Case Study Asthma

This essay will follow the case of Kelly who is a 15 year old girl with a confirmed diagnosis of asthma since childhood. Her asthma has recently been poorly controlled and Kelly presents with an acute attack of asthma. This essay will look at the immediate treatment of Kelly’s attack and discuss the long term management of her asthma using current British Thoracic Society (BTS) and Scottish Intercollegiate Guideline Network (SIGN) guidance to support clinical practice.
Asthma is defined by the Pierce (1999) as an obstructive lung disease; this obstruction is reversible either spontaneously or as a result of treatment. There can be various triggers which cause bronchoconstriction, however the cause it not completely understood. In asthma the
As discussed Kelly’s plan should include education on her inhalers, what they are used for, which inhalers to use when. The action plan should also have best PEF result and advice on how to monitor for signs of deterioration in her asthma and any triggers she may have. Symptoms can be common such as nigh time wakening, reduction in peak flow or using relief medication more. Having said that there can also be other signs such as tiredness or irritability, this will vary from patient to patient so it’s important to tailor this to Kelly. Next, the plan should have instructions on what to do with medication if symptoms are worse, including straightforward and understandable guidance on and what to do and who to call for advice. However it is important to clarify with Kelly that this is about management only when there is deterioration in her asthma and not for acute asthma attack. It must be clear how to recognise an acute attack, what to do and who to call as this is a medical emergency. The plan should be reviewed and updated accordingly at every opportunity (Jarvis 2006). There are various action plans available to suit different age groups. Asthma uk have easy accessible blank action plans which can be downloaded and printed off. Once the action plan is complete with Kelly, a copy should be kept in her medical records and it would be good practice to give several copies for Kelly’s to disperse to
It would advisable to bring Kelly back in one to two weeks to discuss them in more detail. There should be conversation regarding Kelly’s general health to investigate if there are any other problems apart from asthma that could have contributed to her asthma attack. Evidence suggests that asthma can be effected with raised body max index (BMI) The study shows that obese asthmatics suffer from poor asthma control and tend to have more severe asthma than people with a healthy BMI (Dixon 2012). Assessment of Kelly’s height and weight to calculate BMI is suggested and dietary advice provided accordingly. Kelly should be given advice about keeping active however a potential trigger for asthma symptoms is exercise (Wanrooij 2014). Find out what Kelly’s hobbies are, does she play sport and importantly does it trigger any symptoms for her. Kelly should be aware to keep relief inhaler nearby and always have access to it in case she experiences any asthma symptoms. This would be a good time to bring up the subject of pets with Kelly as many young patients are unaware they can be a trigger (Edgecombe et al 2010). If appropriate ask Kelly about her periods and if she is aware of any increase in asthma symptoms during menstruation. A study by Farha et al (2009) has shown that there were some changes in lung function tests in