Masters Level 7 Nursing Essay: Asthma Case Study Analysis

This Masters Level 7 nursing essay presents a case study of Mr. Ali, a 50-year-old man with asthma, exploring the interplay of lifestyle factors, including smoking and obesity, and their impact on his condition. The essay delves into the application of Essential Skills Clusters (ESCs) in nursing care, emphasizing care, compassion, communication, organizational aspects, infection prevention, nutrition management, and medication management. It examines the pathophysiology of asthma, highlighting the influence of Mr. Ali's habits and non-adherence to medication. The essay also discusses the role of the Nursing and Midwifery Council (NMC) guidelines in ensuring patient confidentiality and the importance of medication adherence. The analysis underscores the correlation between lifestyle choices, such as smoking and BMI, and asthma severity, while emphasizing the nurse's role in patient education and holistic care. The essay concludes by highlighting the necessity of lifestyle modifications and medication adherence to improve patient outcomes and manage asthma effectively.

Running head: NURSING ESSAY case study MASTERS LEVEL 7
NURSING ESSAY case study MASTERS LEVEL 7
Name of the student:
Name of the university:
Author note:

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Introduction:
Asthma is considered as a serious respiratory disease which became the socio
economic issues, affecting more than 300 million individuals across the globe. The disease is
considered as an inflammatory disease in the airway, leading to the airway obstructions,
hyper responsiveness and airway wall alteration. As discussed by researchers significant
number of patients with asthma develop asthma because poor lifestyle and unhealthy habits.
The documented literature suggested that majority of the patients with asthma develop the
disease because unhealthy habit of smoking. While smoking is one of the major risk factor of
development of asthma, other risk factors also contribute to high prevalence of asthma such
as lack of physical activity, poor diet, obesity and stress. Hence, in order to reduce the high
prevalence of asthma, it is required to amend the lifestyle. The competency skills of nurses
such as essential skills clusters play crucial in amending the lifestyle of the patients for
supporting the wellbeing of the patient. This essay will explore execration of asthma in
relation to the patients’ lifestyle.
Discussion:
The case study:
The provided case study is regarding Mr. Ali, an old gentleman of age 50 years with
the medical history of asthma suffering. He is a cleaner in a shopping complex and he stays
with his wife and 4 children. After witnessing an asthma attack, he was admitted to the
Accident and Emergency (A&E) and after which he came under General Practice (GP) for his
asthma suffering. He admitted that he had a habit of smoking and smokes up to 20 cigarettes
per day and also consumes alcohol on minimal amount. Mr. Ali’s Body Mass Index (BMI)
was around 40 which stated his obese condition. he is also found to skip his medications. He
was provided with medication Clenil modulite 2 puffs (100mcg) twice daily and was also

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administered with Salbutamol only when required. His treatment related information, the
nursing staffs and the other stakeholders involved in his care and treatment process were kept
confidential under the code of the Nursing and Midwifery Council (NMC). The code for
confidentiality of the Nursing and Midwifery Council (NMC) guides the nursing staffs and
other health care professionals to keep the patient’s health and treatment details confidential
and must not share or disclose it to everyone (Duffy & Gillies, 2018). The details should be
disclosed only if it is necessary and is required for the treatment and well-being of the patient.
Disclosing one’s health and treatment details to everyone is a counted as an offensive
behaviour (Shepherd, 2017).
Essential Skills Clusters (ESCs):
The Essential Skills Clusters (ESCs) is divided into 5 divisions and are described as
follows:
Care, compassion and communication is one of the major essential skills that needs to
be practiced by every nursing staff in order to deliver a better care and treatment to the
patient. The nursing staffs needs to demonstrate these skills as the first step of care delivery
according to the standards for all the process with the Nursing and Midwifery Council
(Sinclair et al., 2016).
The organizational aspects of health care states that the registered nursing staffs needs
to systematically evaluate, prepare plans and also provide a better holistic care to the patients
according to the needs of the individuals. It guides the nursing staffs to provide support and
protection to the children and adults who are in vulnerable conditions (Heintz et al., 2015).
Also co-ordination, leading and providing properly managed care to the patients in need. It
provides the nursing staff with a better guidance and knowledge regarding the effectiveness

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of the care and treatment provided while working as a multidisciplinary team (Gordon et al.,
2018).
The infection prevention and control is one of the essential skills which guides the
nursing staff about the need of the nursing staff to have appropriate idea, knowledge and
understanding regarding the treatment they are providing to their patients and also skills they
need to provide to the patients according to their health condition and needs (Berríos-Torres
et al., 2017). the infection prevention and control provides a better understanding regarding
the safety and precautions that needs to be implicated in order to avoid infection or any
severity in the health condition of the patients (World Health Organization, 2016).
The nutrition and fluid management is also one of the major aspects of essential skills
cluster, as it guides the nursing staffs regarding the management of the diet and nutrition
uptake of the patients. It is the nurse’s role to guide the patients and manage the diet and
nutrition uptake of the patients according to their health condition and needs in order to retain
a better health outcome (Klek et al., 2016).
The last type of essential skills culture states medicine management. It provides the
knowledge and understanding to the nursing staffs regarding the management of treatment
and medication that needs to be provided to the patients in order to help them recover from
their health conditions (Habib et al., 2015). The nursing staff is the primary factor of an
effective health care system, as the nursing staff provides a management plan and mi tors the
health outcomes of the patient, thus it is important for the nursing staff to have a better
understanding regarding the management of medicines (Stavropoulos et al., 2016).
The condition:
Asthma is a long term chronic health condition which effects the person by inflaming
and narrowing the airways of the lungs which leads to swelling of the airways (Lambrecht &

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Hammad, 2015). Asthma leads to wheezing, tightness of the chest, coughing and witnessing
shortness of breath. The symptoms of asthma are found to be ranging from mild to severe.
Worsen asthma symptoms leads to asthma attack (Pavord et al., 2018). The causes of asthma
can be the response of the immune system on exposure to any allergen existing in the
environment (Stein et al., 2016). The asthma consists of various factors such as the airway
constriction, mucus hypersecretion, eosinophils, IgE mediated inflammatory response and
smooth muscle hyperplasia. Inflammation plays a major role in the asthma pathophysiology.
The asthma patients are found to be suffering from airway block which is the result of
exposure to allergen which ultimately ends up releasing various bronco constricting
mediators (Barnes, 2016). These bronco constricting mediators stimulates the airway muscles
which leads to its contraction. Also, narrowing of the airways may also occur because of
previous and present edema and mucus constriction. These frequent changes in the airways
structures are called airways remodelling which generally leads to asthma condition for the
individuals (Mazzeo et al., 2015). The lifestyle of Mr. Ali and his habit of smoking excessive
amount of cigarettes a day has been affecting his health and is increasing the negative effects
of his asthma condition. smoking is found to effect the respiratory system and creates
blockage and damages the internal parts which increases the severity of asthma.
Though there are various cause has been recognized for the asthma condition, and also
there are studies stating that the breathing disorder is triggered due to a variety of aspects (v
et al., 2016). These factors are found to include:
 Past medical history of pathological infections. individual with a medical history of
pathological infections during their childhood are found to be more susceptible to
suffering from the asthma condition (García-Rio et al., 2018).

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 Genetics. Family history of asthma is one of the reason behind occurrence of asthma
condition. individuals are transferred with the disorder genetically from their parents
if they also have the condition of asthma (Ghani et al., 2017).
 Primary allergen acquaintance. Recurrent exposure to harmful allergens and
pathogens is found to increase the risk of emerging asthma condition in individuals
(Kanazawa et al., 2018). Sanitation hypothesis. The sanitation hypothesis recommends that infants must not
be exposed to adequate pathogens in their primary age. Thus, it leads to a situation
where the child’s immune systems lose their ability to develop strong enough to
protect the individual from the asthma and other health conditions (Lodge &
Dharmage, 2016).
Impact of patient’s BMI on the asthma condition:
According to Johnston & Shore, (2019), obesity is one of the furthermost common co-
morbidity in asthma condition; it has been supplementary to the increased possibility of
occurring asthma exacerbations, which leads to worsen asthma symptoms and deprived
control. Mr. Ali’s Body Mass Index (BMI) was around 40 which stated his obese condition.
this played another important factor in the development of severe condition for his asthma.
Thus in order to avoid the increase in severity of the asthma condition, individuals suffering
from asthma condition needs to work on reducing their weight by performing various
exercises and physical activities. Weight loss will also help them maintain a healthy life and
it will protect the other organs from getting effected and will maintain a heathy body.
Obesity, in various studies have shown to worsen the asthma signs and develops the
condition more difficult to manage (Shore & Cho, 2016). Merely being overweight may
increase the risk of emerging asthma condition. In accumulation to witness more frequent
hospitalization due to the individual’s asthma condition, obese asthmatics are observed and is

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found to knowledge a lesser quality of healthy life than asthmatics people who aren't
suffering from obesity (Maniscalco et al., 2017). It has been observed that obese individuals
have greater chances of witnessing acid reflux, which is found to be a factor which triggers
and impressionist asthma symptoms (Umetsu, 2017).
Effect of non-adherence of medications according to NMC:
According to the World Health Organization, refining the medication adherence
might tend to have a superior influence on people health than refining precise therapeutic
treatments. Non adherence to medication in asthma condition is correlated to a wider range of
difficult and harmful outcomes for the patients suffering (World Health Organization, 2016).
The role of Nursing and Midwifery Council (NMC) is to guide the nursing staffs and
other health care professionals regarding the administration of medication to the patient
according to their needs. their role is also to provide education and knowledge regarding the
adherence of the medication and also the consequence of the non-adherence of the prescribed
medications (Parry, Barriball & While, 2015). They need to be trained in order to avoid any
medication error as well as make sure that the patient is appropriately administrating the
medications and also they need to be updated enough to restore the changes made throughout
the session of treatment (Cloete, 2015).
As Mr. Ali was prescribed with Clenil modulate 2 puffs (100mcg) and Salbutamol
when required, these medication has specific guidelines for administration, as they need to be
followed strictly in order to retain better health outcomes. Non-adherence of Medication can
be stated either as the deliberate or ignorant failure to administer medications as
recommended by the health care professionals (Bussell et al.,2017). If the patient does not
follow the administration process of the medication according to the healthcare professional,
the patient will later witness reduced efficiency of the medication and the treatment which

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might lead to the deterioration of their health condition (Lam & Fresco, 2015). The non-
adherence of the asthma medication includes deprived rate of asthma control, amplified
amount of exacerbation, increased incident of hospitalization, failure of lungs normal
functions, and increased chances of mortality (Brown et al., 2016).
Mr. Ali is often found to skip the medications prescribed by the health care
professionals for his asthma condition. he needs to be guided and provided knowledge
regarding the administration of Clenil modulite as it is recommended that these medications
adherence should not be paused abruptly (Sellers, 2017). It is necessary to use Clenil
Modulite on a consistent basis even though they are found to be asymptomatic (Todorov et
al., 2017). Mr. Ali is prescribed with Salbutamol in order to avoid the severity caused by the
asthma. It helps to avoid the circumstances of asthma attack occurrence in patients (Jinno et
al., 2018). Salbutamol is administered in order to get rid of the signs of asthma and COPD
which includes wheezing, feeling breathless and coughing (Katsunuma et al., 2019). It
functions by comforting the muscles of the air route inside the lungs which permits the
patient to breath better.
These above mentioned medications were prescribed to Mr. Ali focusing on his health
and asthma condition. but he was found to ne avoiding adherence to these medications which
was one of the reasons behind the increase in health issues and severity that cause the asthma
attack (Yu et al., 2018). These medications have specific functions which is useful for
controlling asthma symptoms and management of the severe health conditions lead by the
asthma (Parry, Barriball & While, 2015).
Asthma care and delivery management:
As observed in this case study, the patient was experiencing asthma attack, he was
admitted to the Accident and Emergency (A&E) and after which he came under General

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Practice (GP) for his asthma suffering. He admitted that he had a habit of smoking and
smokes up to 20 cigarettes per day and also consumes alcohol on minimal amount. In this
case, the social, economic and political context of care is required to consider for the patients,
in order yto amend the lifestyle of the patient so that his exacerbation can be reduced.
Social context of care:
The social context of care consider the social factors, more preciously social determinants
in order to analyse the contributing factors of the disease and amend the factors in order to
support the wellbeing of the patients. Taking a deep insight of the situation, the patient
worked as a full time cleaner in shopping centre and lives with his wife and 4 children. In
this case, patient may feel depressed or stress as it may be difficult for the patient to provide
the adequate financial accommodation to each child. In this case, the nurses are required to
provide intervention such as stress management therapy. Stress in severe quantity often
effects the treatment process of asthma and it also effects the process of controlling an asthma
attack, making it more problematic (Oland, Booster & Bender, 2017). The nurses are
required to involve her in the stress management therapy such as meditation and exercise. As
discussed by researchers mediation reduces the stress hormone resulted in reduction in
exacerbation. On the other hand , Nyenhuis, Dixon and Ma (2018) at regular exercise
plays a greater role in reducing the risk factors associated with asthma attacks and also will
help restore of breathing difficulties. Providing patients that proper health literacy regarding
the smoking habits and benefit of adherence to the medication may reduce the habit of
frequent smoking and alcohol consumption and improve the wellbeing of the patients.
Nurses must involve family members in each intervention so that the patient feel empowered
and comfortable. As discussed by () amending dietary intake may reduce the stress and
support the faster recovery of the patients. In this case, nurses must design proper diet
containing vegetables and fruits for reducing the stress and improving health condition.

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Economic context of care:
Poor economic condition is one of the leading social determinants that contributed to
the development of the disease. In this current context, the patient worked as a full time
cleaner in shopping centre and lives with his wife and 4 children. As discuss before since the
patient had poor socio economic status, he failed to provide daily necessities that might be
the cause behind smoking habit and associated asthma. In this case, nurses are required to
provide communicate with the local government and general practitioner regarding the
reference of the patient for better employment so that exacerbation of the disease can be
reduced . In this case, nurses are required to arrange insurance for the patient in order to
reduce financial cost of the disease. It will reduce the economic burden of the patient and
reduce the wellbeing of the patient.
Political context of care:
While political context was not mentioned in the case study, it can be observed that in
majority of the cases, the high prevalence of disease is observed because of lack of
appropriate infrastructure for caring for the patients with asthma. In this case, nurses are
required to provide the access to the health care access to the patients. Researchers suggested
that providing accurate access to the care despite the low socioeconomic status is crucial for
reducing the high morbidity and global burden of disease. In this case, the nurses are
required to provide access to the health care services to the patients with low economic status
so that they receive specialized form of care according to the need of the patients. The nurses
are required to communicate with the local government and policy maker to amend the
relevant policies so that the patient with asthma receive adequate care. It will reduce the
health inequality and improve the wellbeing of the patient and reduce exacerbation of the
disease.

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Conclusion:
In order to conclude, it can be stated that, Asthma is a major type of inflammatory
disorder of the airways connected to the lungs. It makes difficult for the person to breath
appropriately and it is also found to make the conduction of various physical
accomplishments problematic or sometimes makes it even impossible. It has been found in
several studies that, the Body Mass Index (BMI) which leads to obesity in individuals can be
a major reason behind the severity of asthma condition in people and it may also lead to
asthma attacks which may affect the development of the health as well as lead to mortality of
the person. Losing weight is one of the important step that can be taken towards a better
health achievement for individuals who is witnessing weighty or obese condition, but
possibly it will be effective even more for people who are suffering with the asthma
condition. Various research has showed that people with obese and are also suffering with
asthma condition and later individuals lose their weight often experience a greater
development in their asthma condition symptoms. Mr. Ali was observed to skip medication
very frequently that was prescribed to him by the health care professional. It was also a major
factor enhancing the risk of asthma attack in his case. In order to restore and provide better
health experience to him, the nursing staffs needs to promote a better management plan for
him which will provide him with the knowledge regarding the asthma conditions and its
treatment a medication process (Lee et al., 2016).

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