Pathophysiology and Nursing Interventions for Acute Asthma

Running head: BACHELOR NURSING ASSIGNMENT
BACHELOR NURSING ASSIGNMENT
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Answer 1
The pathophysiology of asthma and related symptoms are easily visible on the patient’s
physiology because of the inflammatory effects and activation of different cell types (Chawes et
al., 2012). On the exposure of foreign material, the inflammatory cells start interaction with
different cell types and mediators that causes the visible symptoms on the person’s health and
wellbeing (Neame et al., 2015). This section discusses about the case study of Jackson Smith a
18 year old man who was admitted to the emergency department of the healthcare facility due to
severe breathlessness. While receiving patient history it was informed by the patient’s family that
the patient is suffering from asthma from the age of 2. Afterwards his admission to the
emergency ward of the healthcare facility, clinical manifestations were collected which indicated
to the presence of severe case of dyspnea, elevated heart and breathing rate (32 breathes per
minute), shortness of breath and increased blood pressure 150/85 mmHg. Besides these the
patient was also observed of having wheezing sounds, increased pulse rate up to 130 beats per
minute and these clinical manifestations indicated towards the symptom of auscultation of lungs.
Several physical examinations were conducted by the healthcare professionals to determine the
lung expansion of the patient and after conduction of X-ray test it was determined that the
patient’s lungs and peripheral areas were swollen and hyper inflated lung fields were witnessed.
Further, on the assessment of blood gas it was found that 90% SO2 PaCO2: 50mmHg and
HCO3: 25mEq/L are the readings. Hence, after the accumulation of clinical manifestation, the
pathogenesis of the acute care asthma in the patient will be discussed.
Prior to identification of the pathogenesis, the commencement of the inflammation
process which is responsible for the emergence of the acute care asthma in the patient will be

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understood (Custovic et al., 2013). There are different host factors such as genetics and
environmental exposure which plays an important role in making the patient’s immune system
react to the allergenic response to the body (Alangari, 2014). As per the case study, Jackson is a
sufferer of asthma from his childhood, therefore for the emergence of acute asthma innate
immunity, respiratory infection, allergens, respiratory infections and other environmental issues
such as pollens or duct particles (Lim et al., 2012). Therefore, while analyzing the emergence of
asthma for this patient, allergens and associated reaction will be discussed. APC or antigen
presenting cells gets activated after the inhalation of foreign allergens and after that it engulfs the
allergens and presents them to the T-cells. after this, the naïve T cells activates the inflammatory
factors which acts as a cascade to activate the respiratory epithelium and helps in the release of
the thymic stromal lymphoprotein and other mediators such as interleukins leukocytes and others
that ultimately regulated the allergic reaction and then present those foreign proteins to the naïve
T cells (Chung et al., 2014, Doeing & Solway, 2013). Afterwards, there are two ways using
which the T cells are provided to the allergic reactions such as TH-2 and TH-17. Due to the TH-
2 involvement, the B cells starts producing the immunoglobulin E with the help of interleukin 4
and 13. These cells are also very important for the increased allergic reaction as the IgE binds to
the mast cells which gets activated and then in the presence of interleukin 4 which activates the
inflammatory reaction and cascade (Nievas & Anand, 2013). Further, these mediators such as
macrophages, eosinophil, neutrophils and so on gets activated that leads to airway damage and
stimulation sof the T cells with presence of bronchoconstriction, which is seen in the case study
of Jackson. Besides these, there are symptoms such as shortness of breath, elevated pulse rate
and breathing rate that indicated to the fact that the patient has chronic inflammation due to the
presence of leukocytes and epithelium. In this situation, due to the increased inflammation, the