Case Study: Tegan Smith's Asthma, Treatment, and Management

This case study analyzes the case of Tegan Smith, who is suffering from allergic asthma. It begins by identifying the type of asthma and its triggers based on Smith's exhibited signs and symptoms, highlighting the role of environmental pathogens and genetic predisposition. The study then delves into the pathophysiological changes associated with asthma, including the inflammatory nature of the disease and its relationship with other conditions like sleep apnea and gastro-oesophagal reflux. It categorizes the disease phenotypes based on clinical characteristics and explores various treatment options, including reliever and preventer medications, as well as allergen immunotherapy. Finally, the case study outlines standard asthma management education for parents and children, emphasizing the importance of understanding triggers, medications, and emergency plans, and providing a framework for ongoing support and follow-up care.

Running head: TEGAN SMITH CASE STUDY 1
Tegan Smith Case Study
Student’s Name
University

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Tegan Smith Case Study
Question one: The type of asthma that Tegan Smith is suffering
From the signs and symptoms that Tegan has exhibited, she is suffering from allergic
asthma identified through sensitive reaction to certain pathogens that make the immune system
of the individual to react through tightening of the airway muscles and flooding them with mucus
to prevent the pathogens from entering the lungs. This type of asthma is characterized by
symptoms like fatigue, wheezing, stuffy nose and coughing (Tan, et al., 2015). Further, if the
level of allergic reaction is too much, the individual can show signs like watery eyes or postnatal
drainage. Scholars have attributed these allergic condition to genetic makeup of the individual
which can be inherited from parents. This means that the condition can follow the family line
through allergic reactions that some parents in the family head. For example, Tegan’s mother had
an allergic history characterized by sinusitis, allergy and nasal polyps. Reactions that Tegan
showed are related to environmental pathogens like pollen, dust mites, pet dander, tobacco
smoke, strong odour from perfumes, polluted air and strong chemicals which trigger the signs
and symptoms of the condition (Bostantzoglou, et al., 2015). The severity of the reaction
depends on the nature and amount of pathogens inhaled into the system. Tegan’s body system
was reacting to environmental changes that she was experiencing since she developed the attack
at home. Therefore, allergic asthma patients should be sensitive to the environment that they
operate in and develop strategies to ensure that they protect themselves from such allergy
causing pathogens that can trigger the reaction and lead to attacks.
Question two: The pathophysiological changes in asthma
Asthma as a disease has undergone pathophysiological changes for the last twenty-five
years characterized by the patterns of the disease that are both acute and intermittent. The nature

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of the condition is inflammatory which means it can be controlled and managed through a
patient-centered approach that focusses on reducing exposure to allergic reaction triggering
pathogens (Sbihi, Tamburic, Koehoorn, & Brauer, 2016). The major problem is asthma is
exhibited immunological which means young children in early years of the infection show
excessive inflammation of the airways. Asthma is currently related to different conditions that
can trigger the presence of such allergies thus creating pathogenesis of the disease. Patients with
sleep apnea and asthma have been seen to improve when the apnea is diagnosed and treated
(Sbihi, Tamburic, Koehoorn, & Brauer, 2016). On the other hand, patients with gastro-
oesophagalreflux disease who have repetitive episodes of acid aspiration makes it difficult to
control asthma thus calling for the need to understand its relationship with asthma. Further,
Robinson & Klein (2012) argues that asthma is also related to exposure to air pollution during
pregnancy since some women have immunological shift caused by hormonal fluctuations which
play a major role in asthma pathophysiology.
Further the pathophysiology of the disease can be grouped in three ways of the
individual, impact and level of inflammation. Since the disease has roots in the genetic make up
of the individual, then the genetic history of the family is important in undestanding the
likelihood of the disease (Von-Mutius & Drazen, 2012). Clinicians group the phenotypes of the
disease using clinical characteristics that place patients in clusters using the degree of similarity.
From this characteristics, the Global Initiative for Asthma (GINA) identified types of asthma as;
allergic asthma, asthma with fixed airflow limitation, asthma with obesity, non-allergic asthma
and late-onset asthma (Jiang, et al., 2016).
Question three: Different treatment options for asthma

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The National Asthma Council Australia (2018) suggests that there are two types of
asthma medicines in Australia; relieves and preventers. Relievers exist for all those people who
have the conditions since they require it when they have symptoms. This includes a puffer or
inhaler which are mostly available over the counter without prescription.
On the other hand, preventers are used mostly in adults through taking a low dosage
every day to reduce the manifestation of the disease. This drug is mostly corticosteroid whose
work is to reduce inflammation of the airways thus reducing the risk of severe inflammation.
Children require the same preventive medication and relievers to keep the condition in check.
Asthma Australia (2018) states that these drugs include Alvesco, Flixotide, Pulmicort and Qvar
that come in the form of inhalers for repairing the airway cells thus reducing sensitivity in
inflammation and excess mucus. There are other inhalers like Breo, Flutiform, Fluticasone +
Salmeterol Cipla*, Seretide, and Symbicort which contain both inhaled corticosteroid and a long-
acting reliever which work in the same way.
Allergen immunotherapy is also used to cure asthma since the available medications do
not cure but only prevent the manifestation of the allergies. This process involves administration
of regular allergen doses, which are gradually increased over a period of years. This can be
through injections, sprays, tablets or sublingual form (Tippets & Guilbert, 2009). The role of the
medication is to change immune system reaction to allergens thus switching of the allergy. This
method requires three to five years commitment to the therapy since it is not a quick fix
treatment option.
Question four: standard asthma management education for parents and children before
discharge

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a) According to the National Asthma Council of Australia (2018) standards have been set to
assist parents with asthmatic children manage the condition to increase the response to
any medications that have been prescribed.
b) Establish standard management goals with the parent that will be followed during
administering of education through a personalized plan of care developed with the
practitioner.
c) Ensure that parents have adequate knowledge and understanding of asthma and its
triggers, signs and symptoms to easily respond and manage them.
d) Offer specific training and education to the child inhaler use if the child is of appropriate
age to help in managing the condition.
e) All parents need to have adequate supply of all the necessary medications, spacers and
discharge scripts.
f) Ensure that the parents understand how to use a WAAP in case of an attack.
g) Parents need to be taken through the asthma management plan post forty-eight hours of
discharge or proper healing and prevention of inflammatory reaction.
h) Provide the kids health info fact sheet to parents for reference purposes.
i) Ensure that parents are linked to the GP and inform them the role that the GP plays in the
management of asthma.
j) Ensure that the patient has a follow-up appointment with a health practitioner to assess
the extent of the body response.
k) Consider referrals to community-based asthma groups and other supportive services that
exist within the locality of the patient for additional asthma education.

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l) Ensure that the patient has a named lead person for managing the condition and follow-up
support for the patient.
m) All parents have to put mechanisms in place for children to receive clinical assessment
after discharge based on the care goals set.

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References
Asthma Australia. (2018, April). Your asthma medicine. Retrieved from Asthma Australia:
https://www.asthmaaustralia.org.au/national/about-asthma/manage-your-asthma/your-
asthma-medicine
Bostantzoglou, C., Delimpoura, V., Samitas, K., Zervas, E., Kanniess, F., & Gaga, M. (2015).
Clinical asthma phenotypes in the real world: opportunities and challenges. Breathe,
11(3), 186-193.
Jiang, L., Diaz, P. T., Best, T. M., Stimpfl, J. N., He, F., & Zuo, L. (2016). Molecular
characterization of redox mechanisms in allergic asthma. Annals of Allergy, Asthma &
Immunology, 113(2), 137–142.
National Asthma Council of Australia. (2018). Medicines and treatment. Retrieved from
National Asthma Council Australia: https://www.nationalasthma.org.au/understanding-
asthma/treatment-and-medicines
National Asthma Council of Australia. (2018). Asthma & Allergy. Retrieved from National
Asthma Council of Australia:
https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/
brochures/asthma-allergy#
Robinson, D. P., & Klein, S. L. (2012). Pregnancy and pregnancy-associated hormones alter
immune responses and disease pathogenesis. Hormones and Behavior, 62(3), 263–271.
Sbihi, H., Tamburic, L., Koehoorn, M., & Brauer, M. (2016). Perinatal air pollution exposure
and development of asthma from birth to age 10 years. European Respiratory Journal,
47.

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Tan, D., Walters, E., Perret, J., Lodge, C., Lowe, A., Matheson, M., & Dharmage, S. (2015).
Age-of-asthma onset as a determinant of different asthma phenotypes in adults: a
systematic review and meta-analysis of the literature. Expert review of respirator. Expert
review of respiratory medicine, 9(1), 109-123.
Tippets, B., & Guilbert, T. (2009). Managing Asthma in Children: Part 1: Making the Diagnosis,
Assessing Severity. Consultant for Pediatricians, 8(9).
Von-Mutius, E., & Drazen, J. (2012). A patient with asthma seeks medical advice in 1828, 1928,
and 2012. New England Journal of Medicine, 366(9), 827-834.