Acute Asthma: Pathogenesis, Positioning, and Medication

This document discusses the pathogenesis of acute asthma, the benefits of positioning the patient in a high Fowlers position to alleviate respiratory distress, and the use of medication such as Salbutamol, Hydrocortisone, Ipratropium Bromide for treatment. It also includes references for further reading.

Short Answer Exam based on one case study of
acute life-threatening and or traumatic complex
health condition

Table of Contents
QUESTION 1...................................................................................................................................3
Explain pathogenesis causing clinical manifestations with which Peter presents......................3
QUESTION 2...................................................................................................................................3
How does positioning patient with acute asthma in a high Fowlers position assist to alleviate
respiratory distress?.....................................................................................................................3
Selection of Oxygen delivery device and choosing reason and how it helps and assist Peter....4
QUESTION 3...................................................................................................................................5
Information related with medication...........................................................................................5
REFERENCES................................................................................................................................7

QUESTION 1
Explain pathogenesis causing clinical manifestations with which Peter presents.
Asthma refers to chronic inflammatory airway disease which manifests itself and has
cough, wheezing, chest, tightness and Dyspnea. These are some symptoms associated with
obstruction of the airway. They generally occur spontaneously during the early morning or late
night hours. The involvement of Limited airflow creates asthma. This is a reversible disease that
indicates structural changes in a permanent manner in Airway and includes subbasement
membrane fibrosis new vessel formation smooth muscle Hyperplasia and glandular Hyperplasia.
These are collectively referred to as disease severity, lack of reversibility, asthma pathogenesis
progression. Moreover, asthma is associated with a hard decline in lung function which creates
breathing problems for Peter. There is a chronic obstructive lung disease that creates permanent
changes in the structure of the airway inpatient. In asthma inflammation have a critical role in
pathophysiology, this information involves multiple mediators and different cell types in the
airway which have a different feature of the disease is like airflow in limitation, bronchial
inflammation etc. that creates recurrent episode of wheezing, the cough along with shortness of
breath. Airway inflammation during asthma depends upon the duration of disease and
persistence of disease. It is observed that there is structural cells and profiles are quite consistent
during asthma. During asthma, there are different type of complication which includes symptom
& sign which interfere during different activities like sleep, work and many more. It can be
observed that there is a high number of chances from work and school when there is asthma
inpatient. It needs some prevention which can help to provide better health to an asthma patient
in which there is a need to follow action plan of asthma which is provided by a health
professional. There is a need to get vaccinated for pneumonia and influenza. There is a need to
identify and avoid asthma triggers that can create a high health risk. There is also a need for
monitoring breath to lead to consciousness regarding health (Gonzalez-Barcala, (2018)).
QUESTION 2
How does positioning a patient with acute asthma in a high Fowlers position assist to alleviate
respiratory distress?
High Fowler's position refers to the upright medical position in which patients it is an
elevated head and their upper body raised at some angle that is between 60 degrees to 90 degrees

concerning the lower body. In this, the patient can be straight or bent is dependent on comfort
and need. This is the position that is generally used to improve breathing, feeding, patient
grooming, radiology and other circumstances which require this upright posture. Peter is
suffering from shortness of breath which followers position can help in getting a better breath.
High Fowler's position is an intervention that is used to promote oxygenation to implement drug
event-related to respiratory distress. Due to this, there is a maximum expansion of the chest. This
position facilitates the relaxing of abdominal muscles and helps to improve breathing. This
elevates compression on the chest which causes due to gravity. This position increases other
activity and eating and breathing with this position. To get better and effective breath that can
provide relief to him and improve his breath. In this position, Peter can get easily and can get a
high level of oxygen is can provide some rest to Peter. This position can also help during feeding
which can provide some relaxation to his body and can get relaxed. Peter needs to use this
position to get a maximum expansion of the chest and can breathe easily rather than any other
position. There is a need for this position to Peter which can associate with increasing and breath
and provide relaxation to Peter to create health recovery in the present situation (Daley‐Yates &
Barnes, (2021)).
Selection of Oxygen delivery device and choosing reason and how it helps and assist Peter
There is the use of a Venturi mask which can be used as an oxygen delivery device for
Peter. This is the one which is highly able to provide better health effect and oxygen supply to
Peter. Venturi mass is generally using the Bernoulli principle which helps to deliver pre-
determined along with the concentration of oxygen to the patient. This helps to determine
Oxygen and gas flow and final concentration. This can provide high gas flow which is higher
than the peak inspiratory flow rate. In this, the flow of oxygen passes and negative pressure is
created which creates high pressure of oxygen flow in the body. This can be achieved by the big
window or smaller entertainment purchase which in train ambient air. In this, there is the gas
flow rate of a high place and level to excel gas which is flushed from the mask by its different
holes. Due to this, there is no rebreathing. These are the masks that are generally recommended
to fix oxygen concentration for a patient who has hypoxic drive. Such like that, this mask
increases the oxygen level in Peter in relation to providing better oxygen level to him (Trevor,
(2018)).

QUESTION 3
Information related to medication
Medicine Salbutamol via nebuliser Hydrocortisone IV Ipratropium Bromide
via nebuliser
Mechanis
m of
action
It refers to beta-2-adrenergic
agonist which has
pharmacologic effects that
are of beta2-adrenoceptor
agonist drugs which are
there at-least attributable to
stimulation that is of adenyl
cyclase intra-cellularly.
Here, the enzyme catalyzes
the conversion of ATI to
cyclic AMP. Here, increased
AMP levels can create
relaxation of bronchial
smooth muscle which leads
to inhibition of release of
immediate hypersensitivity
from mast cell, cells.
This is an anti-
inflammatory
adrenocortical
steroid. These have
mineralocorticoid
activities and short-
acting glucocorticoid
and have highly rapid
actions.
This is an acetylcholine
antagonist that is of cyclic
guanosine
monophosphate. It
decreases the contraction
of smooth muscles of
airways and able to dilate
bronchial smooth muscle
(Tobi, (2018)).
Reason
for
receiving
This one can help in the use
of routine management
which is of chronic
bronchospasm unresponsive
for conventional therapy
which can help during
treatment of acute severe
asthma (Siu, (2018)).
This has a highly
onset action nature
which provides
highly effective and
improves lungs
disorder in the body.
This helps to dilate
smooth muscle and helps
in getting better breathing
and prevents symptoms
caused due to lung
diseases.
Nursing
considera
This can help to get better
medication and better and
It helps to monitor
sigh of
This can avoid urinary
retention and able to

tions effective treatment for and
provide better care to the
patient.
hypersensitivity
reactions which
includes wheezing,
tightness in chest etc.
prevent hyperpyrexia and
ensures adequate
hydration. There is a need
to provide medication on
time and can help in care
and different situation that
can be there due to not
having better health.
Expected
Clinical
response
This creates a fast onset of
action and helps to prevent
asthma attacks and duration
of action between 4-6 hours
in patients.
This can help to treat
asthma with the body
and enhance the
immune system
(Powers, (2017)).
This can blockage of
muscarinic cholinergic
receptors which can help
and decrease the
production of cyclic
guanosine
monophosphate. This
helps to provide better
and relaxation in smooth
muscle and also provides
a decrease in contraction
in it.
Clinical
observati
on
It is seen that after taking
this as medication, it helps to
provide relief from an
asthma attack and improves
breathing.
It is given
intravenous which
creates highly rapid
action and provides
relief to the patient.
This is an oral inhalation
dosage and is a short-
acting bronchodilator that
is there in clinical trials.
This inhibits salivary and
mucus glands and able to
dilate bronchial smooth
muscles which provide
better and easy inhalation.

REFERENCES
Books and Journals
Daley‐Yates & Barnes, (2021). Therapeutic index of inhaled corticosteroids in asthma: A dose–
response comparison on airway hyperresponsiveness and adrenal axis
suppression. British Journal of Clinical Pharmacology, 87(2), 483-493.
Gonzalez-Barcala, (2018). Asthma exacerbations: risk factors for hospital readmissions. Irish
Journal of Medical Science (1971-), 187(1), 155-161.
Powers, (2017). Intravenous ferric carboxymaltose in children with iron deficiency anemia who
respond poorly to oral iron. The Journal of pediatrics, 180, 212-216.
Siu, (2018). Management of Recurrent Preschool, Doctor-Diagnosed Wheeze. The Indian
Journal of Pediatrics, 85(8), 658-666.
Tobi, (2018). Acute respiratory distress syndrome following a biphasic anaphylactic reaction to
morphine: a case report and review of the literature. Southern African Journal of
Anaesthesia and Analgesia, 24(6), 165-167.
Trevor, (2018). Severe asthma in primary care: identification and management. The American
journal of medicine, 131(5), 484-491.