Posted: December 20th, 2021

Asthma

Asthma

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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 26 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 3 to 4 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.
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 from https://www.eadt.co.uk/news/thetford_mother_of_bradley_wilson_who_died_of_asthma_attack_told_there_was_nothing_she_could_have_done_1_1375128

Glissman, B. (2012, May 21). Girl’s death puts focus on asthma’s broader grip. Omaha World-Herald. Retrieved from https://www.omaha.com/article/20120521/LIVEWELL01/305219975

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Pathophysiology of Asthma
Asthma is a chronic inflammatory disease of the airways that causes recurrent episodes of wheezing (a whistling sound when breathing), chest tightness, shortness of breath, and coughing. The airways are the tubes that carry air to and from the lungs. In people with asthma, the airways become inflamed and swollen, and the muscles around the airways tighten. This makes it difficult for air to flow in and out of the lungs.

The inflammation in asthma is caused by a combination of genetic and environmental factors. Genetic factors make some people more likely to develop asthma, while environmental factors, such as exposure to allergens, can trigger asthma attacks.

During an asthma attack, the inflammation in the airways gets worse. This can cause the airways to narrow even more, making it even harder for air to flow in and out of the lungs. The airways may also produce more mucus, which can further block the airways.

The changes in the airways during an asthma attack can lead to a number of symptoms, including:

Wheezing
Chest tightness
Shortness of breath
Coughing
In severe cases, an asthma attack can be life-threatening.

Pathophysiology of Acute Asthma Exacerbation
An acute asthma exacerbation is a sudden worsening of asthma symptoms. Exacerbations can be triggered by a variety of factors, including:

Viral infections
Allergens
Exercise
Cold air
Strong emotions
Medication non-adherence
During an exacerbation, the inflammation in the airways gets worse. This can cause the airways to narrow even more, making it even harder for air to flow in and out of the lungs. The airways may also produce more mucus, which can further block the airways.

The changes in the airways during an exacerbation can lead to a number of symptoms, including:

Wheezing
Chest tightness
Shortness of breath
Coughing
In severe cases, an exacerbation can be life-threatening.

Changes in Arterial Blood Gas Patterns During an Asthma Exacerbation
During an asthma exacerbation, the changes in the airways can lead to a number of changes in the arterial blood gas patterns. These changes include:

Hypoxemia: A decrease in the oxygen level in the blood.
Hypercapnia: An increase in the carbon dioxide level in the blood.
Respiratory acidosis: A condition in which the blood pH is too low due to a buildup of carbon dioxide.
These changes in the arterial blood gas patterns can be a sign of a serious exacerbation and may require immediate medical attention.

Impact of Patient Factors on Pathophysiology of Asthma
A number of patient factors can impact the pathophysiology of asthma, including:

Genetics: People with a family history of asthma are more likely to develop the condition.
Gender: Asthma is more common in children and women than in men.
Ethnicity: Asthma is more common in people of African American, Hispanic, and Native American descent than in people of Caucasian descent.
Age: Asthma is most common in children and young adults, but it can occur at any age.
Behavior: Smoking and exposure to secondhand smoke can increase the risk of developing asthma and can make it worse.
Diagnosis of Asthma
The diagnosis of asthma is based on a combination of factors, including:

The patient’s history of asthma symptoms
The results of a physical examination
The results of pulmonary function tests
Pulmonary function tests are used to measure the amount of air that can be inhaled and exhaled. These tests can help to confirm the diagnosis of asthma and to assess the severity of the condition.

Treatment of Asthma
The goal of treatment for asthma is to control the inflammation in the airways and to prevent asthma attacks. Treatment may include:

Inhaled corticosteroids: Inhaled corticosteroids are the most effective treatment for asthma. They work by reducing the inflammation in the airways.
Long-acting beta-agonists: Long-acting beta-agonists help to open the airways and make it easier to breathe.
Short-acting beta-agonists: Short-acting beta-agonists are used to relieve acute asthma symptoms.
Other medications: Other medications that may be used to treat asthma include leukotriene modifiers, anticholinergics, and immunomodulators.
The type of treatment that is best for a particular patient will depend on the severity of the asthma and the patient’s individual needs.

Mind Maps
Here are two mind maps that illustrate the pathophysiology of chronic asthma and acute asthma exacerbation:

Chronic Asthma

mind map for chronic asthmaOpens in a new window
EdrawMax
mind map for chronic asthma
Acute Asthma Exacerbation

[Image of mind map

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