Follow Up Asthma Case Study

Discuss the prevalence of asthma in certain patient populations that you might see in primary care. Asthma is chronic airway inflammation disorder that is characterized by persistent episodes of wheezing, breathlessness, chest tightness, and non-productive cough, mainly at night and in the early morning. The inflammation of the airway results from physical, chemical, and pharmacologic stimulus, which causes bronchial hyper-responsiveness, constriction of the airways, edema of airway wall, and chronic airway remodeling (Cash, 2014). Asthma occurs at all ages, with about 50% of all cases developing during childhood and another 30% before age 40. In the United States, it is estimated that 25 million people have asthma and the prevalence continues to increase (McCance, & Huether, 2014). Previously, asthma was considered

Asthma is a chronic inflammatory lung disease that affects approximately 22 million people in the United States. Six million of those people are children, making it the most common chronic disease of children (“What is Asthma” and National 1). Asthma may be associated with morbidity, mortality, and diminished quality of life. Asthma is considered a long-term disease because there is currently no cure (Young). Further defining this disorder will be achieved by explaining the disease and symptoms, addressing how it is acquired, ways physicians diagnose it, and elaborating on treatments.

Medications used are corticosteroids, bronchodilators, and leukotrienes. Corticosteroids are used to suppress the inflammatory process in the airways of asthmatics. This medication stops the regulation of pathways that are involved in the cytokines and inflammatory mediators. Corticosteroids work its way into the respiratory epithelial cell in the airway through the glucocorticoid receptor. The steroid receptor within the nucleus promotes the transcription of genes that decrease inflammation and stops the gene that encodes protein that increases inflammation. Examples of corticosteroids are qvar, pulmicort, symbicort, and advair. The benefits to using corticosteroids are to decrease asthma symptoms, decrease airway hyperresponsiveness, and fewer exacerbations (Sobande & Kercsmar, 2008). Bronchodilators are used to relax contractions of smooth muscle of the bronchioles and improve ventilation. These drugs work on the B-2 receptors in the cells of the airway and cause the smooth muscles to relax, making it easier to breath. There are short-acting bronchodilators such as albuterol and xopenex. Long-acting bronchodilators include advair and symbicort (Ohar & Donohue, 2010). Bronchodilators are used in conjunction with steroids to decrease inflammation and to relax smooth muscle; thus making it breathes better. Leukotrienes are a new class of medication that is used to treat asthma over the last two decades. Leukotrienes

From the information gathered from the case study above, SE asthma is not well controlled because, she has been using her albuterol metered- dose inhaler approximately three to four days a week over the last two months. She has been awakened by cough three nights during the last month. She has shortness of breath during exercise, which does not usually occur to her during exercise. She has been hospitalized two times in the last year due to her asthma exacerbation and SE has visited the emergency department six times for the past six months due to asthma symptoms and exacerbation

Respiratory system: Denies problems. “A cold in the winter once a year” No exposure to pollutants, No history of tobacco use, no history of alcohol, denies difficulty in breathing and cough. Lung sounds was heard in all areas, a respiration of 16, even and unlabored with no adventurous sound on

Patient is a 10 year-old male admitted into the hospital for Chronic Asthma. Patient is experiencing shortness of breath, fatigue, nausea, and tightness in chest area. Patient has a history of Chronic Asthma since birth. .

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I am also suspicious that she is struggling with eustachian tube dysfunction. We talked about treatments. We briefly discussed the idea of antibiotics, but at this point, my suspicion is this is still more viral. She is aware of what to be watching for and knows to call me if there is not improvement here through the course of the rest of the week or into early next week. We talked about good hand hygiene to avoid new illness or spread to others. One of her biggest complaints is just coughing at night and keeping her awake. I did write her for Tussionex cough syrup 5 mL twice daily p.r.n. four ounces with no refills. She is aware of side effects and is aware of sedation, in particular. She will not take it if she is driving or with any other sedating medication. She will monitor her symptoms, in the interim. She will continue with her Flonase and if there is no improvement here into next week or so, consideration for antibiotics can be done. If there is acute worsening in her respiratory status or other concerns, she will seek care if necessary and will otherwise follow up as needed with Dr. Lilly. All questions answered in the office

Ms. Anastas is a 56-year-old female here today to follow up for her asthma. She is also considering cosmetic surgery.

This patient is a 48-year-old male who required inpatient hospitalization due to acute on chronic hypercarbic respiratory failure secondary to asthma/COPD exacerbation. She was presented to the emergency department with complaints of shortness of breath accompanied with cough and chest pain and was admitted for further treatment and evaluation.

The patient is a 69-year-old woman who has COPD, and asthmatic bronchitis; who presents for evaluation of increasing shortness of breath, cough, and increased sinus congestion and pressure. She has been on steroids because of exacerbation of asthma now for some time, is actually on 40 mg daily. In spite of this she notes ongoing wheezing, and shortness of breath when doing her exercise tolerance. She has had no high fevers, no localized chest pain. She is using her inhalers as prescribed. Others at time in [Place] have also had an upper respiratory illness. She wanted to make sure she would not need antibiotics. She has had some facial pain, that seems to better today. She had some yellow discharge that now seems to be clear. The patient did

Patients’ education should also include trigger avoidance, an understanding of the disease process and its management; properly use of asthma devices, keeping asthma under control, and more importantly adherence to the asthma medication. Patients education should also cover the understanding of the disease process such as asthma is a treatable and manageable, but not curable. Therefore, medication should not be discontinued even when the symptoms are under control. Lastly, patients’ education should also include compliance to the follow-up appointments even when the symptoms are under control or not. If patients’ symptoms are not under control, then the further referral may have needed to an allergist and a pulmonologist for further testing in order to achieve the overall

On clinical observation, Cora's pulse rate was 105 beats per minute (bpm), respiratory rate 29 bpm appears to be with the normal range, indicating that Cora's asthma exacerbation is under control. According to Li et al (2009) in asthma exacerbation, a pulse rate >30 bpm and a respiration rate >120bpm is considered to be an indication of a moderate exacerbation. Cora is conscious, alert, not agitated and able to respond verbally, though she is breathless. Li et al (2009) emphasizes that the signs and symptoms of slow breathing, disorientation, exhaustion, unconsciousness, total lack of communication and cyanosis of the fingernails in an individual with asthma exacerbation are signs that the asthma attack is becoming life threatening and needs urgent

This 59-year-old female presents to the clinic with a history of progressive shortness of breath, with a white colored productive cough He indicated that these symptoms started three days ago and that his inhaler is not helping anymore. He was treated for asthma attack about 14days ago. Patient has a history of asthma, hypertension, anxiety, insomnia and hyperlipidemia. The patient is a chronic smoker. He smokes about one and a half pack of cigarette a day. He has been a smoker for over 40years.

Woo and Wynne (2012) define asthma as a chronic inflammatory disorder of the airways (Woo & Wynne, 2012). Asthma is a condition that cannot be cured, but its symptoms can be controlled (Mayo Clinic, 2014). Inhaled corticosteroids are known to be the most effective form of long-term management of persistent asthma (National Heart, Lung, and Blood Institute, 2013). Inhaled corticosteroids help keep asthma under control daily and make it less likely to have an asthma attack (Mayo Clinic, 2014). Beta adrenergic agonists are used as quick relief medication to treat acute asthma attacks, but regular long term use of beta adrenergic agonists are not as beneficial as inhaled corticosteroids (National Heart, Lung, and Blood Institute, 2013).