Asthma

Asthma
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1.Briefly describe asthma in a way that Tony and his mother would understand. What pathophysiology is occurring which makes it difficult for Tony to breathe?
Asthma is a condition that causes interference to breathing by making the airways narrow that are leading or within the lungs. The narrowing of the airways restricts the movement oxygen entering the lungs and the oxygen entering the lungs. There are various causes of the condition that results in difficulties in breathing. First, the inflammation of the airway lining causes swelling of the airways making them narrow for adequate amount pf air to pass. Tightening of the muscles that usually wrap around the airways may be another problem that may lead narrowing of the airway. Bronchospasm is muscles that encircle the airway and at times tighten and contract as they overreact to some triggers in the system thus causing difficulties in breathing as a result of their narrowing. The overproduction of mucus in the airways is a factor that may lead to asthma attacks because the mucus tends to block the airways because of overproduction of mucus which at times becomes sticky and dry thus resulting in the obstruction of the airways. In extreme cases, the growth of bacteria in the mucus in the airways may also lead to bronchitis. The twitchiness of airways which also referred to as the bronchial hyperreactivity may result in asthma triggers such as the cold air and exercises resulting to asthmatic attacks (Leigh & Marley, 2013).

2.What are some of the questions that you might ask Tony and his mother, when gathering history, to get a better sense of what triggered Tony’s attack? Explain your answer.
Various questions can be asked to Tony and his mother regarding the condition to assist in determining what may have triggered the Asthma attack. One of the questions is “Does your family have a history in Asthmatic condition?” Asthma is a hereditary condition; therefore, it is good to determine whether anyone in the family lineage had that condition which may be a probable cause of Tony’s condition. Another question that might be asked is, “Do you have in mind any environmental factors in mind that you feel triggers the asthmatic attacks?” This question will help in determining some of the environmental factors that act as triggers for the condition. Seasonal changes, mold, air pollution, high pollen counts, climate changes and pet dander are some of the environmental factors that are associated with the Asthmatic condition. Another question that would be asked is whether someone in their family uses tobacco products at home or whether they have a nebulizer at their homes. These are some of the comorbid conditions that have to be determined since they do accompany the condition. Other conditions to look for include drug-induced asthma, gastroesophageal reflux, and allergies related to Bronchopulmonary Aspergillosis (Akinbami, 2011).
3.What is the highest priority nursing treatment for Tony? Explain your answer.
There are various highest priority treatments for Tony that will ease the condition. First, supplementary oxygen using face masks will be paramount because most of the Asthma patients are hypoxaemic. This treatment will ensure that SPO2 values have been maintained between 94% to 98%. The same Oxygen can be provided to Tony through Oxygen-driven nebulizer that will be nebulizing Beta-adrenergic Agonist Bronchodilators which will be effective to prevent desaturation of oxygen. Another treatment that will be combining nebulized ipratropium bromide with the nebulized Beta-adrenergic Agonist which will lead to a short duration of admission and faster recovery (Merikanto, 2014).
4. If Tony experiences a reduction in wheeze intensity while he’s at the clinic, does that mean he is improving? Why or why not?
Wheeze is termed as a high-pitched and adventitious sounds in the lungs that result from the abnormally compressed or narrowed airway. Reduction in wheeze in Tony would mean that he is improving. The decline of the wheeze intensity is an indication that bronchoconstriction has improved thus easing the airflow obstruction. However, the reduction in the intensity of wheeze may mean that airflow rates have reduced to generate wheeze or there is a presence of mucus that has obstructed a region that is huge in the peripheral airways. The same may be an indication that Tony is experiencing fatigue in the respiratory muscles a condition called asthmatics thus he requires immediate treatment (Nicolae, 2011).
5.What advice would you provide to Tony to prevent or reduce the risk of future attacks? Discuss at least 4 with appropriate explanations.
I would advise Tony on the approaches to use so as to reduce the risks of emergence of future attacks. First, I would urge Tony to adhere to his action plan strictly. An action plan is detailed to guide the patient in taking medication as well as managing asthma attacks. Asthma requires conventional treatment and monitoring because it is an ongoing condition. An action plan will ensure that Tony has taken control over their condition as well as their treatment. The second advice that I would make to Tony is to make sure that he has identified asthma triggers as well as avoiding these triggers. Tony should ensure that he has identified outdoor irritant and allergens such as air pollution, cold air, pollen, and mold that are likely to trigger asthma attacks. After identifying the triggers and factors that worsen the condition, I would urge him to avoid them completely. Thirdly, I would advise Tony to ensure that he has always monitored his breathing his breathing which will help him in recognizing warning signs for an asthma attack. Some of the warning signs that he may recognize are slight coughing, shortness of breathing, and wheezing. Therefore, it is advisable for him to acquire home peak flow meter to be measuring and recording peak air flow. The fourth advice that I would give to Tony is making sure that he has taken asthma medication as prescribed. Tony should ensure that he has not changed anything before talking to a doctor even after noticing an improvement in the condition. Additionally, I would advise Tony to be bringing with him medication for every doctor visit for double checking whether he is taking right medication as well as right dosage (Senna, 2016).
6.After assessing Tony, the physician advises him that he needs to have a written action plan. This is the first time Tony and his mother have heard of an action plan. How would you explain an action plan to Tony and his mother?
I would start by giving an explanation to Tony and his mother what a written action plan is all about and its importance in asthma management. A written action plan is a document that is developed by a nurse together with the person suffering from asthma with their parent or guardian. An action plan helps patient and their parent or guardian to realize worsening situations of asthma and therefore provides clear instructions on what need to be done to respond to them. Every patient has a different action plan that is suited to the unique symptoms that they experience even though the plan must have identical key information. Tony and his mother need to follow the written action plan so that Tony can have better-controlled asthma. The action plan can help in reducing asthma attacks, hospital visits, medical relievers and other benefits. Tony and his mother must work together with the nurse so as to develop an effective action plan (Merikanto, 2014).
7.Explain some of the emotional and psychological issues Tony and his mother may experience. How can you as a nurse support Tony and his mother to help them cope with this situation?
Tony and his mother are likely to experience emotional and psychological issues. Stress and anxiety are common to asthma patients as well as their caregivers. There is a great likelihood for Tony and his mother to suffer from depression and anxiety disorders. As a nurse, I can support Tony and his mother by offering counsel. It is important to explain to them that the disease can be managed completely and Tony can live his life like other people provided that all medications and steps are followed. I would advise them to seek counseling regularly to ensure that they are helped to overcome these emotional and psychological issues (Senna, 2016).
References
Akinbami, O. J. (2011). Asthma prevalence, health care use, and mortality: United States, 2005-2009. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Leigh, D., & Marley, E. (2013). Bronchial asthma: a genetic, population and psychiatric study. Elsevier.
Merikanto, I. (2014). Evening chronotypes have the increased odds for bronchial asthma and nocturnal asthma. Chronobiology international, 31(1), 95-101.
Nicolae, D. L. (2011). Meta-analysis of genome-wide association studies of asthma in ethnically diverse North American populations. Nature genetics,43(9).
Senna, G. (2016). The role of the pharmacy in the management of bronchial asthma: A literature-based evaluation. Annals of Allergy, Asthma & Immunology.