Case Study: Asthma - Symptoms, Causes, Pathophysiology, and Management

This case study discusses Jackson, who is suffering from acute asthma. It covers the symptoms, causes, and pathophysiology of asthma, including the role of inflammation and hyperresponsiveness. The study also outlines strategies for managing asthma, such as measuring lung function, identifying environmental stimuli, and administering medication.

Running head: CASE STUDY: ASTHMA 1
Case Study: Asthma
Student’s Name
University Affiliation

CASE STUDY: ASTHMA 2
Case Study: Asthma
Introduction
The case study involves Jackson who is suffering from acute asthma. Acute asthma is a
disorder that causes narrowing and the inflammation of airways thus affecting airflow. Some of
the symptoms of asthma range from mild to severe. Such signs and symptoms may involve
shortness of breath, coughing, chest tightness, and wheezing. The signs and symptoms of
exacerbation asthma include increased heart rate, agitation, difficulty in breathing or speaking
and hyperventilation.
The condition can be caused by several things. Some of the common causes include colds,
allergens such as mold, food, dust miles and pollens, dogs and cats, tobacco or smoke, exercises,
gastroesophageal reflux disorder, or upper respiratory infections (Powell, 2016). Since the
disorder can be as a result of many factors, it can be triggered by either one factor or a
combination of factors. Any individual who is at high risk of this disorder is the one who has a
high tendency of exposure to these factors. The disorder can be diagnosed by the doctor with the
use of several tests such as spirometry, peak flow test, blood oxygen level tests and nitric oxide
test.

CASE STUDY: ASTHMA 3
Concept map of asthma
Asthma
Disorder
Caused by:
Colds and allergens such as mold,
food, dust miles and pollens, dogs
and cats, tobacco or smoke,
exercises, gastroesophageal reflux
disorder, or upper respiratory
infections.
Prevention
Avoid eating or exposure of substances that
stimuli asthma attack.
-Avoid exposure of allergens that trigger asthma.
Treatment
-Adrenaline
injection
-Epihedrine or
Theophylline
-Breathing hot
Sign and symptoms
Wheezing sound
- Increased heart rate,
-Agitation,
-Difficulty in breathing
- Hyperventilation.
Common in children
with relatives with
asthma
Medication
- Nebulised
Ipratropium bromide
Hydrocortisone
-Neuralized
Salbutamol
Begins in children and may
become problem for years

CASE STUDY: ASTHMA 4
Understanding Asthma pathophysiology which is the condition that Jackson is suffering from
can help one understand how the disorder can be diagnosed and treated. Asthma involves several
pathophysiological factors. These pathophysiological factors may include inflammation of
bronchioles with airway constriction and resistance that occurs when one is wheezing, coughing
or during the shortness of breath.
Inflammatory airway disorder also referred to as asthma is linked to hyperresponsiveness of
airway with the conditions of coughing, shortness of breath, wheezing or tightness of the chest.
For the most part, these conditions are connected with the blockage of wind stream that may
either be turned around unexpectedly or with treatment. Extreme intense asthma influences
around 280 million individuals throughout the world. Past research studies have demonstrated
that male kids have a higher asthma chance though, in grown-up, ladies have a higher hazard
(Holt, et al., 2012). Researchers believe that the condition of asthma is as a result of several host
factors such as environmental and host factors or a combination of both. For this situation, host
factors incorporate hereditary qualities, heftiness or sexual orientation. Hereditary components
incorporate atopy and can be characterized as a hereditary inclination to create unfavorably
susceptible disarranges like hypersensitive rhinitis, asthma and atopic which is for the most part
identified with an immunoglobulin E interceded reaction to allergens (Murphy, et al., 2009).
Severe asthma can affect the bronchioles, bronchi or the trachea. Irritation in these
breathing organs can exist yet it is not clear signs and side effects of asthma can result.
Bronchospasms, muscle and epithelial harm and unreasonable bodily fluid can result in
bronchoconstriction. Bronchoconstriction which can also be defined as a sharp contraction of
smooth muscles found in the bronchial narrows the airway. At that point edema from
microvascular spillage adds to air route narrowing (Poon, et al., 2012). Air vessels may then

CASE STUDY: ASTHMA 5
expand and release prompting an expansion in emission which in turn results to impair in the
mucus clearance.
Asthma may also result in an increased cell that secrets mucus with the expansion of mucus
glands. An expansion in bodily fluid emission would then be able to result in thick bodily fluid
fittings that lead to the blockage of airway. Additionally damage of the epithelium may result in
peeling which to an extent can impair airway. The barrier of the epithelium to its functions
makes allergens to penetrate which causes the hyper-responsive of airways and the degree to
which the hyperresponsiveness of airway depends generally on the degree of irritation and the
immunologic response of the patient.
Asthma additionally results in loss of catalysts that typically separate fiery receptors that bring
neural impacts from tangible nerve exposure. Without legitimate treatment measures, asthma can
prompt air route rebuilding bringing about changes to body cells and body tissues in the lower
respiratory tract. Such remodeling may be irreversible which can lead to a decreased response to
medication and loss of lung function.
Asthma can be ordered into either atopic, nonatopic or the blend of both atopic and nonatopic.
Atopic asthma begins to develop amid the youth arrange and is identified with triggers that
brings the sentiment of wheezing. Mostly, it may arise after the exposure of certain allergens like
foods, some drugs, smoke, grass or plant, dust mites or pet dander.
As a result of this exposure, excessive IgE is released which results into the activation of B-
lymphocyte. This then leads to the release of several inflammatory mediators. These
inflammatory mediators include leukotrienes, histamine, chemokines, nitric oxide, cytokines, and
prostaglandin D2 which in turn triggers the occurrence of bronchoconstriction and airway

CASE STUDY: ASTHMA 6
inflammation. Furthermore, ladies who smoke amid pregnancy may uncover their unborn
children to more elevated amounts of IgE prompting hyperresponsiveness in this way asthma
advancement. Also, presentation to air contamination may offer ascent to a similar impact (Poon,
et al., 2012).
Secondly, asthma can be classified into nonatopic. This sort of asthma does not include any
IgE reaction and it might have more subtle triggers for the most part happens in grown-ups
conceivably because of a viral disease. It should also be noted that exercise also induces the
condition of asthma. Exercise-induced asthma can be as a result of vigorous physical activity that
triggers acute bronchoconstriction in individuals (Holt, et al., 2012).
The primary points of asthma administration in healing center settings is to keep up typical
action levels, keep up ordinary pneumonic capacity rates, anticipate interminable and
troublesome indications, for example, coughing and avoiding intermittent scenes. Besides the
objective of asthma management is to avoid adverse effects from medication (Murphy, et al.,
2009).
One of the priorities that nurses can strategize on in order to manage Jackson's conditions is
to measure lung function and conditions. Measuring Jackson’s lung function is crucial for
making the diagnosis. It is also important as it helps nurses to assess the severity of asthma and
help them to use accurate control plans for the conditions. Nurses can also give instructions and
work with Jackson to make sure that lung function evaluation is made with the best reproducible
techniques.
As part of the measurement of lung function nurses should include peak flow monitoring
which measures PEFR. This part of asthma management helps patients like Jackson with the

CASE STUDY: ASTHMA 7
objective measure of their lung function thus helping them become actively involved in asthma
management. Peak flow measurements can also be utilized by nurses to assess the response to
therapy.
For this situation, attendants ought to guarantee patients to get their exact spirometric
readings by instructing and helping them to peruse and use the right system. They should also
coach and instruct them on how to use peak flow meter. Furthermore, nurses should make sure
they ask patients like Jackson to demonstrate their PEFR technique during each visit.
Secondly, nurses should strategize on the environmental control measures of the patient.
This is crucial as several stimuli can increase airway inflammation and bring on acute asthma.
Elimination or reducing the exposure to such stimuli can help in the management of acute
asthma. This is proven as effective in decreasing the requirement for asthma medication
(Murphy, et al., 2009). Some of the environmental stimuli that can worsen asthma include
infections, airborne allergens, and irritants. In this case, a nurse can identify possible
environmental stimuli that make patient’s asthma worse by taking a thorough history of Jackson.
Neuralized Salbutamol is inhaled and its mechanism of action is at beta adrenoreceptors.
The action takes place at the smooth muscle of the bronchi. The drug ties non-covalently to the
dynamic site of epinephrine receptor which balances out the receptor into its dynamic form. The
receptor remains in its settled form for quite a while and in this way more cAMP which triggers
intracellular cascade resulting into the release of potassium ions and a lessening in intracellular
calcium ions. This obstructs the capacity of the muscles to contract and once salbutamol unbinds
from the receptor; it is conveyed throught the body by the blood. Before being inactivated in the
stomach and in the liver, salbutamol acts at several beta receptors (Holgate et al., 2010).

CASE STUDY: ASTHMA 8
Nebulised Ipratropium bromide acts as anticholinergic agents which obstructs the
acetylcholine muscarinic receptors. This hinders vagally interceded reflexes by offending the
activity of acetylcholine which is the transmitter operator discharged from the vagus nerve.
Anticholinergics keep the expansion in intracellular centralization of cyclic guanosine
monophosphate which prompts the collaboration of acetylcholine with the muscarinic receptors
of bronchial smooth muscles (Holgate et al., 2010).
Hydrocortisone is a steroid drug that is utilized to treat inflammation as a result of different
disorders. The drug is similar to cortisol which is a body hormone produced by adrenal glands.
Its mechanism of action is that it has a potent anti-inflammatory action which suppresses the
immune response (Neame et al., 2015).
The implications especially when administering these medications to a patient with an acute
severe asthma is that there is some potential for additive interaction with concomitantly utilized
Nebulised Ipratropium bromide medication. Thus caution is advised during coadministration of
ipratropium bromide together with other medications with anticholinergic properties (Holgate et
al., 2010).

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References
Holgate, S. T., & Polosa, R. (2010). The mechanisms, diagnosis, and management of severe
asthma in adults. The Lancet, 368(9537), 780-793.
Holt, P. G., & Sly, P. D. (2012). Viral infections and atopy in asthma pathogenesis: new
rationales for asthma prevention and treatment. Nature medicine, 18(5), 726.
Murphy, K. R., Meltzer, E. O., Blaiss, M. S., Nathan, R. A., Stoloff, S. W., & Doherty, D. E.
(2012, January). Asthma management and control in the United States: results of the
2009 Asthma Insight and Management survey. In Allergy & Asthma
Proceedings (Vol. 33, No. 1).
Neame, M., Aragon, O., Fernandes, R. M., & Sinha, I. (2015). Salbutamol or aminophylline for
acute severe asthma: how to choose which one, when and why?. Archives of Disease
in Childhood-Education and Practice, 100(4), 215-222.
Poon, A. H., Eidelman, D. H., Martin, J. G., Laprise, C., & Hamid, Q. (2012). Pathogenesis of
severe asthma. Clinical & Experimental Allergy, 42(5), 625-637.
Powell, C. V. (2016). Acute severe asthma. Journal of paediatrics and child health, 52(2), 187-
191.