Running Head: ASTHMA

Asthma

Mrs. Houston

NUR162 Concepts of Nursing

January 11, 2019

Asthma
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Asthma is defined as a chronic respiratory disease that affects the airways due to

inflammation and narrowing of the airways which carries oxygen towards the lungs, and it is

considered to be one the crucial non-communicable disease in the whole world. Asthma results

in causing wheezing on a continuous basis thereby causing coughing, shortness of breath, and

chest tightness. A person suffering from asthma often encounters coughing at night as well as

early in the morning. Asthma uses to hamper people of various ages, and this disease generally

starts from childhood. According to the recent survey, it has been identified that about 334

million people are presently affected due to asthma and about 250,000 deaths occurred by this

particular disease in every year (Asher & Pearce, 2014). Asthma is spreading at a great speed,

and by 2025, about 100 million people will be suffering from that disease.

According to the epidemiology of asthma, it is evident that the prevalence of asthma is

different in different regions of the world because of the occupational, environmental, and

genetic risk factors. Epidemiology deals with the factor regarding how a particular disease is

spreading within a community on a large scale. In the year 1837, Armstrong published a journal

known as "The Practice of Medicine" which suggests that asthma is frequently occurring on men

rather than women and the asthma attacks mainly occur during the cold winter and in the heat of

the summer. Though there has been an epidemiologic history of asthma, still a confusion is

always there related to the prevalence of asthma (Loftus & Wise, 2016).

According to the research, it has been identified that the most crucial risk factor for the

development of asthma is to have a parent with asthma disease. The other risk factors associated

with asthma is having a frequent respiratory infection in children, having several allergic factors,

and exposure to the industrial dust in some workplace. The list of risk factors associated with

asthma are as follows:

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Family background: If the parent of an individual has asthma then that person is about

three to six times more prone towards the development of asthma than those persons who do not

have parent-having asthma.

Allergies: If an individual was having an allergic condition like allergic rhinitis or atopic

dermatitis then it is considered to be a risk factor for the development of asthma (Asher &

Pearce, 2014).

Viral types of respiratory infections: The respiratory issues during the time of infancy and

childhood can result in causing wheezing. If any children were experiencing viral respiratory

infections, then those children are vulnerable to the development of chronic asthma.

Air pollution: In the research, it has been identified that the primary component of smog

known as ozone can increase the risk of asthma. The people living in the urban areas are at

higher risk for the development of asthma.

Smoking: The smoking of cigarettes results in irritating the air passage. The smokers

generally have a risk of developing asthma. If the mother of any child smoke during the time of

pregnancy then that child may likely to have asthma (Asher & Pearce, 2014).

Occupational exposures: If an individual has asthma then that exposure of various

elements present in the workplace can develop asthma symptoms in that person. Exposure to

different specks of dust, molds, and chemical fumes can result in causing asthma.

Obesity: The adults and children with obesity are more vulnerable to asthma. The patients

with obesity require more medications and faces difficulty during the time of controlling asthma.
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According to the current statistics in the United States, it is evident that the number of

people suffering from asthma is going to increase concerning time. In the year 2009, about one

out of twelve people were suffering from asthma. About 53% of the people having asthma had

got asthma attack in the year 2008. In the year 2007, around 3,262 adults and 185 children died

because of an asthma attack. The rate of asthma increased about 50% on the black children

during the year 2001 to 2009 (Akinbami et al., 2017).

Pathophysiology

According to the research, it has been identified that inflammation has the primary role in

the pathophysiology of asthma. From the definition of asthma, it is evident that the airway

inflammation occurs due to the interaction of the multiple mediators and cell types within the

airways that results in bringing the pathophysiological features of asthma. The list of

pathophysiological features of asthma includes airflow limitation and bronchial inflammation

which is followed by shortness of breath, wheeze, and cough. Different phenotypes of asthma are

present that includes aspirin-sensitive, exercise-oriented, persistent, and severe asthma attacks

and in all these types there has been an airway inflammation which follows a consistent pattern

(Education, on the Diagnosis & of Asthma, 2007). The pattern associated with the airway

inflammation in asthma not always depends on the persistence, disease severity, and duration of

the disease. Finally, it has been identified that the response by the structural cells associated with

asthma is consistent in nature.

According to the clinical presentation of asthma, it is evident that the wheezing is caused

due to the airflow turbulence and it is considered to be the most crucial symptoms of asthma.

Asthma also occurs without any wheezing when the obstruction is formed by small airways

(Morris, 2017). In the research, it can be seen that the children having asthma are at higher risk
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for acquiring a progressive disease that results in failure for attaining the lung growth and further

results in functional and clinical impairment. Asthma is regarded as a heterogeneous disorder

that is characterized by wheezing, shortness of breath, cough, bronchial hyper responsiveness

and limitation of reversible airflow. This disease results in causing viral respiratory tract

infections. Children having the persistent wheezing can be diagnosed to have asthma (Szefler et

al., 2014).

Current trends in treatment

According to the research, it has been identified that the prevalence of asthma is

increasing on a large scale and for that reason, there has been a continuous requirement of

improved therapies for curing the disease. Proper diagnosis of asthma can be done with

appropriate kind of treatment plan. There are four cornerstones for the treatment of asthma

includes allergen immunotherapy, measures for triggers avoidance, symptomatic treatment,

education of the patient. According to the current trends in asthma treatment, it is evident that the

pharmacotherapy is considered to be effective for controlling the symptoms that are caused due

to the allergic diseases. It has also been noted that the withdrawal of medication may cause the

reappearance of the allergic symptoms within a very short period of time (El-Qutob, 2014). The

allergen-specific immunotherapy is considered to be the only etiologic treatment of any allergic

diseases such as asthma and which results in alteration of the natural course of the disease.

Researches have proved that the specific immunotherapy is effective only during the time of

extrinsic asthma.

During the research, it has been analyzed that the management of asthma depends upon

the utilization of medication for reversing the bronchial obstruction and elimination of the airway

inflammation. Any kind of uncontrolled inflammation can result in structural changes of the air
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passages, and the process is known as remodeling. This process results in fixed airflow

obstruction thereby hampering the clinical results. The main goal of asthma treatment is

considered to be the long-term controlling of that chronic disease that includes curing of

exercise-oriented asthma and nocturnal symptoms.

According to the pathogenic point of the view, it is evident that asthma can be treated by

fixing various kinds of targets. Corticosteroids are considered to be the anti-inflammatories that

help in reducing inflammatory cells present in the airways thereby preventing the blood vessels

from any fluid leakage within the airway tissues. Moreover, Omalizumab is considered to be an

anti-IgE monoclonal antibody which is an improved therapy for controlling any severe allergic

asthma (El-Qutob, 2014).

Cultural Sensitive Care

The Cultural Sensitive Care plays an important role in diagnosis and treatment of Asthma

in the American culture. Discrimination is considered as a primary issue in the sensitive care,

where the White Americans are entitled to some distinguishable features than the Native

Americans and Hispanic Community people. The Native Americans are sometimes got deprived

of getting the benefit of the insurance policy, but the State Child Health Insurance Program

(SCHIP), is a key player in offering the best health insurance facility to the children of the

United States. In spite of that, there are approximately 6% children suffering from asthma, are

still out of the health insurance program. The people who are not entitled to the insurance

service, are reported as the financially incapable of affording the expenses of the treatment of

asthma, and they even are not able to purchase the medicine for treatment.
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In American culture, the Native Americans or the Negros are entitled to the private

healthcare system, where the pattern of the health care is not so good as compared to the other

quality insurance services (Moghaddam, Momper & Fong, 2015). But as a whole, it can be said

that the medical system of the United States significantly focus upon countering asthma as the

disease is becoming a concerned issue in the country and for that reason, advanced healthcare

facilities are being incorporated in the treatment for asthma. The medical experts and the

scientists have invented different kinds of modern therapy against asthma, and along with it, the

government has also introduced the asthma self-management education. In this type of education

system the children, students, adults are given the functional aspects of asthma, and they are

guided by the absolute measure for not being infected with the disease. The determining of the

symptoms followed by the major syndrome for asthma, necessary medicines, and health care are

explained in the self-management system of asthma. The government of the United States

supervises the asthma treatment across the country through Centers for Disease Control (CDC).

According to the report of the organization the medical system of the country has come

across that irrespective of the race and community all the children and the people infected by

asthma, have been given as the best strategy to counter the disease for getting the ultimate cure.

The patient and their relatives are given the best possible lectures on the effects of asthma and

how to minimize the disease to some great extent (Moghaddam, Momper & Fong, 2015).

In Japan, the percentage of asthma affected patient has been increased since many years,

and people of the country are much concerned about this issue. The Japanese culture is

considered as a motivational culture for countering this disease, because in this disease the

respiratory system and the pulmonary activities of the lungs, are getting suffered because there

are many foreign particles that infect the trachea through which the pure air enters into the lungs.
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But it is a positive sign in the medical system of Japan, which the percentage of a patient dying

from asthma has been decreased to some great extent and it happens because the advanced

medical system that has been incorporated in Japan (Horikawa et al., 2014).

The main asset of getting the best treatment of asthma and the other serious diseases is

the healthy relationship between the doctor and the patient. This is achieved by establishing the

connection and the communication between the doctor and the patient; this leads to the mental

strength of the patient and his relatives. In Japanese culture, various therapies are utilized for

determining the curing of asthma, and this is done with the help of some therapeutic agents

which are used to diagnose asthma by determining the syndrome and after that the probable

reasons of the disease are removed, which leads to minimizing the risk factor of the disease

effectively. In case of the children and the minors, the Government of Japan follows specific

guideline in determining asthma and treatment, and it has been evident that in most of the case

the diagnosis of the disease in early stage is given the most preference and it is followed by

applying medicine to the patients at the primary stage. The syndrome of the disease is also given

high focus because studying the syndrome is an important thing to provide the best possible

treatment to the patients. Apart from that the patients especially the children are taken for a

regular routine check-up after they have been suffered from the disease since a particular time

because this is an important step in the medical care of Japan (Horikawa et al., 2014).

In asthma, an inflammation occurs in the respiratory system, where the whole respiratory

system is affected with severe damage in the lungs, and along with this coughing, chest pain and

the breathing problem are the main irritating syndrome. All the syndromes are experienced

during the mid-night or during the morning time. This case study is involved with a patient who

had been suffered from bronchial asthma for some years, and he had been taken to the hospital.
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Various laboratory activities have been performed in the analysis the disease of the person. One

of the main objectives of doing the laboratory work is calculating the Complete Blood Count.

Based upon the result of the test it has been determined that the Lymphocytes, the necessary

component of blood had been reduced in the early stage when the bacterial infection has

happened. After that, a Drug study has been made where Salbutamol had been applied to the

patient, but in this case, no adverse reaction has been experienced. In this test, the function of the

cardio-respiratory system has been analyzed to determine the effect of bronchial asthma (Sharpe

et al., 2015).

Nursing diagnosis

Unproductive Clearance of Airway: It is one of the primary diagnosis in nursing of

asthma. The syndrome leads to the secretion of the antibody inside the body at an extreme level,

and for that reason, the trachea of the respiratory system gets blocked, and hence the passing of

the air is hampered inside the lungs. As a result, a huge amount of mucus is formed inside the

throat, which is an irritable thing for the patient and most of the time coughing is common

(Doenges, Moorhouse & Murr, 2016).

Improper Breathing: In this diagnosis, it has been determined that because of the forming

the mucus in the excess level, the patient has the problem of breathing that leads to the anxiety of

the patient (Doenges, Moorhouse & Murr, 2016).

Allergic reaction: This is an important diagnosis because there are several sources for

being attacked by the allergic symptoms like seasonal changes, pollen grains, animal furs, etc.

Nursing goal
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To provide the best effective treatment to the patient to counter the infection of asthma to

the patient and this will be accompanied by the medical professionals.

To carry out the important medical test to determine asthma (Baldassano & Mack, 2016).

Nursing Interventions

Helping the patient to extract the mucus.

Motivating the patient to take breathe effectively.

Explaining the symptoms of the infections (Baldassano & Mack, 2016).

Supervising the vigorous sign of the patient.

Assisting the patient to raise his head.

Ensuring proper diet.

Making the atmosphere clean (Baldassano & Mack, 2016).

Keeping the patient away from animal contamination.

Keeping the room hygienic.

Conclusion

The Nursing Strategy for Asthma is very important from the point of view of both the

patient and the disease itself. Proper care is required to be taken for the patient of asthma. One

more thing is needed to be kept in mind is that asthma is contaminated with air or water. So it

must be remembered that the patient of asthma should be kept isolated in a place so that other

patients will not be infected by him, especially the children should be kept away from the asthma

patients because the immune system of children is not much developed at their age, which is a
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critical issue. In all over the world, the disease has been analyzed with high sincerity and

scientist, and the doctors are giving their hard efforts in countering the disease efficiently.

References

Akinbami, L. J., Rossen, L. M., Fakhouri, T. H. I., & Fryar, C. D. (2017). Asthma

prevalence trends by weight status among US children aged 2–19 years, 1988–2014. Pediatric

obesity.
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Asher, I., & Pearce, N. (2014). Global burden of asthma among children. The

international journal of tuberculosis and lung disease, 18(11), 1269-1278.

Asthma Statistics. Retrieved from: http://www.aaaai.org/about-aaaai/newsroom/asthma-

statistics

Baldassano, A. A., & Mack, J. (2016). Asthma Control Screening Using the Electronic

Health Record.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nursing diagnosis manual:

Planning, individualizing, and documenting client care. FA Davis.

Education, N. A., on the Diagnosis, T. E. P., & of Asthma, M. (2007). Section 2,

Definition, Pathophysiology and Pathogenesis of Asthma, and Natural History of Asthma.

El-Qutob, D. (2014). New Trends in Asthma Treatment.

Horikawa, Y. T., Udaka, T. Y., Crow, J. K., Takayama, J. I., & Stein, M. T. (2014).

Anxiety associated with asthma exacerbations and overuse of medication: the role of cultural

competency. Journal of Developmental & Behavioral Pediatrics, 35(2), 154-157.

Loftus, P. A., & Wise, S. K. (2016). Epidemiology of asthma. Current opinion in

otolaryngology & head and neck surgery, 24(3), 245-249.

Moghaddam, J. F., Momper, S. L., & Fong, T. W. (2015). Crystalizing the role of

traditional healing in an urban Native American health center. Community mental health journal,

51(3), 305-314.

Morris, M.J., (2017). Asthma Clinical Presentation. Retrieved from:

https://emedicine.medscape.com/article/296301-clinical
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Sharpe, R. A., Bearman, N., Thornton, C. R., Husk, K., & Osborne, N. J. (2015). Indoor

fungal diversity and asthma: a meta-analysis and systematic review of risk factors. Journal of

Allergy and Clinical Immunology, 135(1), 110-122.

Szefler, S. J., Chmiel, J. F., Fitzpatrick, A. M., Giacoia, G., Green, T. P., Jackson, D. J.,

... & Raissy, H. H. (2014). Asthma across the ages: knowledge gaps in childhood asthma. Journal

of Allergy and Clinical Immunology, 133(1), 3-13.