ECOLOGIC MODEL I. HYPOTHESIS Asthma is a chronic inflammatory respiratory disorder.

It is commonly results from hyper-responsiveness of the trachea and bronchi to irritants. Inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and cough, especially at night or early in the morning. These asthma episodes are associated with airflow limitation or obstruction that is reversible either spontaneously or with treatment (Hockenberry, 2005) Bronchial asthma is the more correct name for the common form of asthma. Bronchial asthma is usually intrinsic asthma (not allergy related, caused anything except allergy) It may inhalation of cigarette smoke or cleaning agents, chest infection,stress, laughter, exercise, cold air, food preservatives. But it also occasionally caused by a specific allergy which is called extrinsic astma. A foreign particle which enters the body, our immune system over reacts to those often harmless items forming antibodies that defends the body from foreign substances entered. II. PREDISPOSIONG FACTOR

HOST
Age: years old Sex: Female Physiologic: Fatigue due to lack of enough sleep and rest Family history of asthma

AGENT
Viral Respiratory Infections such as Pneumococcus and exposure to allergen

ENVIRONMEN T
Physical Environment: exposure to unhealthy environment because of her occupation Biologic Environment: dense human population, Change in weather

III. ECOLOGIC MODEL

HOST
years old Female Fatigue Family history of asthma

AGENT
Bacteria such as pneumococcus and Allergens

ENVIRONMENT
Exposure to unhealthy occupation environment Dense human population Change in weather

IV. ANALYSIS The agent-host-environment model is primarily used in predicting illness rather than promoting wellness, although identification of risk factors that result from the interaction of agent, host, and environment are helpful in promoting and maintaining health. Because each of the agent-host-environment factors constantly interacts with others, health is an ever changing state. Health is seen when all three elements are in balance while illness is seen when one, two, or all three elements are not in balance. (Kozier and Erbs, Fundamentals of Nursing 8th edition volume 1, Pearson 2008)

Asthma is a complication involving environmental problems. Another factor is exposure to unhealthy environment in her job where transmission of the disease is more likely. In addition to that, the lack of enough sleep, stress and fatigue that she got from her work might contribute as well to her condition. In certain situation, which our client has asthma, it increased the risk to acquire communicable diseases such as pneumonia because her immune system has been impaired. Risk of developing some uncommon types of pneumonia may be increased because the client is exposed to people who are sick such as her officemates and also her father in law, who also have pneumonia. And exposure to allergens such as home factors that can lead to exacerbation include dust, animal danders and molds at any given home. In regards to clients gender, perfumes are common cause of acute attacks in female. And other air pollutants may also damage cilia function, which is a defense against bacteria in the lungs. In the case of the client, another factor to be considered is the genetic factor. Children born to families with history of asthma are more likely to have asthma. In relation to this, they have a history of asthma in her father side. Moreover, her illness might be the effect also of sudden changes of weather in the month of December. Although these are not possible direct causes, but these may lead to the weakening of the patients immune system and thus increasing the susceptibility factor of the patient to the disease. V. CONCLUSION It can be inferred in the statements above that the client is suffering from bronchial asthma in acute exacerbation and community acquired pneumonia, and can be probably be caused by the lowered immune system of the client from the identified predisposing factors. It may have been caused by the clients exposure to unhealthy environment and stressed due to her occupation. VI. RECOMMENDATON This case presentation aims to recommend modification of lifestyle including drinking enough amount of water (at least 8 glasses) a day for water requirement increases because of fever, sweating and increase respiratory rate. Adequate caloric and vitamin (especially Vitamin C) intake are essential since the body serves are rapidly depleted by the increased rate of metabolism due to high body temperature and it also helps to increase the immune system of the client against diseases. Moreover, the client must also avoid factors that could aggravate her condition and the client should take her medications on time because it is essential for the clients wellness. In addition, regular checkups would monitor the patients health condition and would more likely prevent the aggravation of the disease and prevention of further complications.