Simeon 1

Asthma Management

Chederline Simeon

Rasmussen College

Course#: Essentials of Pathophysiology

Shaun Creary- Walker

February 28, 2021

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Asthma Management

Asthma is a chronic inflammatory disorder of the airways. The chronic inflammation

causes increase in hyperresponsiveness. The triggers of Asthma are allergens most of the cases

are due to allergic response it can be seasonal and related to pollen. Non seasonal forms of

asthma may be related to dust mites, molds, and animal feathers. Exercise can also trigger

asthma typical exercise induced asthma occurs after vigorous exercise. Air pollutant such as

cigarette or wood smoke, vehicle exhaust, silver dioxide and nitrogen dioxide can trigger asthma

attack. Gastrointestinal esophageal reflex disease is the contents can be aspirated into the lungs

cause reflex bagel stimulation and bronchoconstriction. Inflamed airways react to environment

triggers like dust, pollen, smoke, environment pollutants, and some toxic chemicals. Clinical

manifestations are wheezing, chest tightness, cough, severe or dry cough, difficulty in breathing,

rapid breathing, shortness of breath, and anxiety. The treatments that were given in the

emergency department were fluticasone/salmeterol inhaler, oxygen through a nasal canula,

intravenous fluid, oxygen support on 4 litters, and intravenous (IV) D5W at 75 mL/hr. The

treatments that should have been given are oral steroid (tablet prednisolone 40 mg),

nebulization with short-acting beta-adrenergic agonist hourly (salbutamol), nebulization with

the short-acting cholinergic antagonist (ipratropium), and antibiotic macrolide to take care of

infection and inflammation (azithromycin). Signs of hypoxemia, restlessness, anxiety,

inappropriate behavior, pulses paradoxes, Lawrence pressure, increased respiratory rate, and

use of accessory muscle for respiration. The additional therapies that are needed to mitigate the

asthma symptoms and return the client to wellness are learning to identify triggers, recognize

the triggers, avoid triggers, and track of breathing. I do have concerns about the numbers the

patient has a very high respiratory rate suggestive of tachypnea. The patient's heart rate is also

high suggestive of tachycardia this tachycardia could be because of hypoxia and due to
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Asthma Management

salmeterol (beta-adrenergic agonist). The patient's blood pressure is also high. High

blood pressure, high respiratory rate, and high heart rate are all suggestive of respiratory

distress. The Arterial blood gas is also abnormal. The pH is low (normal - 7.35 - 7.45) suggestive

of acidosis. The paCo2 is high (normal 35 - 45 mmHg) this suggests that respiratory muscle is

fatigue. The bicarbonate is high this suggests that renal compensation for respiratory acidosis

has started. Therefore, the patient has uncompensated respiratory acidosis. PaO2 is also less

(normal > 60 mmHg), suggestive of hypoxia secondary to bronchospasm. The patient also has a

fever. The cause of exacerbation is must be respiratory tract infection. The patient has fever

because of the infection. This infection has led to exacerbation of asthma. It is best to test

history collection and physical examination, chest X-ray, ABG analysis, allergy skin testing, blood

level of eosinophil, nitric oxide level, and pulmonary function test. The causes of exacerbation of

asthma are exposure to allergen like dust and pollen. The types and causes of Asthma adult-

onset asthma-In this type person develop asthma only in adulthood, allergic asthma-Asthma due

to any allergens such as pollen, dust, cold air, animal hair, saliva, non-allergic asthma-This may

be due to any viral respiratory infections, stress, exercise induced, weather, and occupational

asthma-Mainly seen in person working in industry such as paint, latex products, wood, cleaning

products. Any of the etiological factors causes airway inflammation. This inflammation causes

hypersecretion of mucous, airway smooth muscle constriction and edema in the bronchial

membranes. This causes narrowing of the airway. Due to narrowed airway, patient shows

clinical features such as wheezing, shortness of breath, chest tightness, cough etc. Cellular

changes in asthma include airway thickening, epithelial hypertrophy, myofibroblast hyperplasia,

atrophy, mucous metaplasia, subepithelial fibrosis, vascular changes and dysplasia. These

changes cause the associated clinical manifestations hypertrophy which is enlargement of the
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Asthma Management

individual cells, hyperplasia cell number is increased, atrophy Reduction in cell number

and cell size, metaplasia transformation from one type of epithelium to another, and dysplasia

disordered growth of cells.

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References

Mayo Clinic. 2021. Asthma - Symptoms and causes. [online] Available at:

<https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653> [Accessed

28 February 2021].