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Case Study of Pathophysiology of Asthma

Question

Task: Prepare a short report on the Pathophysiology of Asthma.

Answer

Introduction
The biological condition of asthma comes under the category of long-term pulmonary diseases. In the medical discipline, it could also be termed as chronic respiratory disease. In simple terms, it is an acute inflammatory disorder which heavily affects the respiratory tracts. The inflammation in the respiratory tract would make it very hard to pass through it consequentially making the process of breathing laborious. The major symptoms of asthma are difficulty in breathing, wheezing, stiffness in chest, coughing, etc. The condition of asthma is sometimes also termed as bronchial asthma. The condition of asthma makes the respiratory system highly sensitive to the factors present in the atmosphere and often pulls the trigger leading to the asthma attack. The pollutants in the air or condition like cold could turn out to be an evident trigger for asthma. Apart from an asthma attack, the extreme condition of blockage in the respiratory tract could also be termed as Asthma episode or an asthma flare-up.

There is no specific age group that is specifically affected by this condition. Irrespective of their age and gender a lot of people are affected by the condition of asthma. Although the symptoms of asthma could be suppressed by implying appropriate treatment and medication, it is most probable that the condition would surge again in the body. Although asthma occurs irrespective of the age group, the symptoms of it get quite obvious in older age. The level of acuteness in asthma differs from person to person. Hence the condition of asthma is categorized into several forms as per the severity of its symptoms.

  • Mild intermittent asthma: The frequency of the symptoms would be very less and appears only fewer than twice a week. The symptoms would be very mild in this stage.
  • Mild persistent asthma: In this type of biological condition of asthma, the frequency of attacks would be around six times a week. Specifically describing the unexpected attacks like at night time would be around only four times every month. Although the occurrence of the attacks is a little evident, the daily life of the patient is less probable to be affected by the symptoms.
  • Moderate persistent asthma: In this stage of asthma, the frequency of attacks would be around 6 times every week. The unusual occurrence of nocturnal attacks would only be the same as in the previous case (6 times a week). In this stage, the normal life of the patient could be affected because of this condition.
  • Severe persistent asthma: This condition is very severe and would inflict the patient both irrespective of day and night. Even the basic activities in the daily life of the patient are affected by the severity of the symptoms.

It should be noted that the situation of asthma is found with the symptoms of restricted and difficult patterns in respiration accompanied by coughing and wheezing (Zone and Guide 2017). In this report on the pathophysiology of asthma, the context of Jessica White, an asthma patient who is five years of age. If looked back at the medical history of Jessica, it could be observed that she had suffered from frequent attacks of asthma. The patient had also witnessed frequent exposure to the common cold and viral infections. By drafting this report, we have aimed to provide the scope and significance of the pathophysiology of asthma.

Various symptoms and mode of the pathophysiology associated with asthma
The context taken in this report on the pathophysiology of asthma is regarding the treatment given to an asthma patient named Jessica White. As per the pieces of information provided by the member of the family, the child was born only prematurely at a period of 33 weeks. In the initial phase of her life (within one year), the patient had suffered from acute wheezing symptoms. As mentioned above in this report, Jessica had suffered acute eczema along with the viral infection throughout her medical history. It is quite evident in the medical discipline that a child who is below the age of five years would find it very difficult to cope with the symptoms of asthma. The crucial symptoms of asthma get covered by prominent symptoms like coughing and wheezing, which in turn out to be very detrimental for the patient.

If taken into account the pathophysiology of asthma, it majorly comprises of the irritation and swelling in the respiratory tract that contributes to the major problem of difficulty in breathing (Olin and Wechsler 2014). It is the irritation in the outer cells of the windpipe and esophagus that makes the gaps in between the walls minimal. The consequential symptoms of this bronchial inflammation would be the occurrence of wheezing, laborious breathing, coughs, etc. (Heijink, Nawijn and Hackett 2014). If a patient is affected by the condition of asthma, his cells in the windpipe would always be at risk and would react at the same rate to the irritating agents in the atmosphere. In the case of Jessica, the occurrence of asthma could be related to the premature birth of her. It was only the gestation or incubation period when the child was born. As per the observations laid down by the renowned researchers in the field of medicines Tronnes et al. in 2013, the occurrence of asthma is very frequently occurred in the infants who are born before the gestation or the incubation period when are compared to the infants who are born after their complete maturity period. The lungs of the patient have been in an immature state and hence could be considered as the major reason behind the occurrence of asthma in her.

Although we have earlier said in this report on pathophysiology asthma, that the occurrence of asthma is not limited to a certain group of people, the special biological situation like the immature birth of a child would increase the probability of the occurrence of asthma. In the case of Jessica, she had started to display the major symptoms of asthma even before she had reached the age of three. Though it is only estimated that asthma is occurred because of premature birth. Hence the root cause of the infections and thereby the occurrence of asthma is not still clear. The occurrence of and symptoms of asthma found in children are entirely different from that of the adult population. Although the inflammation occurs as same in the case of an adult, the gap in between the walls of the windpipe is much narrow in infants, which would display very augmented symptoms when accompanied by the excessive production of the mucus (Zefler et al. 2014). In the case of the infant, the symptoms of asthma are very dangerous and could cause death. As the gap between the windpipe becomes much slender and narrow, the infant to force the air through it to sustain his life. To cope up with the deficiency in air, the circumstance of whistling and wheezing occurs It was frequently observed in the case of Jessica that the breath appeared to be very loud and forced.

The sure presence of asthma had been confirmed in 14% of the newly born infants whereas around 50% of the children with the status of immature birth had displayed acute symptoms of asthma (Priante et al. 2016). Jessica is also very sensitive to climate change and at the instance of the cold, she had also shown some irritation on her skin that had led to the condition of eczema. It had been observed among the infants with eczema allergy that around 60% of them are affected by the condition of asthma. The condition of eczema would disclose the cells in the windpipe to the irritating factors. By the continuous contact of the body tissues with the irritants the extreme symptoms like inflammation, tremor, contraction, and the excessive secretion of the mucous appear in the respiratory system. This is the basic reason why the asthma patient has to witness the blockage in the flow of air through windpipe, and heavy breathing accompanied by screeching sound while both exhalation and inhalation. It was observed by the medical practitioners that both the premature birth and occurrence of eczema had contributed majorly to the occurrence of asthma.

The body witnesses the lack of oxygen since the passage to the lungs is heavily restricted because of the irritation and inflammation under the condition of asthma. In the case of Jessica, the inflammation windpipe has restricted most of the air passage and has even risked her existence. When her undeveloped lungs were being disposed to the allergens in the atmosphere her respiratory system had immediately reacted to it causing the excessive emission of mucus. The mucus along with the inflammation has worsened the condition of Jessica and she needs urgent medical interventions. This condition could also lead to the inception of some other diseases since various other organs are being subjected to a shortage of oxygen and hence are witnessing heavy damages to the tissue (Ionescu 2013).

As per the observations obtained from the research of National Heart, Lung, and Blood Institute, the symptoms of asthma could be illustrated and identified by observing the laborious and small breaths, coughing and heavy wheezing (Kang et al. 2016). The parents of Jessica had told that she had exhibited most of the symptoms at night time and had suffered heavily when she was respiration during her sleep. She was prescribed with salbutamol puffer, to which her body especially the respiratory system had responded well, and had reduced the level of symptoms of asthma. Although the reaction to the medicine was only the initial phase, the body of Jessica had stopped responding to the salbutamol puffer. The prescribed accessory medicine ipratropium combined with the dose of prednisolone had also stopped creating any impact on the body of Jessica. Since the level of oxygen in the body of the patient had decreased to a very dangerous level, she was provided with 93% saturated oxygen gas.

We should ascertain that the patient, Jessica was going through the heavy exhibition of symptoms like extreme wheezing, loud coughing, and small breaths, etc. The medical practitioners had got feedback from the family that she had frequent occurrences of eczema, fever through viral infection, and common cold that may have induced the infection of asthma in the respiratory tract of Jessica. The epithelial tissue around her neck and chest area were seen to be very stretched and also have shown a very loud wheezing sound while respiration. Having the occurrence of cold is very frequent in Jessica. It was after diagnosis done after observing these symptoms that the confirmation of asthma infection was done. The asthma symptoms and difficulties because of it had increased when the impact of eczema had worsened. By checking the living environment of the patient, it had been confirmed that there is a presence of a pet in their home. The patient had very large interaction with the pets accompanied by her grandmother. The collection of the pets consisted of several dogs and cats which are heavily furred. The entrance of fur in the respiratory tract must have prompted the infection of asthma.

If the patient is below the age of five years, then the repercussions of asthma would be very worse and have to tackle with heavy lack of oxygen. The patient would also have to face heavy consequences and repercussions because of wheezing and coughing. The laborious breathing had sucked in the stomach and duodenum inwards since the high efforts hadn’t supplied with enough air or oxygen. The abdomen section was seemed to be pulled into the ribs because of the high pressure implied. The mother of the patient had informed the medical practitioners that if the condition of the patient seems to be comparatively better, then she occasionally used to wake up at night. The patient had even suffered from intense coughing when she had engaged in physical activities. The coughing while the physical activity had increased while the infection of asthma had increased gradually per day (Depner et al. 2014).

All of these symptoms in the situation had helped the medical practitioner in ascertaining the infection of asthma in Jessica. The doctor had observed that the symptoms of wheezing, cold and heavy breathing were resentful in the child and the medical intervention should have been done urgently to save her. As per the doctors, Jessica was diagnosed with moderately severe asthma that had to be immediately addressed since it is affecting the life of the child. The previous medical theory had provided the nurses with the information that the dose of salbutamol puffer is not making any impact on the patient and to carry out the process of normal breathing, she had to sit in a slanting position.

The medical tablets or the direct ingestion of salbutamol relaxes the internal wall of the windpipe so that the efficient flow of air could be ensured. Hence the medicine, salbutamol comes under the category of bronchodilator. This drug is widely used all around the world to cure symptoms like laborious breath, heavy coughing, and loud wheezing. The asthma attacks in Jessica would continue for around four to six hours. The use of salbutamol would reduce the symptom and suffering, but is not sufficient enough to prevent the occurrence of an attack.

In this case, also the healthcare executives have prescribed the patient with salbutamol puffer that had reduced the effects of the symptoms. In the intensive care unit, the nurses have observed that the air passage including the lungs have contracted and the air is not flowing insufficient manner. This condition was more evident when the patient had witnessed the occasional wheezing attack. It is in this case that the Salbutamol dose comes very handy which would ease the condition by relaxing the muscles of the windpipe and thus facilitating the flow of oxygen-rich air. The salbutamol dose is ingested in the patient's body by using the device of spacer and inhaler. These tools would facilitate a very convenient and safe flow of air into the lungs of the patient. Since the condition of Jessica was very acute, she was ingested with salbutamol dose with an interval of two hours using the inhaler and spacer. By the continuous and controlled prescription of salbutamol to the patient, the symptoms were effectively subdued. The patient was admitted in the evening and by the next day morning, Jessica had resumed her normal rhythm of respiration. This was made possible because the gap between the windpipe was increased because of the medication.

The patient was also ingested with steroids for the speedy recovery from the worse situation. The injection of prednisolone was also done to reduce the inflammatory state of the cells in the windpipe. This integrated use of the medicines has bettered the situation of Jessica and thus the oxygen level has increased in the body. The inflammation in the windpipe had considerably gone down which has subdued the symptoms like coughing, laborious breathing, and wheezing (Page and Barnes 2013). The majority of the medication was provided to Jessica in the intensive care unit orally by medical practitioners, which was quite enough to bring back the worse condition of the patient to the normal condition. The new mixture of medication has also helped the patient after she was discharged from the hospital. The symptom was thereafter subdued by using this medication in the context of Jessica. The asthma plan prescribed to Jessica was very effective and could be preferred in the case of other patients affected with the symptoms of asthma.

From this report on the pathophysiology of asthma, the context of a five-year-old asthma patient Jessica White has been considered. The main causes and the symptoms of asthma are discussed thoroughly in this report. It has been offered that the dose of salbutamol puffer could turn out to be very effective in suppressing the symptoms of asthma. The authentic and innovative medical course was prescribed to Jessica and had made a very good impact on her biological condition.


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