Case Study Asthma

Asthma can be genetic, therefore, no way to prevent a genetic predisposition. There are ways to try to prevent increased incidences of asthma symptoms by decreasing or controlling
Case Study on Asthma/Pathophysiology certain risk factors that could decrease the rising occurrence of asthma in the population (Peat, J.
K. 1996).
Treatment:
There are several ways to treat asthma. Some involve medication and some involve decreasing the risk factors and minimizing exposure to triggers. The ways to treat asthma are to stay away from whatever triggers an attack to try to control symptoms that a person might have. There are medications that help with controlling asthma symptoms. Mainly, are two types of asthma medications that are prescribed:
first one is a rescue medications or short-acting medication which gives quick relief and the second is prescribed for long term control that are long-acting medications, commonly called “controllers”. The rescuer or quick relief medications are used if the person thinks they might be getting ready to have an asthma attack. The patient would want to have their short-acting or rescuer medication with them in an inhaler form when they leave their home since they most likely wouldn’t be able to get home fast enough to use their nebulizer. The long-acting or controller medications help with decreasing the inflammation caused by asthma. As asthma is an inflammatory disease, oral steroids have been the most effective anti inflammatory medication in the treatment of this disease. These oral steroids, although very effective, should only be used in acute exacerbations due to the risks of side effects in long term use. These medications include: Medrol, decadron, dexamethasone and prednisone. These medications decrease the inflammation in the airways and the action of the medication might begin within hours. Tablets can be effective up to 4-6 hours, these meds can be administered via liquid and IV as well.
Case Study on Asthma/Pathophysiology Commonly used for controlling asthma symptoms are inhalers such as: inhaled corticosteroids, some doctors have been adding beta2-agonists which are bronchodilators, for a combination therapy to include such medications as, theophylline. Bronchodilators, relax smooth muscles a in the bronchial tubes so air can flow more freely, allowing the person having the constricted bronchi to be able to breath better. The preferred method of administering beta2 agonists would be the inhalation method, usually via nebulizers. There are short-term and long term beta2-agonists, the short-term are the fast acting, these will give relief from symptoms in as little as minutes and last as long as 4-6 hours. The longer acting beta2-agonists don’t have rapid onset for their actions, although they last longer than the short-acting, up to 12 hours. The longer acting bronchodilators shouldn’t be used to acute asthma symptoms. They have side effects of fast heartbeat, tremors, nervousness and difficulty sleeping but these will decrease as the patient continues to use them. Some of these medications are: Ventolin Albuterol, Proventil HFA,
Brethine Terbutaline and Serevent (long acting) Salmeterol xinafoate. Theophylline is also a bronchodilator and relaxes the smooth muscles in the bronchi opening the airways more so the air can move better. As this medication is in the blood, they can do lab work to check the therapeutic levels of the medication. Theophylline has been used for a long time and now has newer long acting medication forms that can be taken daily or twice daily.
Some of these medications are: theophylline, Slo-bid-ER capsules, Theo-Dur Sprinkle-SA capsules and Theo-24-ER capsules. Theophylline can also increase effectiveness of ciliary action and increase the contractibility of the diaphragm. There are side effects and there are also toxic side effects for this medication and this is when the blood levels reach the toxic levels. Seizures and nausea/vomiting can occur with toxic levels and this can happen if the patient has a viral infection or incompatibility to the medication.
Case Study on Asthma/Pathophysiology There are two others that will be mentioned in this case study, the first one is Albuterol
Sulfate, this is an inhalation medication that can be administered via nebulizer or a metered dose inhaler, this is in the class of the bronchodilators. Its action is to relax smooth muscles in the lungs and dilates air passageways making it easier to breathe. In a lot of cases, this is used as a rescue medication although the action begins within 15 minutes after using it and the peak effect would be within 1-1.5 hours and will last up to 3-6 hours. Some other cases, this medication is used on a regular basis as prescribed by the doctor. It can cause dizziness, restlessness, lightheadedness, anxiety and nervousness. The last medication that is being discussed in this case study are Leukotriene Inhibitors. These, stop or inhibit the actions of leukotrienes that are made by mast cells, an example being histamine, then released once the mast cells are activated in the immune system. Inflammation will occur in the bronchi and airways from the stimulation by
the immune system causing the inflammatory response that will activate the leukotrienes causing them to be released. Since this causes inflammation, the airways will become constricted and harder to move the air. Leukotriene Inhibitors will stop this occurrence. Clinical Relevance: As a nurse taking care of a patient with asthma symptoms, in the patient’s plan of care, the nurse would monitor their oxygen saturation and respiratory status. The doctor would order pulmonary function tests and possibly oxygen if the patient’s O2 sat is lower than 92% on room air. During the hospital stay, the nurse would listen to the lung sounds and monitor for audible wheezing that can be heard with or without a stethoscope and monitor for signs and symptoms of shortness of breath, like using accessory muscles to breathe, labored and shallow breathing and unable to verbalize to the nurse due to not having enough air in the lungs to speak.
Case Study on Asthma/Pathophysiology The nurse would set goals in the care plan, after deciding a nursing diagnosis and then come up with interventions that would need to be implemented in order to reach the goals set for him/her. As the patient begins to get closer to meeting their goals, the nurse would begin patient teaching on how to use his/her medications, signs and symptoms of respiratory distress, about asthma exacerbation and asthma symptoms. The patient would need to perform the use of his or her inhaler or nebulizer treatment and verbalize understanding of what is being taught. Once the patient leaves the hospital, the nurse should’ve taught what the patient needed to know about asthma and should have made sure that the patient understood to the best of their ability. Conclusion: In conclusion, asthma is a common illness among children and adults. Asthma can be acute and would require short acting medications to help with the relief of asthma symptoms.
There are long term medications that can be used to control the symptoms of asthma so that there might be less possibility of having an acute attack or an exacerbation that could hospitalize
the patient or even become fatal for him or her. There are triggers that could be environmental that can set off the symptoms of this disease. These could be environmental or internal like stress or illness. Attempting to reduce the environmental can help to prevent or decrease symptoms. This disease effects almost all the body’s systems with the three main ones that were discussed being the respiratory system, the circulatory system and the nervous system. Asthma is common but as stated earlier can become severe and even fatal if not controlled.