Asthma Management: Case Study Analysis, Treatment, and Education

This report delves into the comprehensive management of asthma, using a case study approach to analyze the condition and its treatment. The report begins by identifying the patient's symptoms, which align with allergic rhinitis, and explores the potential environmental and genetic factors contributing to the patient's condition. It then explains the pathophysiology of asthma, including airway inflammation, mucus hypersecretion, and airway hyperresponsiveness. The report emphasizes the importance of proper diagnosis and the role of asthma action plans. Effective pharmacological treatments, such as reliever medications, are discussed, along with the significance of patient education in managing asthma. The report highlights the role of healthcare professionals in educating patients about the causes of asthma, medication usage, and the importance of recognizing warning signs. It also references the 'Australian asthma handbook' and discusses the benefits of asthma education programs, including improved lung function, reduced absenteeism, and fewer emergency visits. The report stresses the importance of patient and family education regarding triggering agents, medication contraindications, and proper inhaler techniques. The report concludes with a summary of the key aspects of asthma management and the importance of a holistic approach that includes patient education, pharmacological interventions, and a well-defined asthma action plan.

Running head: ASTHMA MANAGEMENT
ASTHMA MANAGEMENT
Name of the Student
Name of the university
Author’s note

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Asthma management
1. Tegan smith was likely to have been suffering from allergic rhinitis as indicated by the
signs and the symptoms. The major clinical manifestations of allergic rhinitis is episodic
rhinorrhea, sneezing or obstruction of the nasal passage with pruruitis and lacrimal of the
nasal mucosa, oropharynx and conjunctiva (Wheatley & Togias, 2015). It is evident that
Tegan Smith was wheezing, coughing, and having watery eyes and runny nose that aligns
with the hall mark of the disease. Allergic rhinitis is mainly caused by the inhalation of
external agents such as animal dander, molds, dust or chemical fumes. As stated by
Ozdoganoglu & Songu, (2012) allergic rhinitis can also be triggered as a result of cold or
other environmental allergens. It seems that shifting of Alpine resort might not have been
successful and could probably be the cause of his allergies. The percentage of pollutants
and dust particles or the temperature of the current residence might vary and can
exacerbate the effects of allergic rhinitis (Wheatley & Togias, 2015). The case study
reveals that Tegan’s mother also had history of allergic rhinitis and nasal polyp. There
has been a clear evidence of the environmental and the genetic factors behind the
development of allergic rhinitis. Polymorphism of the candidate genes has been found to
be associated to the clinical expression of the allergic rhinitis. Genome wide studies had
shown association between certain phenotypes of the allergic diseases with markers in
more than one chromosome.
2. The main characteristics of asthma are airway inflammation, mucus hyper secretion and
airway hyper responsiveness that results in airway obstruction leading to excessive cough
, dyspnea, chest tightness and wheezing (Seidman et al., 2012). Exposure of the nasal

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passage to irritants can give rise to a cascade of events beginning with the degranulation
of the mast cells along with the secretion of the inflammatory mediators like histamine,
prostaglandins, interleukins (Seidman et al., 2012). The degranulation of the mast cells is
caused by the cross linking of the IgE molecules to the surface of the mucosal mast cells.
The vasoactive impact of these mediators helps in increased capillary permeability and
vasodilatation which causes an increase of blood flow to that area, accumulation of the
chemotactic factors. The Eosiniphils secretes a variety of substances that causes
inflammation and damage to the wall tissue. The inflammation causes muscular spasm in
the bronchial smooth muscles causing vascular congestion, thickening of the airway,
edema, and production of thick mucus. The normal control of the bronchial smooth
muscles is altered by the production of the neuropeptides (acetyl-choline) causing
bronchospasm (Ozdoganoglu & Songu, 2012). There is an extensive secretion of nasal
mucus and excessive mucus plugging. Thickening of the basement membrane,
hypertrophy in the smooth muscles of the airway is often noted. The late asthmatic
response initiates after the initial exposure and can remain after 24 hours. The
inflammatory response is characterized by the recruitment of the inflammatory cells that
has already been triggered by the chemotactic factors and the molecules adhering to the
endothelial walls. The disrupted muciliary function causes injury to the endothelial walls.
The local injury stimulates the nerve endings that cause the bronchoconstriction and
excessive secretion of the mucus. Rapid and forced expiration and wheezing sound is due
to the passage of airway through the narrow airway.
3. Treatment of asthma initiates with the proper diagnosis of the symptoms as some of the
symptoms are similar to other respiratory distress. An assessment of the medical history

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of the parents is important. It is evident from the case study that Tegan's mother already
had a history of allergic rhinitis and nasal polyp. Treatment of asthma refers to written
asthma plans. One of the long term goals for the management of asthma is to maintain the
lung function and activity (Chung, 2013). Effective asthma management can be done by
pharmacological treatment such as the reliever medications like salbutamol or
ipratropium bromide as they help in rapid bronchodilation (Sumino & Cabana, 2013).
The case study reveals that Tegan had been supplied with nebulizers and metered dose
inhaler.
Patient education plays a wide role in asthma management. The first education lies in
helping out the patients to use the bronchodilators which can be seen to be done by the nurse
Tania Herman in the given case study. Nebulizers actually alter the medication from a liquid
to a mist such that it can be easily inhaled in to the lungs. MDI can be useful in Tegan as it
would help the medication dose to be more consistent.
4. Asthma management plan should be different as per the ages. The parents should be
educated regarding the causes of the wheeze and the probable prevention. Asthma
management plans includes informing the patients and the families regarding the signs
and the symptoms of asthma, the medications and the proper use of the nebulizers.
According to "Australian asthma handbook", (2018), asthma education program helps to
improve the lung function with a small reduction in the work or school absenteeism or
reduction in the number of days with restricted activities. It is also linked with the reduction
in the number of emergency visits and possible a reduced amount of disturbed nights. A
properly written asthma action plan can be useful in providing clear information to the

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patient regarding the adjustment of the medications in response to asthma treatment or how
to access medical care during an emergency (Boulet et al., 2012).
It is necessary to explain to the parents and the patient that asthma is a long term
condition and it persists even when the patient is not having the symptoms ("Australian
asthma handbook", 2018). They should be taught regarding the severity of the flare ups and
the warning signs for taking the patient to an emergency care. One of the important aspects
of patient and family education is to inform the patient and the family about the triggering
agents of asthma exacerbations. While explaining the role of the pharmacology it is also
important to inform about the contraindications or the chance of any adverse drug reaction
(Williams et al., 2013). Emphasis should be given on the use of the preventers regularly. It is
necessary demonstrate the patients how to use the inhalers or the nebulizers and care and
cleaning of the spacers and the inhalers.

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References
Australian asthma handbook. (2018). Australian Asthma Handbook. Retrieved 29 April 2018,
from http://www.asthmahandbook.org.au/management/action-plans
Boulet, L. P., Vervloet, D., Magar, Y., & Foster, J. M. (2012). Adherence: the goal to control
asthma. Clinics in chest medicine, 33(3), 405-417.
Chung, K. F. (2013). New treatments for severe treatment-resistant asthma: targeting the right
patient. The lancet respiratory medicine, 1(8), 639-652.
Ozdoganoglu, T., & Songu, M. (2012). The burden of allergic rhinitis and asthma. Therapeutic
advances in respiratory disease, 6(1), 11-23.
Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., ... &
Ishman, S. L. (2015). Clinical practice guideline: allergic rhinitis. Otolaryngology–Head
and Neck Surgery, 152(1_suppl), S1-S43.
Sumino, K., & Cabana, M. D. (2013). Medication adherence in asthma patients. Current opinion
in pulmonary medicine, 19(1), 49-53.
Wheatley, L. M., & Togias, A. (2015). Allergic rhinitis. New England Journal of Medicine,
372(5), 456-463.
Williams, K. W., Word, C., Streck, M. R., & Titus, M. O. (2013). Parental education on asthma
severity in the emergency department and primary care follow-up rates. Clinical
pediatrics, 52(7), 612-619.