps to determine how much air one can forcefully breathe out after a deep breath and referred to as forced vital capacity (FVC) (Leader, 2020). It also measures how much air can forcefully be breathed out in initial second of the FVC test, noted as the forced expiratory volume in one second (FEV1) (Leader, 2020). These two measurements are compared to develop a FEV1/FVC ratio which is 70% to 80% in a healthy adult (Leader, 2020). However in an adult with an obstructive disease, such as asthma, the ratio is decreased (Leader, 2020). Spirometry also evaluates the total lung capacity (TLC). Which is the “volume of air left in the lungs after exhalation” plus the FVC (Leader, 2020). Other PFT’s that should be taking in consideration is the lung plethysmography which estimates the residual air in the lungs after expiration (Leader, 2020). Diffusing capacity measures how oxygen and carbon dioxide diffuse in the lungs capillaries and alveoli (Leader, 2020).
In the case study, the client was exposed to secondary smoke by way of the father in the home. This along with the particles released from the fireplace is likely to contribute to the patients initiation of asthma. It would be important for the advance practice nurse to educate the patient on environmental risk factors for asthma and how to decrease exposure where possible as well as encourage regular use of inhalers.
References
Centers for Disease Control and Prevention (2019). Asthma. Retrieved from https://www.cdc.gov/asthma/faqs.htm
Leader, D. (2020). An overview of obstructive vs. restrictive lung disease. Retrieved from https://www.verywellhealth.com/obstructive-and-restrictive-lung-diseases-914741
Lynn, S. J. & Kushto-Reese, K. (2015). Understanding asthma pathophysiology, diagnosis, and management. Retrieved from https://www.myamericannurse.com/understanding-asthma-pathophysiology/
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