Understanding Asthma: Causes, Symptoms, And Treatment

Pathophysiology of Asthma

Asthma can be considered as the chronic respiratory challenge that is characterised by the inflammation of the airway as well as hyper reactivity (Yamauchi and Ogasawara 2019). The case study of Isapoinhkyaki the 12-year-old girl of Blackfoot decent living in the basement apartment with her father revolves around her recent diagnosis of health challenge asthma.

Pathophysiology of asthma includes 3 abnormalities which are airway inflammation, mucous impaction and bronchoconstriction. Subepithelial connective tissue of asthmatic airway include several blood vessels which are found under similar locations within normal subject. Research studies reveal that, bronchial vessels currently play the major role in pathophysiology of asthma (Carpaij et al., 2019).

Inflamed Airways during the episode of asthma react to the triggers of environment like pollen and dust particles contributing to the narrowing of the passage and production of excess mucus making it difficulty in breathing (Kytikova et al., 2019). Inflammation is followed by further narrowing of airways as well as excessive mucus production leading to breathing and coughing difficulties.

Asthma that results from immune response in initiating allergens are best understood regarding the casual factors. Inhaled allergens for both the people with asthma and people who are free of disease find their way towards inner Airways and are ingested by type and category of cell known as antigen presenting cells (Papadopoulos et al., 2019).

Research studies reveal that bronchial circulation play a significant role in regulating the calibre of airway since the increase in the vascular volume contribute to the narrowing of airways (King et al., 2019). Vascular blanching of skin is majorly used in the measuring of potency related to topical steroids and similar mechanism that are involved with the effects of inhaled steroids during the asthma. Some of the other significant challenges under pathophysiology that has been detected includes formation of allergenic as well as indoor air pollution leading to development of volatile organic compounds (Francisco et al., 2018). Further more pathogenesis and fundamental challenge in the development of immunological and excessive inflammatory disease in the airway are some of the asthma reflex diseases having repetitive episode among the patients.

Risk factors – research studies reveal that some of the significant factors that provides people at risk for the development of the disease of asthma, includes family history, having allergy conditions like ab dermatitis or allergic rhinitis, viral respiratory infections and respiratory challenges from childhood, occupational exposures to certain elements at workplace like exposure to certain dust and chemical fumes or vapours, tobacco smoking and exposure to significant components of air pollution (Gallucci et al., 2019). Current data also highlighted obesity and overweight to be a greater risk of the development of asthma due to low grade inflammation in the body.

Asthma is majorly the condition in which year winner rose and swells and also produces extra mucus (Phipatanakul et al., 2021). This disease cannot be cured however the symptoms can be controlled. Some of the signs and symptoms that are common in asthma are as follows

Shortness of breath while having in frequent asthma attacks

Bronchoconstriction

Chest tightness or pain while exercising

Wheezing while exiting as the most common sign of asthma among children

Sleeping trouble that is caused by breath shortness, wheezing and coughing

Wheezing and coughing attacks which are worsened by respiratory virus like flu and cold

Frequent breathing attacks that are bothersome

Increase difficulty in breathing and need of the use of quick inhaler for relief

Exercise induced asthma

Occupational asthma from chemical fumes and gas

Allergy induced asthma from airborne substances

Asthma for children, adhering to the case study of Isapoinhkyaki who is a 12 year old girl cannot be cured however can be reduced by following proper action and nursing plan. Understanding the symptoms of asthma for children under 13 years, it is important to ensure in taking asthma emergency in case of severe asthma attack which can be life threatening. Proper testing for diagnosing and monetary the stage of asthma by uses of spirometry and peak flow metres is essential. Other significant treatments include uses of peak flow metre which are portable hand-held device for measuring the lung capacity and effectiveness (Corren et al., 2019). Long term medication which are majorly known as maintenance drug also help in controlling persistent asthma including inhaled corticosteroids, leukoine modifiers and combination inhalers.

Social determinants of health are the non medical factors influencing the outcomes of health of an individual specifically targeting the environment and the place where people grow and work and live. Adhering to the case study of Isapoinhkyaki who is a 12 year old girl living in the basement apartment with her father who worked as a labourer and has intermittent work, the condition in which she resides affected her overall health, leading her to develop asthma. The black foot descent, Isapoinhkyaki has been diagnosed with asthma and she lives away from her mother who is at another city and her grandmother living in the upstairs apartment. Significant factor falling under the social determinant of health is the habit of Isapoinhkyaki and her father to rely on food banks for supplementing their diet (Eyerich et al., 2020). The intense level of poverty together with lack of proper food security, basic amenities and environment of housing followed by job in security as a labourer has contributed to the challenge of access towards affordable health service for Isapoinhkyaki to treat her asthma (Gans and Gavrilova 2020). The following is a nursing care plan which will include objective data as well as objective data together with assessment data focusing on short term and long-term goal and proper interventions.

Please fill up the signs and symptoms section aligning with the goals and intervention

Symptoms	Goals	Intervention
Secretion of mucus –  Yes/No	To demonstrate deep sleep without breathing trouble and coughing. To ensure airway have clear sounds of lungs	Nursing airway management by suction, monitoring the retraction of chest wall as well as respiratory rates
Breathing difficulty- Yes/No	To ensure clear breathing sound To ensure air track is free of dyspnoea and cyanosis.	Effective monitoring of rhythm, frequency as well as breathing depth Encouragement of deep breathing Positioning of the semi fowler position of the chest
Repetitive asthma attacks  –  Yes/No	To monitor arterial blood gasses (ABG)	Ensure that the patient has not developed respiratory alkalosis (Chung, K.F., 2018 et al., 2018).  The condition of hypoxemia leads to rising rate of respiration as well as depth, where carbon dioxide is blown. The ominous findings include respiratory acidosis that indicated the failure of respiratory tract and henceforth needs to be provided with mechanical ventilation.

Asthma self-management training is fundamental for asthma control, and all patients should be encouraged to take charge of their own treatment. When symptoms of asthma are under management, the individual would experience reduced exacerbations, an improvement in quality of life, reduced expenses, a delayed development of allergic asthma, reduced mortality, as well as a decreased likelihood of mortality from the disease (Alimohammadi et al., 2018). Besides symptom management, consumer asthmatic teaching could enhance patient understanding of asthma, as well as patient satisfaction and self-control. Decreased school absenteeism as well as working time, less acute episodes, activity limits, and emergency departments are among the other advantages (Swearingen and Wright 2019).

References

Alimohammadi, N., Maleki, B., Abbasi, S., Shakerian, B. and Hemati, Z., 2018. The effect of adaptation training on controlling maladaptation behaviors in adolescents with asthma based on roy adaptation model. Tanaffos, 17(2), p.103.

Carpaij, O.A., Burgess, J.K., Kerstjens, H.A., Nawijn, M.C. and van den Berge, M., 2019. A review on the pathophysiology of asthma remission. Pharmacology & Therapeutics, 201, pp.8-24.

Chung, K.F., 2018. Precision medicine in asthma: linking phenotypes to targeted treatments. Current Opinion in Pulmonary Medicine, 24(1), pp.4-10.

Corren, J., Castro, M., Chanez, P., Fabbri, L., Joish, V.N., Amin, N., Graham, N.M., Mastey, V., Abbé, A., Taniou, C. and Mahajan, P., 2019. Dupilumab improves symptoms, quality of life, and productivity in uncontrolled persistent asthma. Annals of Allergy, Asthma & Immunology, 122(1), pp.41-49.

Eyerich, S., Metz, M., Bossios, A. and Eyerich, K., 2020. New biological treatments for asthma and skin allergies. Allergy, 75(3), pp.546-560.

Francisco, C.D.O., Bhatawadekar, S.A., Babineau, J., Reid, W.D. and Yadollahi, A., 2018. Effects of physical exercise training on nocturnal symptoms in asthma: Systematic review. PLoS One, 13(10), p.e0204953.

Gallucci, M., Carbonara, P., Pacilli, A.M.G., Di Palmo, E., Ricci, G. and Nava, S., 2019. Use of symptoms scores, spirometry, and other pulmonary function testing for asthma monitoring. Frontiers in pediatrics, 7, p.54.

Gans, M.D. and Gavrilova, T., 2020. Understanding the immunology of asthma: pathophysiology, biomarkers, and treatments for asthma endotypes. Paediatric respiratory reviews, 36, pp.118-127.

King, G.G., Farrow, C.E. and Chapman, D.G., 2019. Dismantling the pathophysiology of asthma using imaging. European Respiratory Review, 28(152).

Kytikova, O., Novgorodtseva, T., Denisenko, Y., Antonyuk, M. and Gvozdenko, T., 2019. Pro-resolving lipid mediators in the pathophysiology of asthma. Medicina, 55(6), p.284.

Papadopoulos, N.G., ?ustovi?, A., Cabana, M.D., Dell, S.D., Deschildre, A., Hedlin, G., Hossny, E., Le Souëf, P., Matricardi, P.M., Nieto, A. and Phipatanakul, W., 2019. Pediatric asthma: an unmet need for more effective, focused treatments. Pediatric Allergy and Immunology, 30(1), pp.7-16.

Phipatanakul, W., Koutrakis, P., Coull, B.A., Petty, C.R., Gaffin, J.M., Sheehan, W.J., Lai, P.S., Bartnikas, L.M., Kang, C.M., Wolfson, J.M. and Samnaliev, M., 2021. Effect of school integrated pest management or classroom air filter purifiers on asthma symptoms in students with active asthma: a randomized clinical trial. JAMA, 326(9), pp.839-850.

Swearingen, P.L. and Wright, J., 2019. All-in-One Nursing Care Planning Resource-E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health. Elsevier Health Sciences.

Yamauchi, K. and Ogasawara, M., 2019. The role of histamine in the pathophysiology of asthma and the clinical efficacy of antihistamines in asthma therapy. International journal of molecular sciences, 20(7), p.1733.