Asthma

This document provides information about asthma and its treatment options. It discusses the use of positioning the patient in high fowlers position, applying and titrating oxygen, and administering medications like Salbutamol, Hydrocortisone, and Ipratropium bromide. It also includes insights into the immunologic mechanisms and epidemiology of asthma.

Asthma
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Contents
Question 2....................................................................................................................................3
Question 3....................................................................................................................................3
REFERENCES................................................................................................................................4
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Question 2
How does positioning patient in high fowlers assist in distress
It has been analysed that fowler position facilitate in relaxing tension of abdominal
muscle. Thus, it enables in improving breathing and oxygen level in body (Boonpiyathad and
et.al., 2019). Along with that, the position will also enable Peter to reduce compression of chest
due to gravity. Moreover, Peter will sit in 90 degree position. So, his head will be elevated and
chest will expand. In this way, oxygenation in body will be proper. Therefore, it will result in
reducing distress. s
Apply and titrate oxygen
What oxygen devise will use?
In this non re breather face mask will be used. The mask contains oxygen reservoir bag
and one way valve that reduce room air entrainment.
Why that device is used?
This device is used in Peter because it contains an oxygen reservoir bag and valve by
which room air is reduced. So, it will help Peter in proper breathing and maintain oxygen level.
How does supplemental oxygen work, how it assists Peter
It is necessary to provide oxygen therapy to Peter. In this it provides extra oxygen to
lungs and cut off negative effect of depletion of oxygen supply in body. therefore, it prevents
patient from asthma attack. This will assist Peter in supplying extra oxygen and preventing it
from asthma attack.
Question 3
Salbultamol via nebuliser
It acts on B2 adreno receptors in bronchial smooth muscle of lungs to allow
bronchodilation. Peter is receiving this because he is being diagnosed with asthma and showing
symptoms of Ventolin PRN. It must be given by using a nebuliser and face mask or T piece
endotracheal tube (Dharmage, Perret and Custovic, 2019). This will help in increasing lung
volume of Peter with induced bronchoconstriction. Here, clinical observation taken is to
measure oxygen level in Peter. Also, to find out if there is any respiratory symptoms or not.
Hydrocortisone IV
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It binds glucocorticoid receptor leading to downstream effect such as inhibition of
inflammatory factor and it promote anti inflammatory genes. Peter is receiving this because he is
admitted in ICU and diagnosed with asthma. This must be given when there is tightness in chest,
cough, etc. being observed in Peter. Its clinical response is that it reduces asthma attack. Clinical
observation in it is to identify if Peter is feeling chest pain or not.
Ipratropium bromide via nebuliser
It blocks muscarinic receptors of acetylcholine and inhibit vagally medicated reflexes by
antagonizing action (Kuruvilla, Lee. and Lee, 2019). It prevents intracellular concentrator of
cGMP with muscarinic receptors of bronchial smooth muscle. Peter is receiving it because he is
having acute chest pain. The nursing consideration is it must be given when there is chronic
reversible airway obstruction or severe asthma. Within minutes of administration it gives
response to chronic obstructive pulmonary disease. Clinical observation in it is to see whether
there is any airway obstruction or not.
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REFERENCES
Books and journals
Boonpiyathad, T. and et.al., 2019, December. Immunologic mechanisms in asthma. In Seminars
in immunology (Vol. 46, p. 101333). Academic Press.
Dharmage, S.C., Perret, J.L. and Custovic, A., 2019. Epidemiology of asthma in children and
adults. Frontiers in pediatrics, 7, p.246.
Kuruvilla, M.E., Lee, F.E.H. and Lee, G.B., 2019. Understanding asthma phenotypes, endotypes,
and mechanisms of disease. Clinical reviews in allergy & immunology, 56(2), pp.219-233.
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