Nursing Management Assignment writing help analysis on: Asthma & Its prevention in future aspects
Asthma
Introduction
Scientists have been working to make the earth free from all diseases from the time which cannot be collected in the memory of the mankind. Unfortunately the objective is still very far away from even beginning stage. Among many dangerous diseases present in this universe, Asthma is one of the major health related problem which can be found in large scale in the society. Be it an adult or a child, this disease has not left any age or gender untouched from its impact (Langenfeld, Bonaiuto & Edmonds 2006). If researchers are to be believed, there are some particular conditions which relate to this disease, however the patterns in which it is present in different people may vary from individual to individual (Levy, Weller & Hilton 2006).
There are various studies which suggest that development of asthma in a human body depends largely on the conditions of lungs present in that body (Koenig & Chesla 2004). It is very important for an individual to acquire knowledge regarding the measures that can help him/ her in preventing asthma once the symptoms of the same are seen in the body (Barnes, Peter & Godfrey 2000). According to Goroll and Mulley (2009), knowledge of preventive measures make sufferers as well as society as a whole more active about a disease and they can then fight against it actively.
There are numerous myths that have been produced with regard to the causes, prevention and treatment of asthma. Tremendous myths related to causes, prevention and treatments related to asthma are there, few of them are so misguiding that they may make the condition of a person highly aggravated as far as asthmatic problem is concerned (Lieberman 1999). Looking at the speed with which number of cases of asthma are increasing in the world at large, educating and enlightening people about the symptoms of asthma and preventive measures that can curtail the development of asthma has become very necessary (Platts-Mills 1999).
What is Asthma
Asthma can be explained as a ruinous conditions which deprave the respiratory system in a human body. A person who is suffering from asthma faces problem in breathing whenever they come in contact with some factors which they are allergic to (Adams 2006).When a person, who is suffering from asthma is contacted with the substances which create irritation in his/her respiratory system their muscle surrounding the respiratory area gets tighten as a result the airways contracts and makes a person uneasy (Levy, Weller & Hilton 2006). Another aspect that also occurs is that the sticky mucus also get increased and thus normal breathing becomes very difficult for a person
Asthma can be of different type. For example Asthma which happens because of substances present in environment such as dust and pollution; Asthma which gets aggravated because of nature of work for example a person working in a coal mine gets asthma because of fumes present around the work area. In case of work-aggravated asthma, most of the time it has been observed the problem already exist in a person but get worsened because of exposure to certail elements such as chemicals, flames, dust etc. Then there is “Occupation Asthma” which gets triggered in a human body because of its exposure to certain substances present at work. Some nurses for instance may develop occupational asthma as a result of exposure to latex (Lieberman 1999).
History of our understanding of asthma
The problem of Asthma in human body is not a recent one but is present in the society from past many centuries (Braman 2006). It is a major challenge for a person suffering from asthma as well as professionals from healthcare stream to manage the problem of asthma. If some studies are to be believed, curing Asthma is next to impossible (Lugogo & MacIntyre 2008). According to health practitioners, it is very essential and important for people suffering from this disease to avoid any type of contact with substances and conditions which can trigger the allergies in their system (Lugogo & MacIntyre 2008). One of the best way by which a person can manage this disease is by avoiding all possible triggers that can exaggerate this problem (Langenfeld, Bonaiuto & Edmonds 2006).
Epidemiology of asthma
children who are exposed to trigger factors such as cigarette smoke and also among children who are born with low birth weight poses the maximum risk of getting this disease (Platts-Mills 1999). A geographical comparison reveals that, children of African Americal origin are more prone to this problem in comparison to children from other communities. Children belonging to families which are unstable economically also poses high risk of developing asthma as it is little difficult for their families to provide them proper medical care because of their limited financial resources (Brown 2003). It has also been observed that the chances of having asthma in children where parents are already suffering from this disease is very high in comparison to those children who are borne to parents where traits of asthma is not present (Behera, 2005). Weight of a human body also has direct co-relation with asthma. The probability of getting asthma in an adults who is overweight is very high in comparison to an adult who has normal weight (Lugogo & MacIntyre 2008).
Prevalence of asthma
In past two decades there has been a substantial increase in the number of cases of asthma (Levy, Weller & Hilton 2006). Most of these cases has been found in children, especially in United Kingdom and United States and other western countries. Factors, substances, environment and surroundings with which a fetal is exposed when it is inside the womb and during early childhood period plays an important role in the development of an immune system in a human body. Changes in the nature of exposures to a variety of factors can be attributed for the increasing cases of asthma in children of developed and developing countries (Peacock 2000). A research also shows that the level of allergy to foreign matter in a human body, which is genetically weak and where immune system is not strong, is very high.
Worldwide
An estimate shows that throughout the whole world there are around 300 million people who are suffering from asthma. Out of these 300 million cases, United Kingdom alone account for 13% cases. Though, none of the age bracket has remained unaffected by this disease, still the number of cases found in children are maximum in comparison to any other age bracket (Braman 2006). In United Kingdom only, it has been estimated that there are more than 6 million children where the symptoms of this life taking disease are present. People suffering from asthma in United States comprise of around seven percent of the total population. In a year, almost 250000 people die because of asthma globally, out of these 250000 deaths, around 4200 death cases occur in United Kingdom alone (Peacock 2000).
Australia
If an estimate is to be believed, in Australia 10% of the entire population, i.e. more than two million people suffer from asthma. According to International medical standards, these figures clearly points out the fact that the level of prevalence in Australia is quite high in comparison to other parts of the world. The size of airways in young boys is smaller in size in comparison to that of young girls. This increases the risk of getting infection and wheezing among boys and probably that is the major reason why the risk of developing asthma among young boys is higher than girls (Barnes, Peter & Godfrey 2000). However, during the adulthood, this trend revert and the number of cases of asthma found in girls are more than that of boys. In comparison to other groups, number of cases found in the Indigenous Australians are largest .
Pathophysiology and pathology
According to a Kaliner (2003), development of three key physiological changes takes place in a human body with the progress of asthma. First and the foremost of them is increase in mucus secretion which result in clogging of airway which ultimately impact the breathing of an asthmatic person. Asthamatic conditions also result in inflamed and swollen respiratory tracts which again makes it difficult for a person to breathe normally. In addition, when a person comes in contact of allergic substances, this swelling increases thereby making things more complex.
As a result, constriction of the airways takes place because of tightening of respiratory muscle. With tenacious blocks of exudates and mucus in addition to cellular components the respiratory tract becomes clogged during fatal asthmatic conditions (Kaliner 2003). There is thickening of epithelial reticular basement membrane and weakening of the surface epithelium of the airways
Physiology of Respiration
The key function performed by the respiratory system in a human body is that of exchanging of gases, and the two gases majorly involved in this process are oxygen and carbon dioxide. During this exchange process, oxygen is introduced to the blood and carbon dioxide is removed from the same.. Oxygen is very essential for the purpose of normal metabolism and carbon dioxide is merely a waste product and can be a harmful for human body. The fact that only a small amount of carbon dioxide get into the body through gaseous exchange implies that a large proportion of carbon dioxide released through exhalation is created in the body (Kaliner 2003).
Mechanism of respiration and gas exchanges
The respiration mechanism in a human body is divided in two groups – internal respiration and external respiration. Intracellular metabolic processes is conducted in internal respiration and explanation to the entire process of gaseous exchange between the cells of the body and the external environment is done through external respiration (Saini 2010).
Pathophysiology
Aetiology of asthma
The most common factors that trigger full blown asthma are “Allergies” and are present in 90% of the people suffering from asthma. Tobacco, smoke, pollution etc are some of the outdoor allergens which act as potential triggers in asthmatic conditions (Koenig & Chesla 2004). Smoke of tobacco, apart from exposing people to the risk of asthma leads to infection in the respiratory system of a person which can even lead to the death. This smoke may also lead to intense wheezing in the respiratory system (Lugogo & MacIntyre 2008).
Environmental causes
Asthmatic symptoms also get triggered because of poisonous gases such as sulfur dioxide and nitrogen oxide together with air pollution (Spear 2002). There has been drastic increase in number of cases of asthma during the periods when level of air poullution has been extremely high (Yeatts 2006). Risk of developing asthmatic symptoms also increases when level of humidity is high. A person suffering from asthma also finds it very difficult to cope with the changes in the weather. Besides aggravating asthmatic symptoms, smoking results in a tremendous deterioration in lung function (Goroll & Mulley 2009). Cigarette smoking is believed to alter the inflammatory response in asthma thereby resulting in reduced response to inhaled corticosteroids. Exposure to second hand smoke has also been shown to negatively impact on the health of asthma patients (Murphy 2007).
Genetic causes
One of the major predisposing factor that leads to the development of asthma is the genetic factor. Number of genes which relate to asthma are several, these genes impact the immune system of a person and trigger asthma in a human body (Clark 2011). According to Behera (2005), chances of getting asthma is quite high in case of a person who consume antibiotics excessively as one’s modulators of immune system get disturbed because of antibiotics (Platts-Mills 1999).
Common Types of Asthma
There are four major groups under which asthma has been categorized, these groups are Mild intermittent and mild persistent asthma, moderate persistent asthma and severe persistent asthma
Comparison between severe, moderate and mild asthma
The key difference in severe, moderate and mild asthma is that of number of attacks that a person gets. In mild intermittent asthma a person suffering from asthma generally gets maximum two attacks in a week where as in case of mild persistent asthma these number of attacks generally cross the level of two attacks in a day. Sometimes these attacks can be two severe, that the normal life of a person can come to a standstill. In moderate persistent asthma, person get attacks twice a day, in morning and in night and that too twice a week.
Management of Asthma
Despite the fact that asthma cannot be cured, professionals from health care stream have come out with certain methods through which one can manage asthma. Treatment of asthma is totally dependent upon the level of severity of the problem (Parker-Oliver, 2005). Bringing down inflammatory states associated with asthmatic condition should be the core objective of the process developed for the management of asthma. Environmental regulatory strategies can be developed to deal with agents that spread asthma in a person rather than emphasizing on symptomatic treatment alone (Crockett 2003). Identification of potential trigger factors and staying away from them is one of the most effective strategy to manage asthma (Gershwin & Klingelhofer 2001). People presenting with asthma are always advisable to seek specialized care in case they are not able to manage the disease even when they are following strategies to avoid contact with the triggering factors (DIANE Publishing Company 1996).
Diagnosis of asthma
Medical history of a person and his or her family, physical examination and test results forms the basis for the diagnosis of asthma in an individual.
Signs and symptoms
Some of the main factors that trigger asthmatic attacks are irritation and infection of the airways. One of the most common asthmatic symptom is wheezing. focusing on potential causes rather than on symptoms is very essential for effective treatment of asthma (Rees, Kanabar & Pattani 2010).
Workup/laboratory results
Diagnosis of asthma also include physical exams in which health practitioner listen to the breathing of a person and look for sign such as extreme difficulties in breathing, wheezing and swollen nasal passages which are possible signs of asthma.
Differential diagnosis
Healthcare practitioners carry out a variety of tests to confirm the presence of asthma in a person as few symptoms of asthma are similar to the symptoms of other diseases as well. Even though some conditions may be allergic and present with symptoms such as wheezing and difficulties in breathing they may asthma in actual sense (Levy Weller & Hilton 2006).
Pre-hospital management
Primary and secondary survey
Pre-hospital management of asthma is beneficial since it helps ensure tat the patient is maintained in a stable condition before being given specialized care. Patients should never be released by emergency personnel before being transported to a medical facility for specialized treatment (Delbridge, Domeier & Key 2003).
Medical Management
Lifestyle modification
An effective way of managing asthma is bringing modifications in the lifestyle of a person apart from drugs and treatment. Keeping away from second hand smoke and strenuous activities can help in a big way to manage asthma.
Fast and long Medications therapy
For the management of asthma, bronchodilators are the most commonly used medicines. But a person gets only short term relief through these medicines and does not cure asthma permanently (National Health Call Centre Network Limited 2012).
Complementary medicine
Some people also make use of complementary medicine to manage asthma. A study shows that, more than 50% of people suffering from asthma in order to manage the same use these complementary medicines. However effectiveness of these medicines is highly questionable (Gershwin & Klingelhofer 2001).
Prevention of Asthma
Reduction of exposure to trigger factors such as cigarette smoke and poisonous gases have been recognized as some of the most effective ways of minimizing cases of asthma attack (Parker-Oliver 2005).
Swimming
One of the most beneficial exercises for persons suffering from asthma is swimming as the air which people breath in during swimming is warmer and humid as compared to air elsewhere as the breathing takes place just above the surface of the water (Clark 2011).
Patient education
Achieving a life for people suffering from asthma which is similar to a normal life and free from symptoms of asthma is quite essential for the management of asthma (Balter 2009).
Future management prospects
Extensive research in the field of severity of this diseases, pharmacogenetics and pathogenesis aspects and most importantly discoveries in the field of drugs and medicines is very essential for the management of asthma (Rees, Kanabar & Pattani 2010).
Conclusion
Summary
We all know asthma is an incurable disease, but still number of treatment strategies that can assist in controlling the disease can be identified by a person. Life of a patient can be improved significantly through proper management of asthma. A handful of changes like avoiding cigarette smoke, dust, pollution etc can bring major benefits to a person suffering from asthma. It is very important for an individual to acquire knowledge regarding the measures that can help him/ her in preventing asthma once the symptoms of the same are seen in the body (Barnes, Peter & Godfrey 2000). According to Goroll and Mulley (2009), knowledge of preventive measures make sufferers as well as society as a whole more active about a disease and they can then fight against it actively.
I have interviewed one of my friends who is just currently graduated from medicine school at University of Newcastle about my topic, so I asked him 2 questions which are:
1:How do you make a diagnosis of asthma?
To diagnose a patient with asthma you need to keep in mind the history of the presenting complaint and the results of some investigational tests. A history of a shortness of breath that is triggered by an exposure to an allergen along with wheezing attacks and productive cough which often worse during night and while seasons change is highly suggestive of a diagnosis of asthma. In addition to the history of the presenting complaint, some tests have to be done to make a definite diagnosis. These tests include respiratory function tests, full blood count, sputum test, chest x rays, and skin prick test to identify the allergen causing these reactions.
2: What medications are used to overcome and control asthma attacks?
The type of medications used to manage an asthma episode depends on the severity of asthma attacks. The main puffers used for asthma are beta agonist, inhaled corticosteroids leukotriene receptor antagonists. A mild episode is usually controlled with short acting beta agonists (SABA) + or – low inhaled corticosteroids (ICS). A moderate episode is controlled usually with SABA, low ICS and long acting beta agonists (LABA). A severe episode is managed with a combination of LABA, SABA and medium to high ICS dose.
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