Case Study
Acute severe asthma is one of the crucial healthcare conditions due to which, the inflammatory symptoms and the interaction of different of different cell types as well as several mediators which is responsible for the physiological changes visible on the patients affected with it (Vestbo et al., 2013). This assignment discusses about the case study of Jackson Smith, a 18 year old boy who was admitted to the emergency department of the healthcare facility after being affected with acute severe asthma and severe breathlessness related episodes. The patient was admitted in a very difficult condition as he was admitted to the emergency ward and the clinical manifestations was collected from patients as well as the family members of the patient. The family members of Jackson informed to the healthcare professionals that the patient was previously admitted to the healthcare facility at the age of 2 as he suffered from asthmatic conditions. Hence, the clinical manifestations that were involved with this process was shortness of breath, dyspnea, multiple episodes of dyspnea, elevated heart rate increased up to 32 breathes per minute and increased blood pressure as well as elevated pulse rate. Besides these the patient also developed wheezing sound as well as the auscultation of lungs. Further, the pathophysiological tests such as x-ray also indicated to the fact that due to acute asthmatic condition swollen and inflated lung cavity as well as the surrounding area (Vestbo, 2013).
Discussion of the pathophysiology of acute severe asthma should be involved of the inflammatory processes which involves the genetics as well as the environmental exposures which is important for the development of the string immune system so that it can react to the environmental factors (Agarwal et al., 2013). As in Jackson’s case, the asthma manifested early in the life, it indicated to the fact that the reason behind this exposure could be the innate immunity, allergens, genetics as well as the respiratory infections or presence of environmental factors such as pollutants and dust particle. However, presence of allergen is the most important reason due to which, this disease occurs in most of the people. The action starts when the allergens are engulfed by the antigen presenting cells or APCs that then presents those cells to the T cells. Therefore, the T cells then activates the release of the respiratory epitheliums which secrets the thymic stromal lymphopoietin and several other interleukins which eventually becomes the reason for the generation of allergic reactions. T helper cells then helps in the induction of the immunoglobulin E and B cells with the production of interleukins 3 and 14. Due to these, the antigen presenting cells then provide those antigens to that of the B cells and the mast ells that then helps in the generation of the inflammatory cascades. As the IgE binds with mast cells presented with the antigens and then helps in the identification and generation of the interleukins which are the primary substances which is responsible for the identification and generation of the inflammation reactions. All these cells mentioned in this segment are important for the generation of the allergic reactions as well as this cascade was responsible for the generation of eosinophils, basophiles, macrophages as well as neutrophils it increases the rate of damages and simulations in the T cells as well as leads to bronchoconstriction in the lungs, which is responsible for the clinical manifestations witnessed in the case study of Jackson.
Answer 1
On the other hand, there are research-based examples, in which generation of such disorders has been linked to the genetics as Kaiko et al. (2013) indicated to the fact that due to the genetic coding the generation of IgE occurred in great extend that leads to the occurrence of airway responsiveness and dysfunctional regulation of different inflammatory modulators such as growth factors, interleukins and cytokine and chemokine (Papaiwannou et al., 2018. Therefore, people with such genetic coding suffer from hyperactive immune response that finally leads hyperactive allergic reaction in them.
The nursing strategy which will be implemented on Jackson and his acute severe asthmatic condition will be the monitoring the peak flowmetry and proving immediate care to the patient in such condition. With the support of recent literatures, both these nursing strategies has been mentioned in the following section.
The first strategy will be providing the patient with immediate care as he has been admitted to the healthcare facility in emergency and is suffering form acute severe asthma, which requires appropriate and fast intervention to prevent it to controllable level. Further as the patient is suffering from progressive and continuous dyspnea, these conditions make them vulnerable to anxiety, depression stress and other asthma related condition (Walford & Doherty, 2014). Therefore, the immediate care will be provided to the patient which involves corticosteroids, which is the primary medication which is provided to the patients if they lack proper airway function and their peak flow variability decreases (Papaiwannou et al., 016. Thereby, using corticosteroids as well as anticholinergics, immunomodulators are on of the immediate medications which can be provided to the patient Jackson for his immediate acute severe asthma condition (Olin & Wechsler, 2014).
The second strategy will be maintaining the peak flow of the patient, which is also responsible for the management for patients affected with acute severe asthma. Using this, professionals uses the evidences from the measurement of the highest airflow during forced expiration as well as exhalation (Lemanske et al., 2917. Researchers also mentioned the fact that the potential complication and hence, the prevention as well as corrective action which should be taken care of in every step against the disease related condition. Hence, using these peak flow measurements, the chest congestion as well as the breathing sounds or wheezing sounds, which is one of the primary healthcare clinical manifestation for Jackson and his acute asthma condition should be provide (Reddel et al., 2014d.
Answer 2
Salbutamol:
This is one such drug which is taken in the form of aerosol and hence it is inhaled and hence acts as one of the β2-adrenoreceptors. This drug affects the smooth muscle cells that ultimately affects the bronchi.
Further due to this, the drug binds itself to the binding site of the epinephrine while it leads itself to the course of stabilization of the receptors that creates ample amount of cAMP and hence, the intracellular cascade is triggered, and it leads to the decrease in the intracellular calcium ion, which helps in muscle contraction ability. For the evaluation, it is mentioned that patient’s improvement and satisfactory results will be used for the identification as well as side effect evaluation so that complete assessment could be carried out (Ponikowski et al., 2916.
Nebulized ipratropium bromide:
This drug is associated with the chronic pulmonary disorder and the method of nebulized ipratropium bromide arcade which use uses, his drug helps in the beta2-agonists for the treatment of reversible obstruction of the airway and hence leads to reliving the COPD and associated this will help in the identification and generation of such conditions in which the healthcare condition beta2-agonists for the treatment of reversible obstruction of the airway ns per by the presence of several healthcare professional which is responsible for patient’s helical intervention could be identified (Vogelmeier et al., 2018)
The third medication which will be used in case of unsliced is the IV Hydrocortisone 100mg as well as these are able to generate firm plant proteins as thee are the rim. As well as it also helps in modification and replacement of the adrenocortical deficiency syndrome. Further the evacuating the intervention could be done by providing the patient information and improvement rate to the healthcare intervention so that it could be implemented on others.
References:
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Answer 3
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