Pathogenesis and Management of Acute Asthma: A Nursing Perspective

Causes Results
Caues
Increased chances of
Diagnoses
Control
1
Asthma
Asthma is a chronic
inflammatory of the
airway. 1, 16
Pathogenesis
Exposure to allergen Mast cell activated
and releases inflammatory mediators’
Mediators elicit immunological response,
causing Bronchoconstriction, abnormal
narrowing, Mucus hypersecretion,
epithelial damage, bronchospasm, airway
remodelling, and decline FEV1.
Progressive asthma becomes more
persistent increased mucus production
decreases the ability to bring air into the
alveoli the inflammation progresses and
other factors may be involved in the airflow
limitation. 2, 5, 8, 17
Symptoms
Cough, wheeze,
Breathlessness, and
chest tightness. 2, 16
Diagnosis
Complete medical history, and
family history
Lung function tests. 8, 12, 16
Pharmacologic Therapy
 Oxygen therapy
 Short- acting beta 2-agonist-
salbutamol
 Anticholinergic drug-
Ipratropium bromide
 Inhaled corticosteroid-
fluticasone propionate.
 Long acting anticholinergic
drug- Tiotropium Puffer
2, 3, 7,13,14,15
Nursing Management strategies
 Educate the caregivers and
patients on allergens
 Educate the patient on risk
factors and importance of
adherence to medication
 Assess the patient’s
respiratory status by
monitoring the severity of
symptoms.
 Asses drug side effects. 1,7, 8
Secondary Prevention
 Allergen-specific
immunotherapy
 Control of
environmental allergens
6, 9, 10, 11
Primary prevention
 Prevention of exposure to
common risk factors
 Prevention of direct
exposure to tobacco smoke
6, 9, 10, 11
Etiology
Atopy- it is
attributable to
family history,
exposure to
allergen causes
asthmatic attack
1, 8, 17,
Risk factors
 Smoking
 Genetic
susceptibility
 Obesity. 2, 16

References
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Answers to assignment 2
Pathogenesis of acute asthma
Mr. Jackson Smith diagnosis was confirmed by laboratory diagnosis including blood gas after he
presented with symptoms including breathlessness, severer dysponoea, and wheeze. At the same
time, his past medical history confirmed that he was diagnosed with asthma at the age of two
years. Acute severe asthmatic attack occurs when an individual is exposed to environmental
allergens such as smoke, dust, pollen grain among others. According to Kaufman (2012), during
acute severe asthmatic attack the normal functioning of the lower respiratory tract that include
the trachea, the bronchi, and the bronchioles is greatly affected. The constriction of bronchial and
the abnormal narrowing of the airways due to epithelial damage, mucus hypersecretion, and
bronchospasm have been mostly cited as the main cause of adverse symptoms experienced by
the asthmatic patient (Hamid, Mahboub, & Ramakrishnan, 2018). Acute asthmatic attack occurs
when an individual is exposed to an allergen that is capable of eliciting immunological reactions
leading to production of inflammatory mediators by mast cells among others. The result of the
immunological response is airways smooth muscles constriction, and hypersecretion of mucus
leading to narrowing and blockage of the airway. According to Whitsett and Alenghat (2015),
hypersensitivity induced by environmental allergen leading to bronchoconstriction and airway
inflammation can be attributed to IgE-dependent mediators that are released by the mast cells
including histamine and prostaglandins whose activities directly cause constriction to the airways
smooth muscles.
Wawrzyniak et al. (2017), suggested that whenever, smooth flow of air into the lung is
interrupted as a result of narrowing of the airways and bronchial wall inflammation there is an
increase in the decline of Forced Expiratory Volume in one second (FEV1) resulting to
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