Asthma Case Review

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SYSTEMATIC ASSESSMENT OF ASTHMA

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Course

Professor

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Systematic assessment of asthma

Authors: Khan, D.A., Maslan, J. Mims, J.W., Zein, J.G. and Erzurum, S.C., Arnold, E.C.,

Boggs, K.U., Davis, S.R., Durvasula, S., Merhi, D., Young, P.M., Traini, D., Bosnic-Anticevich,

S., Castner, J., Sullivan, S.S., Titus, A.H., Klingman, K.J., McCracken, J.L., Veeranki, S.P.,

Ameredes, B.T. and Calhoun, W.J.,

Introduction

Asthma is an illness involving the air passageways, mainly the bronchial tubes which

become inflamed and tighten when exposed to some trigger factors (Khan, D. 2014 13). This can

be extremely damaging to the victim and requires the inhalation of particular medications which

calm the inflammation and subside the swelling of these air passageways. The essay discusses

the effects of this illness, including the processes involved in its systematic assessment and the

roles played by nursing practitioners in its management.

Moreover, the pathophysiology or the processes, signs, and symptoms associated with the

disease are extensively discussed to make a final management plan. Also, a case study of an

afflicted baker is used to give a closer examination of the disease wile illustration, and the role

played by the trigger factors. Therefore the purpose of this essay is to provide a systematic

assessment of asthma while discussing the roles played by nurses in the treatment of patients

suffering from the condition.

Definitions of conditions and pathophysiology

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The patient, a 47-year-old woman with a one-year history of asthma, is showing

symptoms typical of the state. These include wheeze, frequent shortness of breath, allergic

rhinitis, stuffy and itchy nose, and persistent tightness inside her chest with an occasional cough

(Maslan, J. and Mims, J. 2014 9). In her observations, the symptoms worsen within a short

period of her commencing work and the unavoidable exposure to red bran. In her line of work,

the environment is dustier, a significant risk factor to people predisposed to the asthmatic

condition. The pathophysiology of asthma involves airway inflammation leading to frequent

obstruction of the airways. These two cases result in such symptoms as illustrated by the patient,

including shortness of breath and tightness in the chest area. Moreover, the fact exhibited by the

patient is an allergen-induced asthmatic attack and therefore, depends on the presence of these

triggers in the environment for their onset.

Discussion of pathophysiology

Pathophysiology refers to the process of acquisition, signs and symptoms, and the past

management of a disease. The patient has exhibited signs associated with adult-onset allergic

asthma, a condition which manifests in the later development stages of a person. Asthma is a

chronic condition that affects millions of people negatively in their daily functioning but can be

successfully managed by particular medication. The main symptoms presented in asthmatic cases

are the constriction of the bronchial airways when the patient is exposed to trigger factors such as

allergens (Zein, J. and Erzurum, S. 2015).

Moreover, immunohistopathologic features also include acute inflammatory cell

infiltration and mast cell activation, which eventually develop into the airway constriction.

Asthma pathogenesis concepts are incredibly variable according to too various research over the

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years. The link between causes and symptoms is still being investigated to come with better

specific ways of addressing the illness.

These efforts are aimed at creating the most efficient response to therapy, considering

that genetic predisposition is also a factor involved in the development of the condition. In the

inflammation of the airways, many factors play a role such as cells and cell elements,

macrophages, neutrophils, and epithelial cells. Stress has also been discovered to lead to

asthmatic exacerbations and thus a risk factor to predisposed patients. However, it is worthy to

note that the exact mechanisms involved in the development o the conditions are yet to be

determined, and further research is required towards this goal.

Role of the nurse in assessment

Asthma assessment requires a comprehensive, systematic, and holistic approach to

establish the best possible care system or regiment for a particular patient (Davis S. et al. 2015

11). This means that for nurses involved in primary care, the role required of them is almost

indispensable in managing the condition and referring their patients whenever necessary.

Moreover, in the cases of specific severe asthma cases, nurses assess patients, including

determining their asthma types and prescribing or administering novel therapies. Therefore, the

role played by nurses in the assessment of the woman based on a translational knowledge

framework cannot be understated and is extremely important in the management of the

condition.

Patient profile

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The patient, a 47-year-old woman with a one-year history of asthma, is showing symptoms

typical of the condition. These include wheeze, frequent shortness of breath, allergic rhinitis,

stuffy and itchy nose, and continual tightness inside her chest with an occasional cough.

Initial pulmonary assessment:

 Spirometry, pre-albuterol; fev1 78%, post-albuterol: 13% improvement

 Chest X-ray: within nor range

Subsequent pulmonary assessment:

 CT: normal parenchyma without scarring

 Sinus CT: minimal mucosal thickening

 Allergy skin test: positive for dust and flour

 Exhaled NO

fractional(for FeNO) 60 PPB

Analysis of the health assessment

In the case of the assessed patient, it has been determined that her condition is triggered

by her exposure to wheat bran, which she comes into contact with on her job. To assure that the

patients quality of life will not be interfered with, it imperative that she be assigned in another

area at her workplace while continuous assessment is done to determine her body’s reaction to

this change (Castner, J. et al. 2016 23). She was transferred from her workstation to a muffin

packing area to minimize lower exposure to the flour and thus the asthma trigger factors.

Moreover, constant monitoring of her condition shows that since the transfer, there have been no

symptoms which warrant medication. However, it is prudent to monitor her progress regularly to

ensure that any arising events are detected early and a management regimen initiated

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Client’s health needs

The patient was subjected to spirometry testing, which resulted in a reading of

FEV1/FVC 0.62 within a normal workday, which is the predicted limit. Lower readings were

obtained on her workdays as compared to the periods she spent off work. This trend indicates

that the less time she spends exposed to the trigger factors, the less her body is susceptible to

developing the full-blown symptoms of the conditions (McCracken, J. et al. 2017 7). Moreover,

the client needs to have a ready supply of prescribed bronchodilators on hand in case the

condition suddenly manifests without warning.

Role of the nurse in communicating care

Nurses involved in primary care represent the most critical link in the health care system

since they are responsible for ensuring that the patient gets information on the ways to approach

the management of their illness (Arnold, E. and Boggs, K. 2019 12). Therefore, the information

communicated by the nurse is supposed to minimize the patient's exposure to harm as a result of

their adherence to the given instructions. Nurse-patient communication is essential in ensuring

that there is mutual trust and understanding, while the emotional needs of the patient are also

met. This further promotes the relationship resulting in the improvement of overall quality of

care for the patient.

Conclusion

Asthma is a chronic and debilitating condition which can result in the impairment of the

functioning of the patient. Millions of people are afflicted with the state and require specialized

care, including a wide range of bronchodilators to maintain and live uninterrupted lives. In their

treatment, medical practitioners, especially nurses, have essential roles to play in the

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management of patients' condition. The nurses are crucial and often necessary for the assessment

of the situation and even in the administration of novel treatments. Furthermore, the

communication process between the nurse and the patient is essential as it can be used as a

pathway to cater to the patients' emotional needs resulting in quality and effective healthcare.

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References

Khan, D.A., 2014, September. Allergic rhinitis and asthma: epidemiology and common

pathophysiology. In Allergy & Asthma Proceedings (Vol. 35, No. 5).

Maslan, J., and Mims, J.W., 2014. What is asthma? Pathophysiology, demographics, and health

care costs. Otolaryngologic Clinics of North America, 47(1), pp.13-22.

Zein, J.G., and Erzurum, S.C., 2015. Asthma is different in women: Current allergy and asthma

reports, 15(6), p.28.

Arnold, E.C., and Boggs, K.U., 2019. Interpersonal Relationships E-Book: Professional

Communication Skills for Nurses. Saunders.

Davis, S.R., Durvasula, S., Merhi, D., Young, P.M., Traini, D., and Bosnic-Anticevich, S.Z.,

2015. The role of direct support professionals in asthma management. Journal of

Intellectual and Developmental Disability, 40(4), pp.342-353.

Castner, J., Sullivan, S.S., Titus, A.H. and Klingman, K.J., 2016. Strengthening the role of nurses

in medical device development. Journal of Professional Nursing, 32(4), pp.300-305.

McCracken, J.L., Veeranki, S.P., Ameredes, B.T. and Calhoun, W.J., 2017. Diagnosis and

management of asthma in adults: a review. Jama, 318(3), pp.279-290.

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