Category: Asthma

Assessment

G.J is an African American, a five-year-old boy who is brought up in a Christian setting home by his parents. The mother is aged 32 years, the father is 35 years and has a brother who is 4 years. The primary language that is used at their home is English. G.J was taken for medical evaluation and admitted diagnosis was asthma. His mother reported that the boy developed respiratory symptoms at two months of age but she thought that it was not that serious. G.J has been reported to have wheezes, coughs, and a running nose. The boy had sleepless nights due to the wheezes, coughs and vomiting.

G.J was allergic to dogs, seasonal allergies including mold allergies. The hallmark of his illness was that a cold would always trigger his asthma. G.J. would miss school because of asthma. He had never had any emergency room visits, and had never been hospitalized. His asthma symptoms would typically worsen with the weather changes in the spring and fall; the cold winter months were often particularly difficult. According to his mother, he also regularly grinds his teeth at night.

G.J. was delivered normally and the mother had no complications. He weighed 3.0 kilograms at birth. He currently weighs 19.8 kilograms which is fine for his age. He is 43 inches in height. As it was reported by his parent, G.J was a healthy boy who had no illness. He has never been involved in any accident and had not taken any operation. This was his major hospitalization. The father reported that his immunizations were updated.

Developmental milestones

Fine Mortal Level

G. J’s developmental assessment revealed that his fine motor skills were fine because he could take small actions such as grasping objects between the thumb and fingers and could use his lips and tongue to taste objects (Hockenberry and Wilson, 2000, p. 468). He could also feed himself, play, write and draw some funny pictures and he could color them.

Gross motor development

GJ’s developmental assessment clearly indicates the normal fine level of development (Hockenberry and Wilson, 2000, p. 477). G.J was able to grasp objects, point at objects and people, lift and transfer objects from one place to another. He could also exchange items from one hand to the others. G.J could sit, crawl and at the age of 8 months he could stand and walk while holding unto furniture. He could also walk at 15 months and at 2 years he could kick a ball. Now he is five years and he can ride a bike without balancing problems.

Language development

According to his mother, G.J had Language delay a condition whereby he developed with the right sequence but at a slower age. This affected his social life because people could not understand his needs (Hockenberry and Wilson, 2000, p. 25). G.J took speech therapy when he was three years old.

Cognitive development

G.J was having no problems with cognitive development. He is able to understand what people said. He could listen to instructions and get whatever he is being asked by his mother. He also had reasoning and he could remember his things like toys at a tender age of 2 years. He could not confuse his toys with his brother’s toys. Now that he five years he does not have problems in learning, he remembers what they covered in class and can give the right description to pictures or drawings. This therefore indicated that he had a normal cognitive development (Hockenberry and Wilson, 2010, p. 556)

Social development

G. J’s social development had some problems at his early ages because he took long to pronounce sensible words. Sometimes he could just cry to be given something and this brought conflict with his brother. These problems also extended when he went to school, he could not freely socialize and form relationships with his classmates. He sometimes feared his teacher and he could not cooperate in games or molding. Mum and dad both shares responsibility. Child bonds very well with both parents G.J could bond very well with both parents

G.J developed some problems when he lost appetite. This has greatly affected his growth because his height is 43 inches and his weight has also been affected because right now he weighs 19.8 kilos G.J does not eat much and he mostly prefers to eat junk foods like cheese sticks. He only ate 10% of his food. This is not recommendable to a child of his age because they require a lot of energy for their development (Hockenberry and Wilson, 2000, p. 560).

G.J being diagnosed with asthma is on medication that is composed of Albuterol. It is used to prevent and treat wheezing, difficulty breathing and chest tightness caused by lung diseases such as asthma and chronic obstructive pulmonary disease. Albuterol inhalation aerosol is also used to prevent breathing difficulties during exercise (Treece, 2010; Casale, 2010). It works by relaxing and opening air passages to the lungs to make breathing easier. Albuterol controls symptoms of asthma and other lung diseases but does not cure them and so they will help to open his airways (Castro-Rodriguez and Rodrigo, 2009).

G.J. was also given Ampicillin and sulbactam which are antibiotics in the penicillin group of drugs (National Asthma Education and Prevention Program, 2007). They fight bacteria in your body. Ampicillin and sulbactam are antibiotics in the penicillin group of drugs (Polit, 2008). These drugs fight bacteria and they will help to reduce the effects of the allergies that G.J. has developed.

Analysis

According to Duvall’s developmental stages of the family, G.J. is in stage II: Families with pre-scholars being the first born in the family which upgrades from stage one (Hockenberry and Wilson, 2010). The parents live together and they share responsibilities in the family. They involve their children in the house chores. G.J. bonded well with his parents and they both take responsibility of G.J. hospital care. His family is extended because it has both parents and the two kids.

Planning and Implementation

Below are the two internet resources I believe to be helpful both G.J. and his family:

Internet Source I is sponsored by US National Library of Medicine, the largest library in the world that explains all about asthma. It is the encyclopedia of all diseases, their causes incidence, and risk factors, symptoms, signs and tests, treatment, home care, prognosis, complications and prevention. This site will be helpful for both parents and caregivers of children suffering from asthma. It will help the caregivers and parents to know the home based care for such children. It will also help the affected people to know about allergies so that they can avoid whatever they are allergic to.

Internet Source II gives information about asthma medicine and asthma help. It has tabs where you can get information about the cause of asthma, what triggers asthma, diagnosis, symptoms, treatment, medical help and how to deal with children with asthma.

Short-term goal: Through each assessment, G.J will:

1. Achieve social skills and language development will be efficient for his age within the scope of his present abilities during the hospitalization and speech therapy.
2. While in hospital G.J. will gain good nutrition for his age without problems in vomiting. For this goal, I observed G.J.’s eating habits keenly and had no signs of vomiting. His eating habits changed from taking 10% of his food to 50%. This was a good sign that he was progressing well.
3. During hospitalization all the parents were involved in the medical care of their son. They could ask questions and were free to give G.J.’s past history.
4. Within each assessment and hospital stay, G.J. will show some signs of improvement like decrease in coughs and the wheezes will reduce. For this goal, continuous breathing assessment will be taken and the parents will be advised to keep him warm and away from the things that he is allergic to like pets and moulds.

Long-term goal: Through each assessment, GJ will:

G.J. will attain steady gain in weight pattern and progress towards age-appropriate size upon discharge and at home. For this goal, daily weight during hospitalization will be maintained to evaluate the amount of weight G.J. gain in the hospital. Teachings on correct feeding techniques will be given to parents and caregiver, and return demonstration will be required for proficiency. Also restriction on unhealthy diets as well as education on healthy nutrition will be given to family in an understandable language to rid any discrepancies in G.J.’s dietary intakes.

1. By discharge and at home, G.J. will maintain weight gain toward goal with normalization of laboratory values and be free of signs of malnutrition. For this goal, G.J.’s laboratory test should be done again in the hospital to evaluate improvement in results. Family must be thought by medical team on signs and symptoms of malnutrition, and infection, and when to seek doctor’s advice.
2. G.J will not experience any incidences of wheezing, coughs, vomiting or any other sign for asthma. For this goal, progressive assessment will be carried out as well as proper dressing and preventions of allergic conditions. The parents will be required to report to the staff about any signs and symptoms of asthma.
3. G.J. will have no breathing problems. For this goal, medication should according to doctor’s prescriptions. The family members should continually inspect G.J.’s condition. The parents would also be encouraged to visit the websites that were provided for any information regarding to asthma conditions.

References

Brozek J.L., Bousquet, J., Baena-Cagnani, C.E., Bonini, S., Canonica, G.W. and Casale, T.B. (2010). Pediatric Airway Management and Respiratory Distress Self-Study Module. Allergy Clin Immunol, 126 (3), 466-76.

Bush, A. and Saglani, S. (2010). Respiratory System. Lancet, 376 (9743), 348-61.

Castro-Rodriguez J.A. and Rodrigo, G.J. (2009). Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Ediatrics, 123 (3), 519-25.

Hockenberry, M.J., & Wilson, D. (2010). Wong’s nursing care of infants and children. St. Louis, MO: Mosby Elsevier.

Monte, C. (2000). Malnutrition: A Secular Challenge to Child Nutrition. Jornal de Pediatria, 3 (1), 285-297.

National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville: NIH publications.

Polit, D.F. (2008). Nursing Research: Principles and Methods. Philadelphia: JB Lippincott Company.

Rogers, C.A., Burge, H.A. and Spengler, J.D. (2011). British Management guideline on the Management of Asthma. Journal of Urban Health; 84 (2), 185–208.

Rutishauser, C., Sawyer, S and Bowes, G. (1998). Quality-of-life Assessment in Children and Adolescents with Asthma. European Respiratory Journal, 5 (1), 486-494.

Treece, J.W. (2010). Elements of Research in Nursing. St. Louis: Mosby.

Introduction

Osteopathic manipulation is an alternative mode of medical therapy and is gradually gaining popularity and acceptance in the medical community especially in the United States and European nations (Bockenhauer et al. 2002). There are however no controlled trials and studies supporting its efficiency. Osteopathic manipulation principles are based on the interrelationship between body organs and their function and the belief in the body’s natural ability to heal itself.

This article seeks to criticise the application of osteopathic manipulation in the treatment of asthma patients. Several articles investigating the effectiveness of acupuncture as a treatment of asthma have generated conflicting results (Guyton & Hall 2009). Investigations by a group of researchers showed quantifiable improvement in bronchial response to histamine and asthma severity. This study was however limited to spinal thrusting, a technique applied by chiropractors.

Aims of Study

The study reported in this article seeks to critic the hypothesis that osteopathic manipulation techniques can be designed to increase respiratory motion. It also pinpoints the weaknesses of these techniques and their inefficiencies. The study is designed to collect both objective and subjective statistics before and after the application of four well-defined osteopathic manipulation therapy techniques. Benefits that would arise from multiple treatment sessions are sacrificed in a bid to exclude confounding factors.

The focus is on the intervention of osteopathic manipulation therapy in restoring normal functioning and compliance to the thoracic cage that is objectively measurable. Patients’ reports of asthma symptoms and progressive severity have also been monitored to establish any immediate or future change that can be associated with the therapy. The article also seeks to use thoracic vertebrae articulation to find a statistically viable improvement in hyper-reactivity explainable by the effect of treating viscerosomatic reflex areas and return to normal sympathetic nervous system response. Care should be taken to determine whether this therapy will have adverse effects on the patient.

Methodology Used by the Researchers

The researchers used a pre-test-post-test crossover approach where every patient was treated through osteopathic manipulation procedures in line with sham procedures on different dates at least a week apart. This way the patients would serve as their control. Patients underwent two cycles of the pre-test-intervention-post-test protocol. One of these cycles consisted of four recognized Osteopathic Manipulation procedures that included balanced ligamentous tension in the occipitoatloid and cardiothoracic junctions (Ziment 2008).

The examiner measured thoracic excursion at two different locations in 15 minutes before and after each intervention. This methodology ensured that the patient’s progress was closely monitored. The methodology however leaves a loophole in the sense that the patient’s condition and response to the therapy may fluctuate after some time (Ziment 2008). The environmental conditions such as humidity, temperature and oxygen concentration may also influence the results of this study (Szentivaneji & Goldman 2009).

A handheld peak-flow meter was used to measure and monitor the thoracic excursions and collect the patients’ subjective assessment of symptoms. Information as to whether the patients were going to receive osteopathic manipulation, or a sham was concealed from the examiners by the investigator. For thoracic wall measurements, patients were undressed and instructed to take in full inspiration followed by complete expiration. These points in the human body are hard to spot and will require specialized expertise. This procedure is also prone to error (Guyton & Hall 2009).

The osteopathic manipulation procedures took place in settings similar to those of subjects in the same position on the therapy table. Manual pressure was applied on the thoracic outlet region, the occipitoatloid and cervicothoracic junction and the epigastric region. Upper extremities were circumducted at the shoulder region through a passive motion at a partial range.

The researchers in this article chose to recruit patients from Brooklyn, New York. This was because patients from this population were likely to be familiar with osteopathic manipulation therapy. They held a belief that previously treated patients would be able to recognize sham procedures. This selection method is however not completely effective since there is a possibility that some of the patients may not have undertaken osteopathic manipulation therapy (Ziment 2008). Primary care physicians from community-based clinics were requested to recruit and refer all asthma patients who had attained the age of 18 diagnosed through their history and physical examination (Bockenhauer et al. 2002).

Those patients found to have had a change in asthma medication in the past 4 weeks, concomitant diagnosis of congestive heart failure, cancer, cirrhosis, renal failure and expectant mothers were however excluded from the research since it was believed that they were likely to face complications that would confound data. Ten eligible individuals were used in the research. The patients volunteered to participate in the research and signed a consent agreement. It is however hard to establish this since patients are vulnerable and can be easily manipulated (Ziment 2008).

Results

After carefully administering osteopathic manipulation therapy, no complications were recorded. Some patients reported having felt relaxed after both osteopathic manipulation and sham procedures. Two of the patients reported light-headedness after osteopathic manipulation. However, complications might arise days or even months after administering osteopathic manipulation procedures. The patient’s reaction should be monitored closely over a long period to ascertain that the patient has been fully treated.

Patients showed increased respiration motions after undergoing osteopathic manipulation procedures as compared to sham procedures. Upper thoracic excursion significantly increased with osteopathic manipulation while no increase was noted on the application of sham procedures. This is evidence that osteopathic procedures are more reliable than sham procedures. It is however hard to tell how long these effects will last. Repeated administration of these procedures would mean extra costs being incurred by the patient.

Subjects reported improved ease in breathing after receiving both osteopathic manipulation and sham procedures. The difference between the two was of no statistical significance. Ease in breathing is also a feeling hence not tangible. This implies that improved breathing cannot be used as a measure of osteopathic manipulation’s success.

Conclusion

Osteopathic manipulation procedures showed desirable results on patients. Such results included improved ease of breathing, increased respiratory motion and reduced complications. As a result of this, osteopathic manipulation procedures are preferable as compared to sham procedures. Focus however must be put on the availability of these services. It is also not surprising that these services are expensive and out of reach of low and middle-income patients.

Literature Review

The study reported in this article seeks to test the hypothesis that osteopathic manipulation procedure is a viable treatment for asthma patients. Osteopathic manipulation therapy aims to affect therapeutic responses through three distinct physiological mechanisms. At first, physicians attempt to restore full compliance to the thoracic cage aimed at increasing the patient’s respiratory motion. Asthma patients suffer from respiratory exacerbation resulting in overuse injury to the respiratory system. Osteopathic manipulation helps release such strains (Szentivaneji & Goldman 2009).

The second physiological mechanism intends to affect the response of the patient autonomic nervous system function. Study shows branches of the nervus vagus provides parasympathetic intervention to pulmonary structures and diaphragm. Though considered helpful, these procedures are not present in many developing countries and are limited to the privileged few.

Finally, osteopathic manipulation can facilitate lymphatic flow to and from the bronchus. Tissues at times become oedematous and metabolic waste accumulates when the lymphatic flow is inhibited. This adversely affects cellular functions causing diseases. Osteopathic Manipulation Therapy can be used to release strains in the myofascial and lymphatic vessels.

Despite the numerous benefits associated with osteopathic manipulation, this form of therapy also has some shortcomings. Some measures of the therapy’s success are not quantifiable. Some patients reportedly feel lightheaded after therapy. It is however not possible to tell how lightheaded one feels. This makes one question the success of the therapy.

Osteopathic manipulation therapy is also not very popular, especially in developing countries. Therapy can only be fully adopted as a success if it has been widely tested and proven to produce consistent results. Many costly activities are also involved making the service unaffordable to many. This therapy should thus be offered widely to win over people’s support.

Clinical Relevance

Osteopathic manipulation therapy is gaining popularity among members of society especially in European countries and the United States. Research has shown that this therapy is complication-free and can help treat respiratory disorders such as asthma. Although used on small scale, osteopathic manipulation has shown great potential and can turn out to be a preferable treatment for such ailments.

References

Bockenhauer, S et al. 2002, “Quantifiable effects of osteopathic manipulative techniques on patients with chronic asthma”, JAOA, vol. 102 no. 7, pp. 371-375.

Guyton, H & Hall, G 2009, Medical physiology, Free Press, New York.

Szentivaneji, A & Goldman, A 2009, Vagotonia and bronchial asthma, Thomas Learning, South Carolina.

Ziment, I 2008, Alternative therapies for asthma, Free Press, New York.

Case Study

Roger Nowak is a 76-year old Caucasian man, presenting to the hospital’s emergency care unit with complaints, chief of which is Shortness of breath, and body weakness. Roger is reportedly an alcoholic, with a bleeding GI and a loss in kidney functions, presented in anemia. Roger has a past medical history of diabetes, hypertension, gastroesophageal reflux disease (GERD), and hyperlipidemia, and is currently on medication including Metformin, Victoza, Lisinopril, atorvastatin, aspirin, prilosec, and pepto Bismol as needed. Upon further assessment and analysis of results, the patient is found to have a reduced hemoglobin count as well as MCV counts, which might have developed the inability to breath, and general body weakness, and anemia.

Diagnosis

The patient is diagnosed with shortness of breath with weakness in asthma.

Etiology of Shortness of Breath in the Patient

Shortness of breath(SOB) can be caused by many, though most of the Shortness of breath results from cardiovascular and lung conditions, as the main organs involved in the transfer of oxygen to various body tissues while eliminating carbon dioxide (Nair et al., 2017). Shortness of breath can, therefore, be either be chronic from cases such as Asthma or acute from cases instances as COVID-19, Asthma, or as a result of blockages in the breathing system (Azer, 2020). Because As Rogers presents with hyperlipidemia, diabetes, and hypertension, the shortness of breath experienced might have resulted from pulmonary hypertension. This is because pulmonary hypertension affects an individual by limiting the supply of oxygenated blood to the lungs and can cause serious challenges, including heart failure or death. The shortness of breath is known to be a primary cause of Asthma, whereas the asthmatic state of an individual also has the capabilities of influencing shortness of breath as a result of the lung irritations associated with asthma (Anzueto & Miravitlles, 2017).The patients inability to breath properly has further affected the Red blood cells production, given the the oxygen supply to the body has reduced remarkably, thus preventing the full production of red blood cells in the body.

Pathophysiology of SOB

Several reasons come in to invoke changes in an individuals breathing system, as a result of an allergic reaction, or due to a developing or an acute attack to the breathing system. According to Azer, (2020) Asthma presents in airway inflammation, hyper-responsiveness, and increased release of mucous leading to the blockage of the bronchial tubes, thus obstructs airflow to the lungs, causing shortness of breath. Hypertension causes inflation in the respiratory system, straining the respiratory muscles which then becomes shorter thus leading into Shortness of breath (Anzueto & Miravitlles, 2017). According to Anzueto and Miravitlles, (2017), hyperinflation of the respiratory muscles causes the radius of the diaphragm to increase the respiratory motor output leading to Shortness of breath. This process may happen either as an acute or as a chronic manner thus influencing the actions of the lungs to negatively affect health.

Diagnostic tests for SOB

The patient would need to undergo a series of tests, including a chest X-ray or a CT scan, and undertake a lung functions test or an echocardiogram.

Management of SOB

The management of shortness of breath is likely to lean towards managing the asthmatic state through the use of both pharmacological, and on-pharmacological mechanisms. Behavior Change modification is one non-pharmacological angle of consideration aimed at controlling tobacco smoking and a change in dietary practices by reducing the consumption of foods with low-density lipoproteins food sources. However, behavior change modification must be coupled with medication treatment to deliver desirable results. The management must also focus on changing the patients anemic state, by increasing the rate of oxygen supply to the lungs.

Conclusion

Rogers’s condition is highly manageable despite being surrounded by many comorbid conditions such as hypertension, diabetes, and anemia. Prompt treatment and adherence to treatment regimen will go a long way in addressing the situation to correct the negative effects of the disease. Body weakness can be corrected by the management of the anemic condition through the restoration of the hemoglobin counts.

Questions

1. What diseases are affecting Roger’s kidney functions? How do you know his kidney function has decreased?
   1. Rogers kidney functions are being affected by the anemic condition, in reduced red blood cell production. The reduction of Roger’s kidney functions is evidently shown by the reduced glomeruli filtration rate, with creatinine levels at 1.4 units.
2. How is Roger’s kidney disease affecting his RBC production?
   1. In chronic kidney disease, the production of erythropoietin is altered and the restriction of iron absorption by hepcidin-mediated limitations affects the red blood cells production, thus limitng iron absorption and realising stored iron from the body, leading to anemia.
3. How is Roger’s chronic alcohol use affecting his anaemia?
   1. Alcohol consumption deteriorates the liver functions through progressive damages leading to the inflammation of the liver or causing liver cirrhosis. The liver is the main organ in the production of iron, therefore a damaged liver means decreased iron production, which results in anemia. Alcohol increases the rates of hemolysis, therefore leading to the development of anemia in kidney patients.
4. What are some of the possible things that could be causing Roger’s GI bleed, especially if he is drinking daily?
   1. With progressive alcohol consumption, the liver is continually damaged, leading to impaired platelet functions, thus triggering the possibilities of hemorrhage, including GI bleeding.
5. Explain how the SOB and weakness are explained by Roger’s condition
   1. Shortness of breath is a probable case in Roger’s scenario that is likely to have developed as a result of the proportionate destruction of red blood cells leading to anemia. In anemia, the oxygen supply throughout the body, which is critically needed for aerobic functions, remains limited. This causes general body weakness, dizziness, and, in some cases, shortness of breath. This was the case with Rogers’ condition.
6. Type the references you used in APA 7^th edition format
   1. Adawy, Z. R., Mohamad-Saleh, R. A., & Ismail, T. A. A. M. (2017). Is bronchial asthma a risk factor for chronic kidney disease?. Al-Azhar Assiut Medical Journal, 15(1), 27.
   2. Atkinson, M. A., & Warady, B. A. (2018). Anemia in chronic kidney disease. Pediatric Nephrology, 33(2), 227-238.
   3. Gkamprela, E., Deutsch, M., & Pectasides, D. (2017). Iron deficiency anemia in chronic liver disease: etiopathogenesis, diagnosis and treatment. Annals of Gastroenterology, 30(4), 405.

References

Anzueto, A., & Miravitlles, M. (2017). Pathophysiology of dyspnea in COPD. Postgraduate Medicine, 129(3), 366-374.

Azer, S. A. (2020). COVID-19: Pathophysiology, diagnosis, complications, and Investigational therapeutics. New Microbes and New Infections, 100738.

Nair, P., Martin, J. G., Cockcroft, D. C., Dolovich, M., Lemiere, C., Boulet, L. P., & O’Byrne, P. M. (2017). Airway hyperresponsiveness in asthma: measurement and clinical relevance. The Journal of Allergy and Clinical Immunology: In Practice, 5(3), 649-659.

Introduction

The scientific method is crucial in providing analytical, sensible, problem-solving criteria across many fields in the biological learning area. For instance, the scientific method can boost a researcher’s knowledge of a disease such as asthma and allergic reaction. The importance of the scientific method relies on the basic steps such as observation, hypothesis formulation, testing of the predictions, drawing conclusions, and refining them. As in the case of asthma and allergic reactions investigations, descriptive studies can be used to describe the nature of the relationship between asthma and asthma attack, therefore explaining the cause and effect. Additionally, the scientific method of descriptive studies involves critical thinking that enables the application of logic to conclude. In consequence, the descriptive studies help in taking the asthmatic studies from the theoretical discipline to a more explicit biological science.

Asthma and asthmatic attack studies are among the most important areas of inquiry in biology. First, when research is conducted on asthma as a subject, people begin to differentiate between the effects of different allergens. More precisely, they realize that the same allergens that give sneezing fits and watery eyes can cause an asthma attack on others. Secondly, the choice to study asthma, and allergic reactions is informed by its ability to assist asthmatic individuals in understanding their triggers and learn how to prevent them in case of an attack. The understanding is important because allergens are everywhere so symptoms of asthma attack manifest after inhalation of allergy triggers such as pollen grains, dust mites, or mold among others. Without a doubt, the educative purpose of the studies on asthma and asthma attacks can reduce the death-related cases, more so in the present COVID-19 period.

Context of the Biological Kingdom

Biology, in itself, is natural science because it deals with the explanation, apprehension, and prediction of the natural phenomenon based on empirical evidence from observation, experimentation. Again, within the natural sciences, biology occupies the fundamental space of life sciences. This is because biological sciences are more concerned with the study of living organisms and their relationship with their environment. Therefore, there exists a relationship between biology and the study of asthma alongside allergic reactions (Mahmoudi, 2017). The relationship is based on the fact that asthma occurs in humans, who are the living organisms studied in biology. A characteristic such as response to stimuli is well explained by how the body of a human being will react to allergens hence triggering asthma. Accordingly, the study of asthma is valuable in placing the investigation of allergic reactions in a biological context.

By explaining various reactions of the human body towards certain varieties of allergens, the study of asthma can be placed within the context of the biological sub-branch known as immunobiology. In biological terms, the interactions of antigens with specific antibodies can be used to explain the symptoms that characterize asthmatic attacks (Mahmoudi, 2017). Indeed, the study of antiviral immune response links the exacerbations of asthma attacks to viral infections. Most importantly, two types of immunity are investigated for asthma attacks. The overall response that is always explored includes the combination of innate specific immunities and non-particular immunity (Mahmoudi, 2017). The study of non-specific elements such as phagocytes that surround and destroy viruses that are capable of neutralizing virally-caused asthma shows the existing interdependence between immunology and asthmatic attacks (Mahmoudi, 2017). As evident, immunobiology gives a clear explanation of the response of the human body to certain bacteria that may cause asthma and allergic reactions to humans.

Furthermore, the study of asthma and allergic reactions can be studied from the context of pathology, which is a biological sub-branch. Through pathology, a researcher can study the nature of asthma, its causes, and its effects. Notably, the asthmatic condition is referred to as fatal when the airways are occluded are by tenacious plugs of exudate, mucus, and cells (Mahmoudi, 2017). In this particular case, there is the fragility of the airway surface epithelium and the thickening of the nasal cavity wall. Other natures of the respiratory system that have been affected by asthma which is explained using pathology include bronchial vessel dilation, intense inflammatory cell infiltrate, and enlargement of the mass of bronchial smooth muscle among others (Mahmoudi, 2017). In essence, the symptoms that are associated with asthmatic attacks are better understood from the pathological context.

To reduce the number of deaths that are associated with asthmatic attacks, researchers have identified different ways to control asthma. It means that for those who are studying medical biology, asthma provides a rich area of study especially in aspects such as prevention, cure, and alleviation. In as much as extensive research studies have established proper medication for asthma, the main concern has been to stop the asthma attacks before they start (Mahmoudi, 2017). Also included as part of the measure of controlling asthma is learning to recognize triggers and then avoiding them. In case of an asthma flare-up, medical specialists have recommended the usage of quick-relief inhalers (Mahmoudi, 2017). Therefore, the topic of medicine as studied under biology is key in providing an insightful understanding of the cure and control to asthma.

Asthma and Allergic Reactions

Like any other disease, asthma is characterized by several symptoms. Most commonly, asthma is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes (Mahmoudi, 2017). Asthmatic patients experience coughing, especially at night, wheezing sound when breathing, and shortness of breath, chest tightness, pain, or pressure (Mahmoudi, 2017). However, not every patient has the same symptoms in the same way. Illustratively, a person may not exhibit all the symptoms and may have varied signs at different times. Some asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another (Mahmoudi, 2017). In fact, some people with asthma may go for prolonged periods without showing any signs, interrupted by periodic worsening of their symptoms called asthma attacks (Mahmoudi, 2017). Clearly, the difference between asthma and asthma attacks lies in the occurrence of the symptoms which are sometimes known as the attacks.

Being a respiratory disease, asthma is associated with numerous types of triggers that cause the symptoms. The types of triggers that are known include tobacco smoke, dust mites, outdoor air pollution, pests such as cockroaches and mice, pets, mold, and some disinfectants (Mahmoudi, 2017). Apart from the types of triggers, an asthmatic individual needs to know the treatment options that are always available for each specific case. The available treatment options include long-term asthma control medications, quick-relief drugs, medications for allergy-induced asthma, and biologics (Mahmoudi, 2017). There exist behavioral interventions that can help during asthma attacks even without an inhaler. A good example is to ensure that there is enough airflow around the asthmatic individual in case of an attack (Mahmoudi, 2017). It is important to note that that the best way to control asthma is always to ensure that the types of triggers are always avoided.

The study of asthma and asthma attack is quite appealing for many reasons that every biologist cannot fail to appreciate. The study of the topic enables an individual to apply the correct behavioral treatment when treating asthma, especially with other emerging respiratory sicknesses such as Covid-19. The knowledge is only vital to the extent to which an individual understands the immune system’s job of protecting him from bacteria and viruses. Therefore, if an individual has allergies it implies that part of his immune system is overworked when he has an underlying condition such as asthma (Mahmoudi, 2017). Since Covid-19 is a respiratory illness, the persons who are affected most are those with underlying respiratory diseases such as asthmatic patients. As such, to control the Covid-19 among asthmatic patients, one needs to understand the correct treatment technique that applies to his case.

Another reason why the study of asthma is compelling is that it enables a researcher to relish how the body reacts to allergens and this helps in alleviating worries about the illness. More specifically, this is to say that the body produces some chemicals known as antibodies whenever they meet an allergen (Mahmoudi, 2017). The antibodies cause the release of chemicals such as histamine that causes swelling and inflammation (Mahmoudi, 2017). Consequently, the signs of running nose, itchy eyes, and sneezing are witnessed as the body tries to rid itself of the allergen (Mahmoudi, 2017). This is a mechanism that some biologists have referred to as innate control of allergens. As a matter of fact, the study of asthma and asthma attacks helps in boosting confidence even among the patients who have the disease.

Conclusion

Every disease-causing organism undergoes various changes that affect the DNA structure over time. It brings no doubt that there will be transformations to disease-causing bacteria of asthma and asthmatic attack. In consequence, there will also be some changes to the management and control of the disease as will be directed by epidemiologists after a decade from the present time. Notably, the rate of asthma prevalence in the world will increase multiple folds with the rate of urbanization. This condition will be created by urbanization which is currently on the rise because the growth of cities and major towns are to blame for some of the allergens such as industrial smoke. Also, due to increased scientific research and technological advancement, after a decade, more drugs will be available for control and treatment of asthma and allergic reactions. The same way pharmacists worked to invent a drug known as Xolair based on the structure of Immunoglobulin E (IgE) protein it will also force them to create a more powerful drug for asthma. Intrinsically, epidemiologists’ work in controlling the extensiveness of asthma will depend on their improvements to the current medications.

For the fight against asthma to be realized in the entire world and by the individual governments for the future, some necessary accomplishments need to be effected. Firstly, it will be of utmost importance for governments to create foundations that support researches on asthma and other allergy-related infections within their jurisdictions. For instance, they can emulate the US, which has established the American Asthma Foundation which is an organization that supports innovative research on asthma through grants. Through the initiatives, the researchers will be motivated to upscale their investigations to ensure the rising cases of asthma will be reduced. Secondly, it will be requisite for the world nations to enjoin in creating more agencies that support the World Health Organization mission and programs that are aimed at reducing the occurrence of asthma in the world populace. A good example that should be replicated in the world is the Global Alliance against Chronic Respiratory Diseases (GARD). The alliance’s mandate is to prevent and control breathing diseases. In essence, governments all over the world have a greater role to play in the control of asthma in the next decade.

To fully understand asthma and allergic reactions, there are several steps in the scientific method that a biologist needs to follow. One key step is the observation of the symptoms of asthma from the patients. Observation of the signs will make the researcher establish the visible asthma signs with those that are already written by other scientists. From the observations, the researcher can formulate a hypothesis on asthma and allergies. For instance, a researcher can create a hypothesis of whether there exists a relationship between asthma and allergic reactions. After the postulation, the scientist will then devise an experiment to test the data from the observations which had been already made about the symptoms of asthma. Strikingly, if there is no valuable data that has been collected, then the researcher has to identify asthmatic individuals from which information is obtained. In the end, the researcher will refute or support his hypothesis based on the data which has been collected. Distinctively, the steps act as the guide to a complete understanding of the relationship between asthma and allergic reactions.

Reference

Mahmoudi, M. (2017). Allergy and asthma made ridiculously simple. MedMaster Publishers.

Introduction

Asthma, being a complex and long-term disease that affects the lung airways, is a common health condition in the US that can be diagnosed at any age. According to the Asthma and Allergy Foundation of America (AAFA, 2022), some of the most common symptoms of asthma include cough, wheezing, shortness of breath, chest tightness, and fainting. Thus, when the patient is complaining about such symptoms, it is rather challenging to diagnose them with asthma, as the symptoms are generic and can be applied to other health conditions.

Main body

In order to confirm or eliminate asthma, the patient is appointed a series of medical work-up procedures. According to Backer et al. (2018), they include spirometry, bronchodilator reversibility test, bronchial challenge test, and peak expiratory flow rate. Spirometry, one of the most common work-up procedures, stands for the process of checking one’s lung capability by measuring how much air the patient can breathe out in a forced breath (National Health Service, 2021). The bronchial challenge test is aimed at checking asthma by asking the patient to breathe in methacholine. If the lungs narrow when taking a breath, asthma is identified (Backer et al., 2019). The bronchodilator reversibility test measures one’s lung function after taking bronchodilator medication with the help of an inhaler. Hence, all work-up tests are designed to measure lung capacity and identify whether there are any obstructions in the respiratory process.

The asthma diagnostic is a challenging endeavor due to the fact that asthma can be confused with another pulmonary disease. Thus, some of the most common health conditions misdiagnosed with asthma include emphysema, vocal cord dysfunction, chronic obstructive pulmonary disease (COPD), and rhinitis. All of these conditions have similar symptoms, such as shortness of breath, dizziness, wheezing, and cough. Yet, they require different treatment and approaches to monitoring. According to Kavanagh et al. (2019), some other differential diagnoses of asthma can include anxiety disorder, cardiac disease, sleep apnea, obesity, bronchiectasis, dysfunctional breathing patterns, and others. Thus, it is necessary to define the tests and diagnostics that help differentiate asthma from other health complications. According to Inserro (2021), pulmonary tests and spirometry are not always reliable when assessing a patient for asthma. Instead, clinicians should be “made through a CT of the chest with dynamic expiratory imaging, and also direct visualization through a dynamic flexible bronchoscopy” (Inserro, 2021, para. 16). Moreover, it is necessary to pay attention to the specifics of the common symptoms by focusing on the intervals between breath shortness attacks and triggers for the attacks. If the results of this screening demonstrate the risk for other pulmonary conditions, additional screenings such as blood tests and cardiograms should be recommended. Moreover, the patient should fill in the questionnaire that unveils their lifestyle and family history in order to understand the potential risks of asthma.

Conclusion

In conclusion, asthma is a highly complex disease that requires both medical intervention and major changes in the person’s lifestyle. Thus, asthma diagnostics should be as accurate as possible to make sure that the disease is addressed promptly. However, due to the lack of screening standards for asthma, the condition is either mistaken for another pulmonary condition or diagnosed as a comorbidity of obesity or cardiac diseases. Hence, there is a strong need for the development of more precise and innovative guidelines for detecting pulmonary disease that affects thousands of Americans annually.

References

Allergy and Asthma Foundation of America. (2022). What are the symptoms of asthma?

Backer, V., Stensen, L., Sverrild, A., Wedge, E., & Porsbjerg, C. (2018). Objective confirmation of asthma diagnosis improves medication adherence. Journal of Asthma, 55(11), 1262-1268.

Inserro, A. (2021). Distinguishing asthma from other pulmonary diseases. AJMC.

Kavanagh, J., Jackson, D. J., & Kent, B. D. (2019). Over-and under-diagnosis in asthma. Breathe, 15(1), 20-27.

National Health Service. (2021). Spirometry.

Asthma, being a long-term medical condition triggered by various factors, has several approaches to treatment. Practitioners distinguish three major asthma action plans: green zone, yellow zone, and red zone (Centers for Disease Control and Prevention [CDC], 2022). In a green zone, a person with diagnosed asthma has no coughing, wheezing, shortness of breath, or other manifestations of asthma attacks. However, in order to limit susceptibility to the triggers, the patient is advised to take long-term asthma medications on a daily basis. These medications include inhaled corticosteroids such as fluticasone propionate, budesonide, beclomethasone, and fluticasone furoate (Amin et al., 2020). Once the patient feels a sudden deterioration of their condition, feeling coughing attacks and shortness of breath, the action plan moves to the yellow zone. In this zone, apart from the aforementioned long-term medications, individuals are prescribed quick-relief medications and oral corticosteroids if necessary. Quick-relief medications for asthma include short-acting β agonists and bronchodilators (Farag et al., 2018). These medications are supposed to act promptly so that patients can return to their daily lives.

However, if quick-relief medications do not alleviate the attack, severe symptoms emergency is detected, and the patient might require a clinical emergency. After spending more than 24 hours in the yellow zone without any improvements, the patient is advised to take quick-relief medication and oral steroids and contact the practitioner immediately after (CDC, 2022). Apart from the calculated asthma action plan, the treatment plan should also include education on avoiding potential triggers, antiallergen treatment, and attack prevention guidelines.

Considering the fact that every chronic disease management requires daily intake of medication, compliance with guidelines and adherence to the treatment becomes of utmost importance for the patient. According to George and Bender (2019), the two most efficient strategies for improving therapy adherence are shared decision-making and technology-based interventions. The former implies close collaboration between the physician and the patient in order to choose an optimal medication and inhaler. The latter, on the other hand, promotes self-adherence through technology-based interventions such as reminders, educational resources, and feedback on the patient’s well-being (George & Bender, 2019). Hence, compliance improvement in asthma patients is crucial for the treatment plan’s efficacy.

For the therapy to yield beneficial results, patients and families are encouraged to refer to various specialists. Thus, with the help of one’s physician, patients can receive referrals to asthma specialists or support communities that help with disease acceptance and management. For example, if patients have problems with tobacco addiction, weight gain, or severe allergies, they can ask their physicians to refer them to support groups and allergy advisors to minimize the issue’s impact on one’s health (National Health Service, 2019). Moreover, if asthma exacerbation is detected, it is of paramount importance to address specialized asthma care apart from the physician’s management.

Living with asthma can be extremely challenging for the individual, as patients need to come to terms with their chronic condition and the need for a significant lifestyle change. Thus, in order to minimize the stressful implications for the patients, it is necessary to find a support group to address one’s feelings and anxiety. A solid support system for asthma patients includes family, friends, practitioners, and other patients who understand exactly what a person is feeling. For example, the Asthma and Allergy Foundation of America (AAFA, n.d.) presents a map of local asthma support groups where they can find counselors, physicians, and other patients to help them adhere to a new lifestyle. Indeed, early support interventions play a critical role in the overall treatment plan because it outlines the right mindset.

References

Amin, S., Soliman, M., McIvor, A., Cave, A., & Cabrera, C. (2020). Understanding patient perspectives on medication adherence in asthma: A targeted review of qualitative studies.Patient Preference and Adherence, 14, 541. Web.

Asthma and Allergy Foundation of America. (n.d.). Find a local support group. Web.

Centers for Disease Control and Prevention. (2022). Asthma action plans. Web.

Farag, H., Abd El-Wahab, E. W., El-Nimr, N. A., & Saad El-Din, H. A. (2018). Asthma action plan for proactive bronchial asthma self-management in adults: A randomized controlled trial.International Health, 10(6), 502-516. Web.

George, M., & Bender, B. (2019). New insights to improve treatment adherence in asthma and COPD.Patient Preference and Adherence, 13, 1325-1334. Web.

National Health Service. (2019). Other NHS referrals for asthma. Web.

Introduction

Asthma is a respiratory disease that attacks the bronchial tree leading to an inflammatory disorder. The inflammatory disorder occurs in the airways and consequently leads to breathing difficulties. Since its discovery, there has been no successful formulation for a curative drug. However, with the recommendation of physicians, people can learn how to manage the condition and live normally. This paper seeks to discuss the pathophysiology, etiology, diagnosis, clinical manifestations, at-risk populations, and complications of asthma.

Pathophysiology

In normal body functioning, the lungs undergo distension and elastance and, in the process, perform their duties properly. In asthmatic patients, there is inflammation and bronchoconstriction within the bronchial tree, and such changes impact the lungs’ normal functioning (Sinyor & Perez, 2020). The abnormalities in the bronchial tree obstruct normal airflow, introduce strain in breathing, and lead to breathing difficulties (Sinyor & Perez, 2020). In addition to the inflammatory disorder, another feature of asthma pathophysiology is airway hyperresponsiveness, which involves an unusual and enhanced response of constriction in the bronchial tree that is clinically related to a decrease in lung function (Sinyor & Perez, 2020). The pathobiology of asthma remains greatly indeterminate, and its pathophysiology involves abnormalities of the respiratory system organs, including the lungs and the bronchial tree.

Etiology, Risk Factors, and At-risk Populations

Even though there are efforts in research, there is no resource that states the exact cause of asthma. Concerning the etiology of the condition, several factors increase the likelihood of asthma infection amongst people. The risk factors for asthma include genes, the environment, and several host factors. Individuals with a family history of asthma are at risk of asthma development and consequent asthma exacerbations. According to Yang et al. (2017), the cause of asthma is not only an individual’s family history. The increased prevalence of asthma in certain regions with specific environmental triggers is proof that family history is not the sole cause of the disease. The triggers include infection by colds, allergens like pollen, certain medications, especially anti-inflammatory drugs, stress, sudden changes in the weather, and exercise. Additionally, individuals with atopic conditions to triggers like certain foods and eczema are at a higher risk of contracting and developing asthma. Expectant mothers who smoke increase the chances of their babies having asthma symptoms.

Clinical Manifestations

Clinical manifestations of asthma include those that are common during asthma attacks and others involving patterns that propound asthma. According to Quirt et al. (2018), asthma attack symptoms include “wheezing, breathlessness, chest tightness, and coughing” (p. 50). The suggestive patterns that are part of the disease’s clinical manifestations include a norm of the attacks occurring repetitively (episodic), happening and worsening during nighttime, and on exposure to an allergen.

Diagnostic Tests

In addition to clinical manifestation, asthma diagnosis involves communication with the patient and physical examination. There are three tests for asthma that include the FeNO test, spirometry, and the peak-flow test (Kavanagh et al., 2019). The FeNo test consists of the assessment of inflammation in the lungs where a patient breathes into a gadget that measures the level of nitrogen oxide gas. Both spirometry and peak-flow tests involve patients blowing into machines that determine the speed of breathing out. However, spirometry also measures the amount of air that a patient can hold in their lungs.

Complications

Asthma presents complications to the patients that include death, low life quality, and respiratory failure. According to Quirt et al. (2018), the complications include a reduced ability to exercise and sleep deprivation, are life-threatening, and stem from recurrent episodes of asthma exacerbations. Severe asthma exacerbations may involve loss of energy, deep-sucking throat and chest movements, distress, and severe difficulties in breathing. In addition to the need for emergency medical attention, asthma patients are at higher risk of depression that stems from stress and lack of adequate sleep.

References

Kavanagh, J., Jackson, D. J., & Kent, B. D. (2019). Over-and under-diagnosis in asthma. Breathe, 15(1), e20-e27.

Quirt, J., Hildebrand, K., Marza, K., Noya, F., and Kim, H. (2018). Asthma. Allergy, Asthma, and Clinical Immunology. Volume – 14. Web.

Sinyor, B., & Perez, L. C. (2020). Pathophysiology of asthma. StatPearls Publishing. Web.

Yang, I. V., Lozupone, C. A., & Schwartz, D. A. (2017). The environment, epigenome, and asthma. Journal of Allergy and Clinical Immunology, 140(1), 14-23. Web.

Asthma among children of color is a concept that renders profound contrast between rational science and emotional politics across America’s industrialized regions.

Over the decades, communities living near manufacturing plants and major cities experienced an increasing rate of the number of asthmatic children. It is a condition that is mainly caused by exposure to pollutants. A significant percentage of the factories render emission of toxic gases, that is, sulfur dioxide, particulate matter, and ozone. The laborers in the factories comprise individuals from minority ethnic groups who resolve near the factories for convenience in transportation. As a result, the families become exposed to the toxic environmental state leading to elevated cases of the disease among their toddlers (Sze, 2007). The author argues that the emergent health problem is a threat to social growth and development across America since it is rampant within cities and regions such as New York, Williamsburg, West Harlem, and the Bronx. On the one hand, the prevalence of the risk demands attention from the relevant stakeholders and leaders. On the other hand, the matter materialized as a political framework with the establishment of activist groups. Asthma among children of color became the foundational pillar of the interpretation of environmental justice activism based on gender, race, and power struggles.

The increase in asthmatic incidences formed the political structures and mainframes across the American region. In this case, the disease developed into a bureaucratic and doctrinal phenomenon mainly addressed by the communities affected under the spectrum of environmental justice activism (Sze, 2007). Although the prevalence of the issue fosters the necessity to focus on establishing a solution, it is an endeavor that is manipulated by individualistic entities for an optimal benefit such as the attainment of power and influence. On the one hand, the health problem formed the centric foundation of governance in various cities and towns such as New York. On the other hand, the conditioning of the matter to a particular scope hinders the determination of a rational scientific solution to the core issue. It is paramount that administrative constituents focus on the objective view of the concern despite the precautionary perspective to eradicate the hazardous environmental status.

The reading offers a profound issue affecting American society that involves politicizing sensitive matters. Governance plays a significant role in promoting health social-economic growth, and development. Moreover, the rise in the health problem demands the attention of the community and other relevant stakeholders. It is agreeable with the author’s justification regarding the attention of the various institutional entities. Although the sects seek to foster change across the affected areas, it is under the motivation of power and influence. The administration must address the concern under an objective overview that exposure to the toxic chemicals emitted in industries is hazardous. In this case, developing the initiative of environmental justice activism poses a step toward the eradication of the main problem facing the minority groups affected.

Poor living conditions render the unaffordability of health services. Therefore, the prohibition of establishing additional factories due to the provision of employment opportunities to the marginalized population is a contentious construct. A significant percentage of the individuals depend on informal jobs, as a result, reducing the scale of development negatively affects the personnel as a trickle-down effect. It is recommendable that the patrons from different sectors address the medical case of increased asthmatic incidences among children based on sustainable practices to eradicate habitat pollution.

Reference

Sze, J. (2007). Noxious New York: The racial politics of urban health and environmental justice. MIT Press.

Emergency department overcrowding by pediatric patients is an issue that requires an effective solution. Complex and varied reasons cause constant visits that lead to overcrowding. Such factors range from minimal pediatric facilities in the hospitals to minimal access to primary care providers. They also include the influx of fully insured people who require immediate hospital services which results from emergency rooms. Currently, pediatric patients, mainly those looking for primary care services, mostly opt to pursue medical care in the emergency department instead of primary care providers due to inadequate asthma control. There is, therefore, a need to create a sustainable plan to reduce the visits.

Program Value

To resolve the issue, the best evidence-based model is the 5 A’s Behavior Change Model, whose elements include Ask, Advise, Assess, Assist, and Arrange. The model is significant because it will allow clinicians to engage pediatric patients in decision-making and realistic planning concerning their future health status. Medical caregivers can easily involve younger age patients to a minimum of three years in their health assessment process. Compared to other similar models, using the 5A’s makes it possible for such assessment to be carried between the patient and healthcare provider easily.

5A’s program should be scaled up because its model portions, namely, Ask, Advise, and Assess, support in identifying the pediatric patient variables by inquiring about the habits and frequency of behaviors that affect their health. Moreover, it benefits in advising whether the actions have either negative or positive effects on their health. The model also helps assess the patient’s readiness to reduce or quit the harmful manners (Beebe et al., 2019). After the behavior identification and goal setting process, the Assist stage of the model aids the clinicians in providing the necessary interventions.

Scalability

In terms of cost, the program is scaled up to approximately $1,110. The rate will involve 19 Nursing practitioners using 10 minutes of calls under the NP salary of 65 dollars per hour, therefore, totaling 205 dollars. This will be a cost-effective way to help many pediatric patients as compared to the previous methods. The return on the investments will be 5.41 for every 1.00 dollar spent. The process will take at least six months for scaling to be effective. The scaling will also increase awareness for the delayed or problematic outpatient follow-up for primary care. The program will also be scaled up by administering the inhaled corticosteroids from the nurse Emergency Department in the case indicated for symptoms control.

Sustainability

The program has a high potential to be sustainable, with several strategies involved. The medical practitioners involved call the patient they are interested in serving within 24-48 hours of every visit. Therefore, it will be quite possible to add an extra commitment to pediatric asthma follow-up phone calls. Some stakeholders, including Emergency Specialist Physicians Medical Associates, have already shown interest in the program, acknowledging its significance. The sustainability measures taken will be implemented through actively involving the nurse practitioners in the phone call process of communicating with the pediatric patients.

The continuous visits to the emergency department can be effectively solved by practicing the 5A’s program. The program makes it easy for medical caregivers to carry accurate assessments to pediatric patients. The approach has proven to resolve the complex and valid reasons that make pediatric patients constantly visit the emergency departments. The program is easily scalable, and it is also sustainable, making 5A’s the best solution to Child Asthma Emergency Department Visits.

Reference

Beebe, G., Novicevic, M., Popoola, I. T., & Holland, J. J. (2019). Entrepreneurial public leadership: 5A’s framework for wellness promotion. Management Decision.

An 18-years-old adolescent boy was diagnosed with Asthma, which in the recent past has been controlled using a rescue inhaler at a local health facility. The medical team decided that before any nursing plan is put in place for the patient, there must be a comprehensive examination of the boy involving the collection of his subjective and objective data (Kamangar, 2021). To determine the interrelationships of subjective data and objective data, synthesize the data, and identify health priorities for the patient.

Health History

The patient is a Hispanic adolescent boy aged 18 years, weighing 70 kg, 1.76 meters tall, and is a strong member of Jehovah’s witness church. The boy was brought to the hospital because he is asthmatic and the disease keeps on recurring. The patient was looking tired, restless and he was aggravated. The airways were swollen, with contracting muscles. Both the boy and father looked worried about his situation and they seemed to be losing hope in managing the disease. The patients’ father explained that the disease had been controlled in the recent past through the use of an inhaler which has not been effective. The boy and his family suspect that he is suffering frequent asthma attacks due to allergies to cold and dust, however none of his members of the family suffer from asthma. The patient was vaccinated and immunized against polio when he was below 5 years old, and last year against COVID-19. The patient’s skin color was normal, no lesions, no bruises, and no allergic reactions; his hair and nails were in good conditions.

The boy is in the fifth stage of psychological development where he is looking for an identity and sense of being himself. Throughout the interview and from observation, the boy looked sharp, focused, and independent based on some of his responses. He only requires a lot of encouragement and reinforcements from the family and those around him to boost his confidence. Chances are that his disease condition may affect his sense of self-belief because of continuous experience of pain and distress. This may create uncertainty in him, make him feel insecure, confused, and hinder his full development of identity and independence. His family strongly believe in God’s intervention in everything including spiritual healing, and they were not sold to the idea of any man-made or traditional medicine. The boy requires collaborative support, empathy, and counseling from the medics and family members. His family and the community around him including school teachers must take the active role of being his caregivers while at home or in school.

Physical Examination

The patient had ineffective breathing patterns; wheezing sound when breathing out; shortness of breath; and the airway clearance was poor due to bronchospasms, increased pulmonary secretions, or ineffective cough. Inspections of the head, eyes, ears, and the throat showed no problems; thyroid gland and lymph nodes normal. Temperature, pulse rate and blood pressure were normal, mental condition was good, his abdomen was soft, the patient could walk with ease; arteries and veins were functioning normally.

Needs Assessment

Firstly, the patient needs education and counseling on how to keep himself away from asthma triggers. He must be sensitized that asthma is very sensitive and is easily triggered by exposure to cold things, tobacco smoke, dry air, vigorous exercises, upper respiratory infections, and allergens like pollen grain, mold, and dust. Therefore, he should self-manage to always keep far away from these triggers. This is supported by Miller (2020), who said finding out factors that trigger attacks, and avoiding them are important parts of good asthma management. Both the boy and family need psychological therapies to help them moderate their religious beliefs about spiritual healing, which impedes the medication procedures and preventive measures required to manage asthma. Just like Swihart, et al., (2021), observed that the diversity of religion in the world creates challenges for medics to deliver competent medical care.

Continuous exposure to the triggers of asthma, combined with lack of support from both the family, friends, and teachers in school, loneliness, and strong spiritual beliefs, may create doubts in the patient about his condition. This could make him lose hope about managing asthma completely. On the other hand, putting the triggers under control, getting full support and encouragement from the family and school teachers, and incorporating best spiritual practices in his health education will raise his self-belief. It will boost his sense of identity and confidence in the education and management of asthma including following the prescribed medication. The patient will then be assured and positive about the teaching.

Reflection

I introduced myself and had a cordial chat with the patient; this helped to reduce the tension in the room due to worries he had, and build his trust in the process. The interview lasted for 35 minutes; it went on well; the boy was cooperative and independent-minded. There were no communication barriers, or any challenges; nothing went wrong with the approach and the interview; the patient gave out all the information which the interview intended to extract.

References

Kamangar, N. (2021). Health assessment.Health Science Journal. Web.

Miller, R. L. (2020). Patient education: Trigger avoidance in asthma.UpToDate. Web.

Swirhart, D. L., Yarrarapu, N. S., and Martin, R. L. (2021). Cultural religious Competence in clinical practice.NCBI. Web.