Asthma Case Study:
Team Nucleus
Elizabeth Holmes
Alison Husted
Pavithra Jaisankar
Alexandra Keidel
Uma Sankararaman
Violeta Pantaleon
Deirdre Rogers
Kirsten Ross
The Johns Hopkins University School of Nursing
Principles of Pathophysiology
Dr. Olsen/ Dr. Renda
NR 110.312
October 9, 2014
On our honor, we pledge that we have neither given nor received any unauthorized assistance on this case study
I. Overview of Case and Pathophysiology Pathogenesis
Asthma is a chronic inflammatory disorder of the bronchial mucosa and hyperreactive bronchial tubes. Its etiology has been linked to both genetic and environmental factors. Several genes, including those that influence the production of proteins and cells involved in the immune response (such as interleukins, eosinophils, mast cells) have been linked with asthma. A decreased number of T-regulatory cells is also associated with asthma. Environmental factors linked with asthma include exposure to allergens, urban residence, and smoking (or exposure to secondary smoke). Recurrent respiratory tract viral infections may also contribute to the development of asthma. Decreased exposure to certain infectious organisms during early childhood, and the consequent underdevelopment of the immune response, can also lead to the development of asthma--this is known as the hygiene hypothesis (McCance & Huether, 2014, p. 1263-4).
The innate and adaptive immune response start with exposure to an antigen in the epithelium of
Asthma itself is an inflammatory disease characterized by increased airway responsiveness due to a variety of stimulus. The inflammation causes the hyper-responsiveness than in turn causes bronchiolar smooth muscle constriction, resulting in obstruction of airflow. Some
Respiratory disorder, mostly affect the upper or lower respiratory tract, however bacterial or viral infection are the causative agent and the disease is common in all ages. In addition, the lungs and the bronchi can also be affected, causing inflammation and obstruction of the airflow resulting in wheezing, chest tightness, stridor, low grade fever, cough, and hemoptysis due severe damage to the lung tissues. Most common diseases of the respiratory system include; pneumonia, croup, asthma, bronchitis, laryngitis, and tuberculosis, affected disease location determines the signs and symptoms. Hereditary and environmental factors such as allergens and other irritants can be a contributory factor, especially in children. However, respiratory compromise occur as a result of incomplete airway development among this vulnerable population predisposing them to chronic asthma (Huether & McCance, 2012).
1.13. In your own words describe how asthma, which is a chronic illness, can become an acute and life threatening emergency? Asthma is a chronic long term issue where the airways become tightened making it harder to breathe. Acute asthma or exacerbation of asthma is when the airways again become tightened and inflamed, swollen and make it hard to breathe which sounds like wheezing, coughing and difficulty in consuming enough oxygen. Can be caused by a allergenic(Chrisp & Taylor, 2011)
Asthma, as defined by the NIH, “is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing.” (National Institutes of Health, National Heart, Lung and Blood Institute [NHLBI], 2015). There are risk factors that may predispose a child to developing asthma, which include having allergies, eczema, and/or having parents who have asthma. Asthma is not a disease that is preventable. (NHLBI, 2015). The risk or likelihood that someone would have asthma is based on the biological makeup of the individual that would predispose them to the disease, rather than behavioral, environmental, or even social factors.
Having Asthma can affect a person in a number of ways. The physical symptoms can range from the occasional cough all the way to life-threatening cases which are not being able to breathe. The seriousness and frequency of asthma symptoms is all dependant on how well the individual can control their Asthma. There are three symptoms of Asthma, the first being airway obstruction. Allergic substances and environmental triggers make a chain of muscle surrounding the airways tighten, and air cannot move freely. So my theory for this type of symptom would be; if a person was running through a park surrounded with many blossoming flowers, they began to sneeze and became short of breath would be because of the pollen floating around in the air. The second symptom is inflammation; with this type people have red swollen bronchial tubes, which are the airways of the lungs. This inflammation is thought to add greatly to the long-term damage Asthma can cause to the lungs. So my understanding for this type would be; a person has had inflammation for years and now has severe damage to his lungs. So therefore, treating this inflammation would be to the key to managing Asthma in the long run. The third symptom is airway irritability; the airways for people with this type are extremely sensitive. The airways tends to overreact and narrow due even the smallest triggers like pollen or animal dander, My theory for this type would be; If a person has got a new with really messy hair that
Asthma is a chronic lung disease characterized by episodes in which the bronchioles constrict due to oversensitivity. In asthma, the airways (bronchioles) constrict making it difficult to get air in or out of the lungs. Breathlessness is the main symptom. The bronchi and bronchioles become inflamed and constricted. Asthmatics usually react to triggers. Triggers are substances and situations that would not normally trouble an asthma free person. Asthma is either extrinsic or intrinsic. Extrinsic is when the inflammation in the airway is a result of hypersensitivity reactions associated with allergy (food or pollen). Intrinsic asthma is linked to hyper responsive reactions to other forms of
Asthma is a disease of the lungs that can be influenced by different genes or alleles. When the epithelial or mucosal barrier is exposed to pollens, allergens, microbes or pollutants, these can stimulate the underlying antigen presenting cells (APC) which causes an immune response to occur.17 This can cause a cell influx into the airway that is primarily eosinophilic or neutrophilic. When the allergens present themselves, they can initiate a breakdown in the physical barriers, causing further allergic, inflammatory responses.
Cardiff scientists have recently found a link to the airway inflammation found in asthma patients. This inflammation
I pledge my word and honor that I have neither given nor received any unauthorized aid on this
Caleb is a 10-year-old male here today with his mother with complaints of a cold and a sore throat.
Recent studies have established that genetic and environmental factors are associated with the development of asthma (Maddox L, Schwartz DA, 2002). Numerous environmental factors such as allergens, air pollution and other environmental chemicals have been associated with the development and increased asthma severity (F. J. Kelly, 2011). Other factors can include low air quality from high ozone levels, traffic pollution as well as smoking during pregnancy and after delivery (Gold, Diane R., 2005). Asthma runs strongly in families; it is believed that three-fifths of all asthma cases are hereditary (WebMD, 2014). According to a CDC report, if an individual has a parent with asthma, that person is three to six times more likely to develop asthma than someone who does not have a parent with asthma (WebMD, 2014).
Infection of the respiratory tract may cause the exacerbation of asthma for someone who has been diagnosed with asthma. According to Busse, Lemanske and Gern (2010), viral respiratory tract infections, mostly caused by rhinoviruses are related with asthma exacerbations. Moreover, when the infections of upper respiratory tract, which affect the nose, paranasal sinuses, pharynx, larynx, trachea, and bronchi happen, the immune system responds to it with inflammation. According to Rohilla, Sharma, Kumar and Sonu (2013), viral infection causes inflammation which narrowing the air tract. Furthermore, the inflammation may trigger the overproduced of mucus, which worsens the narrow airways. On common conditions, the immune system’s inflammation response
Asthma can best be described as a chronic inflammatory disease involving the pulmonary airways, and bronchial hyper responsiveness that results in lower airway obstruction (Kudo, Ishigatsubo, & Aoki, 2013). The pathophysiology of asthma involves airway inflammation, intermittent airflow obstruction, and bronchial hyper responsiveness (Kudo et al., 2013). It is now considered to be an assortment of several diseases that have similar characteristics and symptoms (London et al., 2017). Cells that were learned to be associated to airway inflammation include mast cells, eosinophils, epithelial cells, macrophages, and activated T lymphocytes (Mims, 2015). These cells influence smooth muscle tone and contribute to remodeling of the airway. Airway hyper responsiveness in asthma occurs from an overactive response to numerous organisms found from
Currently, physicians will perform a variety of tests to diagnose asthma. Physical exams are done to cross out respiratory infections and COPD. Pulmonary function tests are given to conclude how much air moves in and out of lungs as breathing occurs. Spirometry and Peak flow meters are utilized to perform lung function tests. Patients will need to sit in front of a machine to be fitted with a mouth piece. The mouthpiece needs to fit snug for the reason that all the air that the patient breathes goes into the machine. Patients will also need to wear a nose clip so that air won’t come out through their nose. The physician or RT will instruct the patient to breathe in and out deeply and quickly for several seconds. The
Asthma is a long-term medical condition that affects the airways. When a person has asthma the walls of the air tubes that transport the air in and out of the lungs become irritated and swollen. In this condition, the air tubes get smaller and the cells produce more mucus than usual clogging the air tubes and preventing the air to reach the lungs. This disease makes the airways very sensitive, in consequence they may be greatly affected by any allergic reaction a person may have. Asthma affects people of all ages, there is an average of 25 million people affected by this condition in the united states. People that have a family history with asthma and allergies are more likely to have this condition.