Nursing Assignment on Asthma: Pathophysiology and Assessment

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
Asthma is a chronic disease of the airways in the lungs. The following nursing
assignment is based case study of Adam, a 32-year old man who is a victim of childhood
asthma and was recently admitted to hospital due to asthmatic problems after coming in
contact with his uncle who was suffering from flu. The following paper aims to analyse the
pathophysiology behind the development asthma. This will help in understanding the
assessment question that must be interrogated to Adam for highlighting the clinical priority
and framing of the person-centred care plan. At the end, the paper will highlight the nursing
assessment that must be undertaken in order to improve the overall scenario. The paper is
based on the effective management of the asthmatic condition by proper nursing assessment
and patient education.
Pathophysiology and the disease development
Asthma and Reasons of Development
Asthma is a familial disorder. Genetic predisposition, presence of faulty genes like
interleukins (IlL-4, IL-5, IL: 13) and increased secretion of IgE, eosinophils, beta adrenergic
receptors ( used for the sensing of the stress response by the use of adrenaline) and airways
hyperresponsiveness (the ability of the pulmonary airways to constrict quickly) increases the
vulnerability of developing asthma (Cartier, 2015). In case of Adam it can be said that the
familial pre-disposition is responsible for the development of re-current asthma. This is
because, the case study highlights Adam's father died at an age of 40 due to asthma. The
presence of asthmatic tendency in the family makes Adam an asthmatic patient since
childhood. Adam's general health is however good. He swims 2 kilometres three days per
week and walks 5 kilometres three days a week. Practice of swimming might also be a reason

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behind his asthmatic problem. Del Giacco et al. (2015) reported that exercise-induced asthma
are a common problem that leads to development of asthmatic tendency among the
vulnerable adults. The water of the swimming pool generally contains chlorine and frequent
exposure of chlorine during swimming can be regarded as an environmental exposure behind
the development of asthma. Del Giacco et al. (2015) also report that hard core physical
activity like cardio or high-intensity training is also detrimental for the asthmatic patient as it
induced laboured breathing. However, from the case study is it is not clear about the duration
for which he covers the five kilo-meter walk thrice per week. The time taken will be helpful
in quantifying the level of intensity of the physical exercise. However, Lochte et al. (2016)
stated that regular practice of the mild to moderate physical activity reduces the symptoms of
the asthmatic development like wheezing and cough. Aanerud et al. (2015) reported that
smoking of tobacco and weight gain due to unbalanced diet plan is the two important a
modifiable risk factors behind the development of asthma. Adam however, takes balanced
diet, avoids smoke, and drinks occasionally.
Liu (2015) reported that other modifiable risk factor behind the development of
asthma is exposure to allergens in the urban areas and exposure to the respiratory tract
infection. Weber et al. (2015) further reports decreases exposure of the certain infectious
organisms generates an immunological imbalance leading to the development of allergy and
asthmatic tendency. This is defined a hygiene hypothesis. Adam used to take flu-injection
every year as he used to get cold frequently and he used to stay away from people infected
with common cold and flu. This tendency might have resulted in the generation of hygiene
hypothesis causing outbreak of asthma in Adam.
Question that is required to be asked to Adam for Health Assessment
 Whether his swimming pool water contains chlorine

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 Whether he swims during the winter seasons as well?
 Whether he is allergic towards any environmental substance like pollen?
 Whether is workplace is filled with dust (he works in steel works) and whether he
uses face mask while on work?
 The tenure or the time-limit within which he completes the five kilometres walk per
day (three times a week)?
 Whether his uncle smokes cigarettes
 Whether he walks at night (at night there is fog and temperature is low and thus
walking under sky can increase the tendency of developing asthma)
 The ventilation status of the room (during winter poorly ventilated furnaces, heaters
and clothes dryers, fireplaces and stoves) might lead to the generation of breathing
problem
Asthma and Pathophysiology
The principal characteristic as asthma is inflammation in the airways followed by
airway hyper-responsiveness and mucus hypersecretion. This results in the obstruction in the
airways leading to the development of the symptoms like dyspnoea (laboured breathing),
chest tightness, cough and wheeze. The obstruction in the airway arising from the
physiological changes is episodic and is mainly reversible (Maslan & Mims, 2014). Thus, it
can be said that in order to manage the symptoms of asthma, Adam used to take medications
like Beclomethasone (daily) and Salbutamol (occasionally). Beclomethasone is used to
prevent and control symptoms of asthma like wheezing and shortness of breath. Salbutamol
helps in opening up the medium and large airways in the lungs (Ostrom et al., 2018).
King et al. (2018) reported that asthma in the airways is exaggerated by the
development of the inflammatory mediators in the airways. This inflammatory mediators are
inflicted either exposure from allergen or from common cold flue. In case of Adam, he was