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.
All references need to be credible sources there are no large chunks from one particular source need doi or http and no common sources so my percentage will not be high when submitted to Turnitin/safe-assign.
Sample Essay Paper
Asthma Pathophysiology
Severe asthma complications have led to the preventable and sudden death of individuals who looked healthy. Nurses or patients should understand the triggers that prompt the pathophysiological mechanisms and tame the changes (Fuseini & Newcomb, 2017). One of the ways of suppressing the severe complications is adhering to the treatment and avoiding the triggers. Acute and chronic asthma lead to various changes in the body although people have varying degrees of intensity (Lefebvre et al., 2015). Various factors such as genetics, behavior or age can impact the pathophysiological changes. Diagnosis and treatment of the condition are thus necessary to avoid sudden and severe complications.
Pathophysiological Mechanisms
Pathophysiological mechanisms of chronic asthma involve inflammation of the airways as a result of over secretion of mucus along the airways. The inflammation causes intermittent obstruction of the airways (Grabiec & Hussell, 2016). People with chronic asthma can experience difficulty in breathing as a result of obstruction. Bronchial hyper-responsiveness is also a functional change that occurs as a result of asthma (Fuseini & Newcomb, 2017). When a person is exposed to dust or pollen they may develop some complications due to the hyper-responsiveness.
Acute asthma has sudden and severe complications such as shortness of breath as well as wheezing. In some cases, a person may also experience a tight chest or persistent coughing (Matera, Rinaldi, Calzetta, Rogliani & Cazzola, 2019). The pathophysiological changes depend on the severity of the condition. In some cases, a person may experience collapsed lung and thus unable to breath (Grabiec & Hussell, 2016). Severity also determines the possibility of survival. Poor pulmonary function is also a change that occurs as a result of acute asthma.
Arterial Blood Gas Patterns
Arterial Blood Gas (ABG) is used to measure the uptake of oxygen and removal of carbon dioxide in the blood in the lungs. The function may be altered by pathophysiological changes that interfere with breathing or constriction of the airways (Matera, Rinaldi, Calzetta, Rogliani & Cazzola, 2019). When the severity of the condition deteriorates the oxygen level decreases since there is poor absorption in the lungs. For example, an asthmatic patient who is experiencing shortness of breath or difficulty in breathing will record a value below the normal range of 75-100 mmHg. Additionally, a similar patient will also record higher carbon dioxide levels above the normal range of 35-45 mmHg. A person who has chronic or acute asthma may also record a lower value in their pH levels (Grabiec & Hussell, 2016). While healthy people have a pH of 7, asthmatics can record a pH of about 5. It is thus important to monitor the arterial blood gas patterns to avoid severe complications that can lead to death.
Gender
Gender is one of the patient factors that affect the pathophysiology of acute and chronic asthma. While boys are more at risk of an asthmatic attack compared to girls, in adulthood women are more at risk of asthmatic attack compared to men (Matera, Rinaldi, Calzetta, Rogliani & Cazzola, 2019). The reason is that the body changes in women during childbirth, menstrual cycle and menopause interfere with their immunity. Therefore, women are more likely to present severe complications compared to men. The female sex hormones are responsible for triggering airway inflammation in women compared to men (Lefebvre et al., 2015). Other pathophysiological mechanisms in women include smooth muscle contraction, high level of mucus production, and airway mechanisms which increase the risk of asthma. Additionally, female sex hormones were also responsible for the increased secretion of mucus which contributes to the obstruction of the airways. It is thus important for women to take extra care and get tested to avoid preventable conditions.
Diagnosis and Treatment
Diagnosis and treatment of acute and chronic asthma in women will comprise of unique features to address the specific issues about female pathophysiological mechanisms. Diagnosis will start with a review of the medical history and a physical examination (Fuseini & Newcomb, 2017). The treatment plan will involve the prescription of short-acting bronchodilators medication such as Ventolin or Proventil which are essential in relaxing the muscles around the airways. The side effects of the bronchodilators such as increased heart rate should be well-monitored among pregnant women (Rosenkranz et al., 2016). Women should take inhaler steroids which are used to decrease the inflammation of the airways. It is also advisable for women to take Long-acting bronchodilators to prevent life-threatening complications (Grabiec & Hussell, 2016). Other types of medications include leukotriene modifiers, oral steroids, and omalizumab antibodies. They should also take medication to balance the hormones that trigger asthmatic attacks. The treatment plan will also involve regular monitoring of lung function among pregnant women.
Conclusion
Asthma is one of the health conditions that can lead to sudden death despite a quick response from an emergency department. Chronic asthma can develop into acute asthma leading to sudden changes. The changes can cause the lungs to malfunction, a condition that can cause death. Therefore, it is important to get the right diagnosis and treatment to avoid preventable deaths both in men and women.
Mind-Maps
Acute asthma mind map
Chronic asthma
Chronic asthma mind map
References
Fuseini, H., & Newcomb, D. C. (2017). Mechanisms driving gender differences in asthma. Current Allergy and Asthma Reports, 17(3), 19.
Grabiec, A. M., & Hussell, T. (2016). The role of airway macrophages in apoptotic cell clearance following acute and chronic lung inflammation. Seminars in Immunopathology (Vol. 38, No. 4, pp. 409-423). Springer Berlin Heidelberg.
Lefebvre, P., Duh, M. S., Lafeuille, M. H., Gozalo, L., Desai, U., Robitaille, M. N., … & Lin, X. (2015). Acute and chronic systemic corticosteroid–related complications in patients with severe asthma. Journal of Allergy and Clinical Immunology, 136(6), 1488-1495.
Matera, M. G., Rinaldi, B., Calzetta, L., Rogliani, P., & Cazzola, M. (2019). Pharmacokinetics and pharmacodynamics of inhaled corticosteroids for asthma treatment. Pulmonary Pharmacology & Therapeutics, 101828.
Rosenkranz, M. A., Esnault, S., Christian, B. T., Crisafi, G., Gresham, L. K., Higgins, A. T., … & Busse, W. W. (2016). Mind-body interactions in the regulation of airway inflammation in asthma: a PET study of acute and chronic stress. Brain, Behavior, and Immunity, 58, 18-30.
