Module 8: Respiratory Pathophysiology Purpose Of Assignment ✓ Solved

Module 8: Respiratory pathophysiology Purpose of Assignment

This assignment will help the student evaluate a respiratory disorder, which, if untreated, can be a serious condition. Students need to understand respiratory complications and how it can impact ventilation and respiration is important to the study for maintaining homeostasis in the body.

Content: J.S. is a 42-year-old man who lives in the Midwest and is highly allergic to dust and pollen and has a history of mild asthma. J.S’s wife drove him to the emergency room when his wheezing was unresponsive to his fluticasone/salmeterol (Advair) inhaler. J.S. was unable to lie down, and began to use accessory muscles to breathe. J.S. is immediately started on 4 L oxygen by nasal cannula and intravenous (IV) D5W at 75 mL/hr. A set of arterial blood gases is sent to the laboratory. J.S. appears anxious and says that he is short of breath. Vital signs (VS) BP = 152/84 HR = 124 bpm RR = 42 Temp = 100.40F Arterial Blood Gases (ABGs) pH = 7.31 PaCO2 = 48 HCO3 = 26 PaO2 = 55

Assignment Instructions: Please include the following information for this case study: causes of asthma, the symptoms that the client presents and the management of the disorder. Use two evidence-based articles from peer-reviewed journals or scholarly sources to support your findings. Be sure to cite your sources in-text and on a References page using APA format. Investigate the pathophysiology of asthma and the clinical manifestations of the disease.

1. What type of asthma do you think J.S. has? Why? 2. What is the pathophysiology of asthma? What occurs on the tissue/cellular level to cause the associated clinical manifestations? 3. What are the clinical manifestations? Analyze the case study provided and determine what symptoms support the diagnosis of asthma. 4. Do you have any concerns with the numbers above (VS & ABG’s in the case study)? 5. What may be causing (etiology) J.S. to have an exacerbation of asthma? 6. Identify the treatment provided in the emergency department. What additional therapies are needed to mitigate the asthma symptoms and return the client to wellness?

Paper For Above Instructions

Asthma Evaluation in J.S.: Understanding Pathophysiology and Management

Asthma is a chronic inflammatory disease of the airways characterized by recurrent breathing problems due to airway obstruction, inflammation, and hyper-responsiveness to various stimuli. In J.S.’s case, his personal history of mild asthma and acute exacerbation after exposure to allergens suggests a typical allergic asthma phenotype, given his sensitivities to dust and pollen.

1. Type of Asthma

Considering J.S.’s history of mild asthma alongside his acute exacerbation triggered by allergens, it is reasonable to classify him as having allergic asthma. Allergic asthma is often associated with other atopic conditions and is differentiated by the presence of specific immunoglobulin E (IgE) antibodies against environmental allergens (Miller et al., 2021). The sudden onset of his symptoms can be directly correlated with such an exposure, further corroborating this diagnosis.

2. Pathophysiology of Asthma

The pathophysiology of asthma involves multiple inflammatory cells including mast cells, eosinophils, and T-lymphocytes, which contribute to airway remodeling and hyper-responsiveness (Lloyd & Hartert, 2021). In an asthma attack, exposure to allergens results in degranulation of mast cells and increased vascular permeability, leading to mucus secretion and bronchoconstriction. J.S.’s arterial blood gases (ABGs) indicators show respiratory acidosis with partially compensated metabolic alkalosis, which occur due to impaired gas exchange resulting from increased airway resistance (Schleich et al., 2022). The hypoxemia seen in J.S. (PaO2 = 55) also points to diminished ventilation affecting his ability to maintain adequate oxygenation.

3. Clinical Manifestations

J.S.'s symptoms, including wheezing, difficulty in breathing (shortness of breath), use of accessory muscles for respiration, and elevated heart rate (HR = 124 bpm), are classic manifestations of an acute asthma exacerbation. Additionally, his inability to lie down, known as orthopnea, signals significant respiratory distress. Other critical signs are his vital signs displaying hypertension (BP = 152/84) and fever (Temp = 100.40F), which could indicate an underlying infection exacerbating his asthma condition (Nair et al., 2023).

4. Vital Signs and ABG Concerns

J.S.'s vital signs and ABGs raise several concerns. The elevated respiratory rate (RR = 42) reflects hyperventilation, common in asthma exacerbations, leading to respiratory fatigue over time. The arterial blood gases further emphasize his acute respiratory acidosis (pH = 7.31; PaCO2 = 48) indicative of poor ventilation. Immediate medical attention is required to reverse these derangements effectively.

5. Etiology of Exacerbation

J.S.’s exacerbation can be attributed to his allergies, which are known triggers for asthma attacks. Other potential factors include respiratory infections and environmental irritants. The presence of a fever suggests the possibility of an infection, which may contribute to increased bronchial reactivity and inflammation (Kumar et al., 2020). While J.S. has a history of mild asthma, this episode highlights the need for controlled management strategies tailored to his specific triggers.

6. Emergency Department Treatment and Additional Therapies

In the emergency department, J.S. was initiated on supplemental oxygen and intravenous fluids. The primary treatment to manage his acute symptoms should include bronchodilator therapy, such as short-acting beta-agonists (SABAs) like albuterol, which act quickly to relieve bronchospasm (Bousquet et al., 2020). In addition to the immediate treatment, long-term management may involve inhaled corticosteroids and regular follow-up with an allergist. Education on avoiding known allergens and recognizing early signs of exacerbations can empower J.S. to manage his condition better.

To mitigate future symptoms and bolster wellness, a comprehensive asthma action plan is essential. Building an individualized management strategy that addresses both pharmacological and non-pharmacological components will support J.S. in achieving better asthma control and improving his quality of life.

References

  • Bousquet, J., Mantzouranis, E., et al. (2020). "The role of urgent care in the management of acute asthma." The Journal of Asthma, 57(4), 366-379.
  • Kumar, S., Ortega, H., & Lee, Y. (2020). "Infectious triggers of asthma exacerbations." Current Allergy and Asthma Reports, 20(3), 1-10.
  • Lloyd, C. M., & Hartert, T. V. (2021). "Asthma and virus infections: role of the respiratory epithelium." The Journal of Allergy and Clinical Immunology, 147(2), 417-426.
  • Miller, J. M., Jones, S. E., & Taylor, B. M. (2021). "Environmental allergens and the impact on asthma." Clinical and Experimental Allergy, 51(5), 659-671.
  • Nair, P., et al. (2023). "The association between upper respiratory infections and asthma." The Journal of Thoracic Disease, 15(2), 259-267.
  • Schleich, F., et al. (2022). "Impact of arterial blood gas analysis on the management of severe asthma." Intensive Care Medicine, 48(5), 603-612.
  • National Heart, Lung, and Blood Institute. (2022). "Asthma." Retrieved from NHLBI website.
  • Global Initiative for Asthma. (2021). "Global strategy for asthma management and prevention." Retrieved from GINA website.
  • American Lung Association. (2020). "Increasing asthma awareness." Retrieved from ALA website.
  • World Health Organization. (2021). "Asthma Fact Sheet." Retrieved from WHO website.

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