Pathophysiology of Chronic and Acute Asthma.

Posted: November 8th, 2022

Pathophysiology of Chronic and Acute Asthma.

Complications of asthma can be sudden. Consider the case of Bradley Wilson, a young boy who had several medical conditions. He appeared in good health when he went to school, returned home, and ate dinner. However, when he later went outside to play, he came back inside wheezing. An ambulance took him to the hospital where he was pronounced dead (Briscoe, 2012).Pathophysiology of Chronic and Acute Asthma.

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In another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the middle of the night and ran to her grandfather’s bedroom to tell him she couldn’t breathe. By the time paramedics arrived, she had passed out and was pronounced dead at the hospital (Glissman, 2012). These situations continue to outline the importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms. Since these symptoms and attacks are often induced by a trigger, as an advanced practice nurse, you must be able to help patients identify their triggers and recommend appropriate treatment options. For this reason, you need to understand the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation.Pathophysiology of Chronic and Acute Asthma.

To Prepare:
Review “Asthma” in Chapter 27 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of both disorders. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to constructing two mind maps—one for chronic asthma and one for acute asthma exacerbation. Consider the epidemiology and clinical presentation of both chronic asthma and acute asthma exacerbation.Pathophysiology of Chronic and Acute Asthma.

To Complete:
Write a 2- to 3-page paper that addresses the following:
Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.
Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.
Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.Pathophysiology of Chronic and Acute Asthma.

Pathophysiology of Chronic and Acute Asthma
Acute asthma begins when the airways become inflamed resulting in intermittent obstruction in the flow of air with bronchial hyper-responsive. Exacerbation of acute asthma may be triggered by stress, dehydration, and anxiety. Vigorous physical activity is a potential trigger for dehydration where epithelial damage and edema occurs when the levels of body water in relation to the epithelial cells are lesser (Mims, 2015). During an asthma attack in a dehydrated person, the PH of blood increases to levels as high as 7.6 and PaO2 reduces to as low as 40mmHg and PaCO2 increases (Wark & Gibson, 2014).
In patients with chronic asthma, an inflammatory response is often triggered by viral infections, an increase in sensitivity to inflammation or colonization of the airways by bacteria.Pathophysiology of Chronic and Acute Asthma. The most potential trigger is viral infections that replicate in the epithelium causing: continuous inflammation, hyper-secretion of mucus, hyperresponsiveness of the bronchial and edema (Doeing, & Solway, 2013). This promotes the release of dendritic cells, T helper cells, neutrophils and B lymphocytes with an asthma attack gradually setting in. As a result, the PaO2 arterial blood gas reduces to approximately 85mmHg and blood PH increases to levels as high as 7.45(Wark & Gibson, 2014). This process promotes clearance of an existing viral infection and influences symptoms which weaken the immune system and triggers an attack in chronic asthma.
How The Selected Patient Factor May Influence Pathophysiology
The selected patient factor is allergens which can be cold air, dehydration, or viral infections which trigger smooth muscle bronchoconstriction in patients with chronic or acute asthma. At the same time, degranulation influences inflammatory intermediaries such as histamines, leukotrienes, platelet activators, and prostaglandins. This contributes to a cascade of symptoms such as edema caused by increased permeability of the capillaries and an increase in mucus secretion resulting in further airway constriction (Wark & Gibson, 2014). Dendritic cells detect the allergens and trigger the release of interleukin 4 which promotes the production of IgE by the B cells. Similarly, interleukin 5 is produced stimulating the subsequent production of eosinophils and proteins which cause significant destruction of the respiratory system’s epithelium (Wark & Gibson, 2014).Pathophysiology of Chronic and Acute Asthma.
Diagnosing and Prescribing Treatment
As suggested by Lommatzsch & Virchow (2014), a diagnosis of acute or chronic asthma can be made through an allergy test since the patient factor selected for this assignment are allergens. A comprehensive history will, however, be taken to determine any contributory factors from the medical and familial history. Broncho provocative and spirometry pulmonary tests are also necessary to determine the extent of sensitivity of the airways.
Treatment based on the selected patient factor will require patients to avoid potential triggers that cause exacerbation. Inhalers can also be prescribed to either stop an existing attack or prevent occurrence. Inhalers exist in many forms such as leukotriene modifiers, corticosteroids, and long-acting bronchodilators. According to Lommatzsch & Virchow (2014), drugs are recommended for the following reasons: to reduce morbidity risks following exacerbations, to promote healthy lifestyles and for symptom relief.Pathophysiology of Chronic and Acute Asthma.