Asthma Management and Prevention Studies

This assignment compilation focuses on asthma research findings and interventions. It includes studies on general practitioner-delivered adherence counseling, the indoor environment's impact on childhood asthma, and school-based self-management educational interventions. Additionally, it covers bronchial thermoplasty in severe asthma and the cost-effectiveness of peer-led interventions like the Adolescent Asthma Action program. The compilation also explores the use of exhaled nitric oxide levels to guide treatment for adults with asthma.

Clinical presentation
Discussion Report

Table of Contents
INTRODUCTION...........................................................................................................................1
Primary Survey................................................................................................................................1
Underlying Pathophysiology ..........................................................................................................2
Nursing Management.......................................................................................................................3
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
Asthma is a condition that affects the smaller airways (bronchioles). From time to time
airways narrow due to bronchospasm. It can start at any age and common symptoms includes
coughs and wheezing. In this context, the following report will analyse the case of Hannah
Sparkes who has been found short of breath and developed a wheeze. The interpretation of the
data collected by healthcare professional will be described in the study which determines the
stage of severity of Hannah. The disruptions to normal physiology that occur during an acute
asthma attack will be described in the report. The nursing interventions which will be precise to
treat Hannah will be described in the study.
Primary Survey
From the data collected by the healthcare professionals from Hannah, it was identified that she
has been suffered from mild asthma three years ago and she used salbutamol inhaler in order to
reduce its effects. After she fell short of breath and started wheezing, it was identified that Rapid
Respiratory rate (RR) was 26 and heart rate (HR) was 125. The arterial oxygen saturation (SpO2)
was 91 per cent on R/A. Her blood pressure was 130/70 mm Hg. Below is the table that shows
what are the normal values of these elements in human beings:
Elements Normal Rate
Rapid Respiratory Rate 12-18 breaths per minute
Heart Rate 70 to 100 beats per minute for children age 5-
15 years
60 to 100 beats per minute for adults
Arterial oxygen saturation (SpO2) 94% to 99%
Blood Pressure 120/80 – 140/90
Data of Hannah Sparkes
Elements Rate
Rapid Respiratory Rate 26 breaths per minute
Heart Rate 125 beats per minute
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Arterial oxygen saturation (SpO2) 91
Blood Pressure 130/70
Interpretation: From the above table it can be understood that Rapid Respiratory rate and heart
rate of Hannah is exceeding the normal rate. She requires immediate attention and precise
nursing intervention so that her condition can be improved. From further analysis it was
identified her Arterial oxygen saturation (SpO2) rate was 91 per cent. For patients with mild
respiratory disease it is recommended by healthcare professionals that their Arterial oxygen
saturation (SpO2) rate should be above 90 per cent (Shah and etal., 2014). As it Hannah was
suffering from asthma it was expected that her Arterial oxygen saturation (SpO2) rate would be
91 per cent. Her blood pressure was normal which was good sign. Patients suffering form high
blood pressure were found to be at greater risks.
Underlying Pathophysiology
Asthma is common chronic disease. The pathophysiology of asthma is complex as it
involves airway inflammation, intermittent airflow obstruction and bronchial
hyperresponsiveness. The symptoms of asthma varies from person to person. It can cause
disruptions such as increasing wheezing, shortness in breathing, a tight feeling in chest and
coughing (Otim and etal., 2015). It was identified in the case study that Hannah was suffering
from asthma. She fell short of breath and her wheezing got increased. These disruptions
eventually increased her heart rate and rapid respiratory rate enormously which can impact on
her health drastically. The description is provided below:
Rapid Respiratory Rate (RR): In human beings the normal rate of breathing is 12 to 20 breaths
per minute. If it exceeds 20 breaths the condition is known as tachypnea. It can be an early sign
of pneumonia in children. It was identified in the case study that the rapid respiratory rate of
Hannah exceeded 20 breaths per minute thus she was breathing very rapidly. The
pathophysiology cause identified was asthma.
Heart Rate (HR): Heart Rate is also known as pulse which depicts the number of times a
person's heart beats per minute (Langton and etal., 2017). The normal range of heart beat for
adults is 60 to 100 beats per minute and for children age between 5-15 years 70 to 100 beats are
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normal. As Hannah heart beats was recorded 126 beats per minute thus it implies that she has
been suffering from acute asthma.
Asthma is considered as one of the most common and chronic disease which affects millions of
people living in Australia. It can affects the respiratory system of the body and increase
wheezing (Petsky and etal., 2016). As Hannah was suffering from asthma her heart rate and rapid
respiratory rate got increased and she got tachypnea. Asthma is a long-term and potentially life-
threatening condition that requires ongoing treatment. If left untreated, there's a greater risk for
long-term effects and severe complications. These complications include hoarseness, rapid heart
rate, rapid respiratory rate and insomnia. Life-threatening asthma is rare, but tends to cause
symptoms that get progressively worse over several days. The disruptions result in increasing the
state of disease and affects the health of human being. As in case of Hannah, her breath rate got
increase due to shortness of breath. Furthermore, she has an audible expiratory wheeze with
rapid respiratory rate of 26 and heart rate of 125. This implied that she has been suffering from
acute asthma and required immediate attention.
Nursing Management
Nurses plays a huge role in providing treatment to people suffering from asthma. In order to treat
Hannah and provide intervention within first hour, nurses have to follow acute asthma
management plan. In order to manage acute asthma, it is essential for the nurses to follow the
precise plan which is described below:
 Assessing severity: Nurses have to assess the severity before starting medical
intervention (Bereznicki, Chapman and Bereznicki, 2017). The severity can be measured
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to mild, moderate, severe and life threatening. While starting bronchodilator treatment it
is important for nurses to measure the severity of Hannah Sparkes. Administering oxygen therapy: Oxygen therapy is given to adults or children who were
found shortage of breaths. The titration oxygen saturation target must be at least 95 per
cent for children. As Hannah was found shortness in breaths, nurses must give oxygen
therapy to her. Completing observation and assessment: Nurses have to observe the condition of
Hannah in order to continue the intervention and assess the condition so that information
can be obtained (Harri and etal., 2018). This is essential as this provides nurses precise
information regarding the condition of Hannah. Administering systemic corticosteroids: Administration of systemic corticosteroids must
be done within first hour of treatment. Reassessing response: Nurses needs to reassess response to treatment so that they can
gets the precise information regarding the condition of patient. This is done in order to
know whether more treatment is required by the person or not (Foster and etal., 2016). If
acute asthma has not been resolved than patient is transferred to Intensive Care Unite
(ICU) for more treatment.
 Observing Patient: Nurses needs to observe patients for at least one hour after resolution
of dyspnoe or respiratory distress (Gold and etal.,2017). This is done in order to provide
post acute asthma care.
CONCLUSION
From the above analysis, it can be understood that Asthma is common chronic disease.
The pathophysiology of asthma is complex as it involves airway inflammation, intermittent
airflow obstruction and bronchial hyperresponsiveness. The symptoms of asthma vary from
person to person. In this context, the report describes the case of Hannah and provide
interpretation of the collected data. It has been found that rapid respiratory rate and heart rate of
Hannah were significantly higher than normal rate. Furthermore, the pathophysiology of asthma
has been ascertained in the study. The disruptions that affects Hannah has been identified and
eventually nursing intervention plan to treat acute asthma has been developed.
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REFERENCES
Books and Journals
Bereznicki, B. J., Chapman, M. P., & Bereznicki, L. R. (2017). Factors associated with
overestimation of asthma control: A cross-sectional study in Australia. Journal of
Asthma, 54(4), 439-446.
http://www.tandfonline.com/doi/abs/10.1080/02770903.2016.1226899
Books and Journals
Foster, J. M., Smith, L., Usherwood, T., Sawyer, S. M., & Reddel, H. K. (2016). General
practitioner-delivered adherence counseling in asthma: feasibility and usefulness of skills,
training and support tools. Journal of Asthma, 53(3), 311-320.
http://www.tandfonline.com/doi/abs/10.3109/02770903.2015.1091473
Gold, D. R., Adamkiewicz, G., Arshad, S. H., Celedón, J. C., Chapman, M. D., Chew, G. L., ...
& Johnson, C. C. (2017). NIAID, NIEHS, NHLBI, and MCAN Workshop Report: The
indoor environment and childhood asthma—implications for home environmental
intervention in asthma prevention and management. Journal of Allergy and Clinical
Immunology, 140(4), 933-949. https://www.jacionline.org/article/S0091-6749(17)30748-
0/fulltext
Harris, K. M., Kneale, D., Lasserson, T., McDonald, V., Thomas, J., & Grigg, J. (2018). School-
based self-management educational interventions for asthma in children and adolescents:
A systematic review. Journal of Allergy and Clinical Immunology, 141(2), AB207.
https://www.sciencedirect.com/science/article/pii/S009167491732554X
Langton, D., Sha, J., Ing, A., Fielding, D., & Wood, E. (2017). Bronchial thermoplasty in severe
asthma in Australia. Internal medicine journal, 47(5), 536-
541.https://onlinelibrary.wiley.com/doi/abs/10.1111/imj.13372
Otim, M. E., Jayasinha, R., Forbes, H., & Shah, S. (2015). Building evidence for peer-led
interventions: assessing the cost of the Adolescent Asthma Action program in
Australia. Australian journal of primary health, 21(4), 438-
443.http://www.publish.csiro.au/py/PY14066
Petsky, H. L., Kew, K. M., Turner, C., Kynaston, J. A., & Chang, A. B. (2016). Exhaled nitric
oxide levels to guide treatment for adults with asthma. status and date: New, published in,
(9). http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011440/full
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Shah, S., Roydhouse, J. K., Toelle, B. G., Mellis, C. M., Jenkins, C. R., Edwards, P., & Sawyer,
S. M. (2014). Recruiting and retaining general practitioners to a primary care asthma-
intervention study in Australia. Australian journal of primary health, 20(1), 98-102.
http://www.publish.csiro.au/PY/PY12093
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