Nursing Principles: Asthma Management for Diverse Patient Groups

This report provides a comprehensive overview of nursing principles in asthma management. It begins with an introduction to asthma, discussing its prevalence, causes, and the importance of effective treatment. The report then delves into the pathophysiology of asthma, explaining the mechanisms of airway inflammation and hyperresponsiveness. A significant portion of the report is dedicated to the role of nurses in asthma management across different patient groups, including adolescents, children, and adults, highlighting age-specific considerations and care strategies. The report emphasizes the importance of patient education, medication management, and cultural sensitivity in providing effective care. It also discusses the benefits of multidisciplinary teams and the positive impact of nurse-led asthma clinics. The report concludes by reiterating the significance of community nurses in asthma management and the need for proactive patient care to reduce hospital admissions and improve patient outcomes.

Running head: NURSING PRINCIPLES
Principles of nursing management with patient with Asthma
Name of the Student
Name of the University
Author’s Note:

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Introduction:
Asthma is a disorder which can be characterized by means of recurrent assaults of wheezing
and breathlessness, which range in severity and frequency from child to man or woman. In an
individual, asthma attack can occur in any time of the day (Who.int, 2019). Approximately,
100 million to 150 million humans around the globe suffer from asthma and this range is
growing day by day. Internationally, deaths from this condition have reached over 180, 000
per year (Who.int, 2019). Approximately 8 per cent of the Swiss populace suffers from
asthma in comparison with only 2 per cent in 25 - 30 years in the past in sweden (Who.int,
2019). In Germany, there are an expected four million individuals who suffer from asthma.
As per the UCB Institute of Allergy in Belgium, asthma has nearly double its incidence in the
last ten years in the whole Western Europe. In the USA, the quantity of people with asthma
has increased progressively by using over sixty per cent since the era of early 1980s and
deaths have doubled to 5,000 a year (Who.int, 2019). In Australia, one toddler in 6
underneath 16 years of age is affected with asthma. Asthma is not only a public health care
situation for advanced and developed countries but in developing countries as well. On the
other hand, the occurrence of the sickness differs substantially (Who.int, 2019). In Costa
Rica, Brazil, Peru, Uruguay, and Panama occurrence of asthma signs and symptoms in kids
varies from 20 per cent to 30 per cent where as in Kenya, it reaches up to 20 per cent
(Who.int, 2019).
As of now, asthma cannot be cured, however it can be controlled through treatment. In latest
years, there had been fundamental advances inside the knowledge and remedy with regard to
asthma (Loo & Wark, 2016). A better understanding of the mechanisms of disorder by the
way of basic science studies over the last two decades has resulted in the development of
noticeably specific remedies which target the dys- regulated immune response of asthma and

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these are now being translated into new powerful disease- curing remedies (Loo & Wark,
2016).
In today's busy health care sector, physicians are busy and hence lack time to educate dad and
mom of affected children on preventive asthma management plans. Therefore, it is very
critical that, in addition to physicians, other clinical personnel consisting of nurses and nurse
practitioners can be a part of affected individual or his/ her family to enhance self-
management of asthma (Rodriguez et al., 2013). Once properly trained, they can assist in
implementation of preventive medical control plans, train patients and households, and
ensure that patients are on appropriate remedies to achieve proper asthma care plan
(Rodriguez et al., 2013).
Discussion:
In this section patho- physiology of asthma and related findings with regard to the
understanding of the mechanism of asthma will be discussed. In addition, nurses’ role on the
management of asthma in regards to the adolescent, children, and adults will be discussed.
Patho- physiology of Asthma: bronchial asthma outcomes occur from complicated
interactions amongst a selection of mediators, inflammatory cells, and the tissues and cells
which are present inside the airways. Firstly, stimuli spark off the discharge of inflammatory
mediators from mast cells, eosinophils, macro-phages, and other inflammatory cells within
the air ways. Those incitements can also be included as inside and outside allergens, viral
breathing infections, irritants, clouded air, and exercising. As a direct consequence, the
inflammatory mediators sign different inflammatory cells emigrate in to the air ways and to
become activated (Doeing & Solway, 2013). Activation of those inflammatory cells and the
discharge of additional inflammatory mediators cause epithelial damage, enhanced muscle
contraction and mucus secretion, swelling, and changes inside the para- sympathetic control

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of air way feature. As a result, the air ways turns it into extra obstructed and narrow. Those
inflammatory processes also cause air way to become hyper responsiveness, which is
characterised by an extreme narrowing of the air ways in reaction to a spread of stimuli
(Bonini & Usmani, 2015).
Obstruction of air way or narrowing reasons the symptoms of wheezing, coughing, shortness
of breath, chest tightness, and decreased tolerance. Air way obstruction can develop step by
step or unexpectedly (Doeing & Solway, 2013). A schematic diagram of asthma patho-
physiology is depicted in the Figure 1 below.
Figure 1: A schematic diagram of asthma patho-physiology (Source: Nhlbi.nih.gov, 2019)

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Decreasing airway irritation can reduce airway hyper responsiveness, reduce bronchial
asthma symptoms and signs, and reduce the craving for common use of bronchodilators for
the management of asthma. Air way inflammation may be decreased substantially by
lowering or getting rid of contact to the allergens, irritants, or other stimuli that aggravate a
bronchial asthmatic episode and with the aid of taking anti- inflammatory medicine daily
(Doeing & Solway, 2013).
Recent published researches in the area of asthma have presented the fact that there is a very
crucial link present between the type 2 acquired immune response and innate immune
response (Grotenboer et al., 2013). Biological agents are being developed for treatment of
asthma which will specifically target the acute asthma and it might change the course of
asthma treatment with further research and clinical trials. Although, there is a knowledge gap
regarding the understanding of functions in type 2 immune responses.
Nurses’ role in asthma management: As from the discussion above, it can be seen that the
asthma can attack anyone from children to adult and therefore the treatment and caring plan
for the adult and children are different from each other and they are discussed in the section
below.
Asthma management for adolescent and children: Trust need to be developed whilst a minor
range of care givers meet the toddler’s bodily and emotive wishes predictably. Agreeing with
the situation that nurtures bodily and emotional comfort will ensures the toddler’s greater
acceptability to asthma control efforts. Infants trust they are in the control of the situation.
Their favoured word is always “no.” Their capacity to make them understood is restrained.
Mother and father and care-givers ought to take into account that whilst a toddler response is
negative, it does now not constantly imply no. It might suggest sure, not proper now, or I
don’t realize. Nurses ought to work alongside the particular toddler’s family to apprehend the

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specific personality personalities of that particular toddler and to help the circle of relatives
take part in the partnership for asthma care. Preschool youngsters are stepping into a bigger
social atmosphere and starting new actions. They are verbal and might participate in their
asthma care, despite the fact that reasoning is rudimentary in their case, hassle solving is
intuitive in place of logical thinking, and might be selfish. Nurses need to also assist families
apprehend that the pre- schooler desires to, needs to, and has to have possibilities to behave
autonomously. Teenagers receiving right care commonly proceed through their adolescent
years with minor issues because of bronchial asthma. Nonetheless, certain youngsters with
bronchial asthma might also rise up against all constraints and refuse medicinal drug and
remedy. Nurses should work individually and collectively with parents and teenagers to
introduce them to the bronchial asthma care. The message has to convey that they have to be
cautious now (Svavarsdottir et al., 2013).
Asthma management for adults with different age: Among all adults suffering with bronchial
asthma, nurses need to verify whether or not the patient is aware of bronchial asthma
management and evaluation and re- evaluate has to be conducted based on the components of
asthma management. Adults who want to examine should be examined on priority basis and
their experience can be happy through the gaining knowledge of asthma management care.
They also should encourage the desire for research via sufferers’ willingness for the benefits
of getting their asthma under manage. In case of pregnant girl, asthma manipulate is
specifically vital. A good enough deliver of O2 for the foetus need to be sustained. Dangers of
out of control asthma to the pregnant woman affected with asthma and her foetus is in the
way of far greater harm than the dangers from the medicinal drugs to control asthma. Older
adults with bronchial asthma have reduced maximum critical capability, inspiratory reserve
extent, respiratory capacity, and oxygen diffusing potential. Older adults will also be stricken
by regular physiologic modification that occur in their body structures (which includes

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decreases in gastrointestinal absorption, vision loss, and muscle energy) and via co- existing
illnesses (along with arthritis, stroke, and persistent obstructive pulmonary disorder) (Stanik-
Hutt et al., 2013).
Asthma management for people with diverse background: Nurses should obtain a
fundamental understanding of their patients’ lifestyle and historical past and time and interest
should invest to make certain accurate and smooth verbal exchange. In that way, cultural
variations may be converted from limitations in to bridges to a sturdy collaboration for
bronchial asthma care. Open- ended questions should be asked and interest in the patient’s
hobby will assist nurses learn about the sufferers’ beliefs and practices as well as the system
and cultural effects that may have on them. This technique will allow nurses to offer proper
care by knowing an affected person’s tradition and history. Inside each minority or ethnic
institution, there is a wide diversity of human beings. Not every person who belong to a
specific community, trust or behave within the identical manner as everybody. Consequently,
even if nurses are accustomed with an affected person’s culture and history, they want to get
to realize every character affected person (Clark et al., 2013).
Management and medication management for the asthma patients: Many community nurses
handle the management of patient with chronic conditions like asthma. According to the
studies chronic illness like asthma has a greater chance of control if it managed by multi-
disciplinary team. The nurses can work along- side them for the treatment of the asthma.
Evidence published in the recent journals has shown that the treatment of chronic illness like
asthma improved while nurses prescribed the drugs instead of the general practitioner (Carey
et al., 2014). Therefore, it will increase the treatment quality due to the increase number of
points of access. Subsequently, nurses should be aware of the medication that can be used for
the treatment of the chronic asthma. The drugs can be employed are relief bronchodilators,
regular inhaled preventer therapy, inhaled corticosteroid, high does inhaled corticosteroid and

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regular corticosteroid. In addition to the increased effectiveness of treatment, studies have
shown that it will also improve the self- confidence and job satisfaction of the nurses. It has
also been reported in the journals that asthma clinics led by nurses have produced a positive
effect on the community and adherence to the guidelines of asthma management (Maguire,
2015).
Conclusion:
Bronchial asthma is a persistent circumstance which affects the air ways, making them to
constrict the air ways in response to a variety of stimuli. Signs and symptoms encompass
shortness of breath, coughing, wheezing, and an experience of tightness in the chest.
Moreover, many contributing factors may triggers the bronchial asthma which encompass
pets and animals, flu and cold illnesses, house dirt mites, workout, feelings and pressure,
moulds and fungi, pollen, pollutants, recreational drugs and smoking, and climate.
Reasonably skilled nurses who are working in the community health care centre, including
community hospitals, aim to save time required in health facility admissions by
communicating and managing lengthy admission time period, prioritizing the need of the
affected patients at the time of the clinical admission. Healthcare specialists in this sector can
make contributions to the community by raising awareness regarding asthma in the
community as well as emphasizing on the importance of proper diagnosis, testing for asthma
while providing patient centred care. Additionally, working in collaboration with school
nurses can make a significant difference to awareness among the adolescent and children at
their supple age.

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References:
Bonini, M., & Usmani, O. S. (2015). The role of the small airways in the pathophysiology of
asthma and chronic obstructive pulmonary disease. Therapeutic advances in
respiratory disease, 9(6), 281-293.
Carey, N., Stenner, K., & Courtenay, M. (2014). An exploration of how nurse prescribing is
being used for patients with respiratory conditions across the east of England. BMC
health services research, 14(1), 27.
Clark, S., Parker, R., Prosser, B., & Davey, R. (2013). Aged care nurse practitioners in
Australia: evidence for the development of their role. Australian Health
Review, 37(5), 594-601.
Doeing, D. C., & Solway, J. (2013). Airway smooth muscle in the pathophysiology and
treatment of asthma. American Journal of Physiology-Heart and Circulatory
Physiology.
Grotenboer, N. S., Ketelaar, M. E., Koppelman, G. H., & Nawijn, M. C. (2013). Decoding
asthma: translating genetic variation in IL33 and IL1RL1 into disease
pathophysiology. Journal of Allergy and Clinical Immunology, 131(3), 856-865.
Loo, S. L., & Wark, P. A. (2016). Recent advances in understanding and managing
asthma. F1000Research, 5.
Maguire, C. (2015). ‘A breath of fresh air’–initiating a new, nurse led asthma clinic in
general practice. Nursing in General Practice.
Nhlbi.nih.gov. (2019). Retrieved from
https://www.nhlbi.nih.gov/files/docs/resources/lung/nurs_gde.pdf

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Rodriguez, E., Rivera, D. A., Perlroth, D., Becker, E., Wang, N. E., & Landau, M. (2013).
School nurses' role in asthma management, school absenteeism, and cost savings: A
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Who.int. (2019). WHO | Bronchial asthma. Retrieved from
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