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2808NRS Human Pathophysiology And Pharmacology

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2808NRS Human Pathophysiology And Pharmacology

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2808NRS Human Pathophysiology And Pharmacology

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Course Code: 2808NRS
University: Griffith University

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Country: Australia

Questions

scenario

Dion, a 6 year-old boy, presents to the emergency department with worsening shortness of breath alongside a high pitched audible wheeze, and is unable to speak. Since the start of winter Dion has experienced sleeplessness and an ongoing dry cough at night, although the cough occasionally appears with chest tightness after vigorous exercise. Besides a peanut allergy and some bouts of hay fever in spring, Dion has an unremarkable medical history. Dion’s older brother, was diagnosed with asthma five years ago when the family moved to Australia, but it has rarely been problematic since their father stopped smoking around the family.
After subsequent diagnostic testing, Dion is diagnosed with asthma.
1) Explain the links between the patient’s risk factors and aetiology to account for the disease’s/disorder’s pathophysiology.2) Describe how the disease’s/disorder’s pathophysiology manifests through the patient’s signs and symptoms.3) Justify your suggested diagnostic tests and treatment modalities listed in the concept map on their relevance and appropriateness for the diagnosed disease/disorder.

Answers
1. Links between the patient’s risk factors and aetiology to account for the disease’s pathophysiology
Asthma is a chronic disease of the respiratory airways in the lings where the airways get inflamed. They become swollen along which the muscle of the airways get tightened when certain factors triggers the symptoms. This presents moving in and out of the air from the lungs (Al-Durra, Torio & Cafazzo, 2015). These result in symptoms which show coughing, wheezing as well as shortness of breath or chest tightness. In the patients certain risk factors have been identified which had mainly caused the triggering of asthma. The patient in this case study called Dion has shown certain symptoms like shortness of breath as well as high pitched audible wheeze and chest tightness which are some inevitable signs of asthma. However certain risk factors which are identified are the start of winter season as researchers suggest that cold air may trigger asthmatic effects. Often hay fever is severely linked a risk factors for asthma. Medical history of asthma in the patient’s family makes the person more vulnerable in developing the disease due to hereditary effects. Smoking is yet another cause but that cannot be the cause factor foe Dion as his father had stopped smoking. Often asthma symptoms get more pronounced after dark mainly during night result in sleeplessness. Many call it night asthma or nocturnal; asthma as a sinus infection or a postnasal drip may be one factor (Abir et al., 2017).
Moreover, patients with asthma are sensitive to peanut and therefore peanut allergy is intricately associated with the attack. Although it has been yet a mystery, but Australian has a remarkably high number of asthma sufferers and shifting to Australia might be one of his triggering factors. Although not proved but Australian researchers suggest that pollution may be a cause of the attacks but it is not the only factors. Many other factors may also be responsible which are not known yet.
2. How the disease’s pathophysiology manifests through the patient’s signs and symptoms
The pathophysiology of asthma is quite complex with the main mechanism which remains behind the attack is the allergens of asthma that invokes an immune response. Initially, normal people and people with asthma both take in allergens which enter the inner airways and are then ingested by antigen presenting cells (Yawn et al., 2015). They represent the pieces of the allergen to THO cell who check them and ignore them in normal people but is asthmatic people, they have different ns. They get transformed into the Th2 cells for unknown reasons. Many suggest that interleukin 4 gets released form mast cells which cause this differentiation of cells. These newly formed TH2 cells from TH0 cells in certain unfortunate patients’ initiates’ pathway of immune reactions called the humoral immune reactions producing antibodies (Al-Loola et al., 2014). Therefore when they get exposed to same antigens in future, antibodies identify them and produce humoral response. Inflammation that has occurred in Dion has resulted from such pathway which inevitably results in thickening of the airway walls, cells proliferate after scarring resulting in remodelling of the airway (Raun et al., 2017).
Mucus production takes place after becoming larger and larger that ultimately causes cell mediated immune system to activate. When the airways become more hyperactive, they become more prone to bronchiospasm. The hygiene hypothesis which states the imbalance in Th cells in early life to be a major factor for long term domination of cells in allergic responses in comparison to those who are fighting infection (Coelho et al., 2017). Dion might have been exposed to certain microbes in the past that had caused this suffering.
3. Justification for suggested diagnostic tests and treatment modalities listed in the concept map on their relevance and appropriateness for the diagnosed disease
The main treatment plan would mainly involve the short acting beta2 which are adrenergic agonists. These help in relieving the patients from acute symptoms as well as the preventions of different exercised induced asthma (Pearson et al., 2014). As Dion also faced exercise induced effects of asthma, these would be helpful. Antocholinergic inhibit the muscarine cholinergic receptors which help to reduce the intrinsic vagal tone of the airways (Martin et al., 2016). Besides, corticosteroids and leukotriene modifiers are also helpful as they alleviate airway functions and dilate blood vessels and alter permeability respectively (Koinis et al., 2016). Immuno-modulators should also be provided which helps in binding with of IgG to high affinity receptors of basophils as well as mast cells Nurses should mainly assess the patient history, assess respiratory statues, assess medications, provide pharmacologic therapy and maintain a proper fluid therapy (Morrison et al., 2014). Proper evaluation of the proper success of the interventions should be evaluated and also provide a proper discharge plan and home care guidelines to make sure that the attacks do not occur again. Proper health educations are extremely important along with the patients’ compliance to therapy to make the treatment successful.
References:
Abir, M., Truchil, A., Wiest, D., Nelson, D. B., Goldstick, J. E., Koegel, P., … & Brenner, J. (2017). Cluster Analysis of Acute Care Use Yields Insights for Tailored Pediatric Asthma Interventions. Annals of Emergency Medicine.
Al Aloola, N. A., Naik-Panvelkar, P., Nissen, L., & Saini, B. (2014). Asthma interventions in primary schools–a review. Journal of Asthma, 51(8), 779-798.
Al-Durra, M., Torio, M. B., & Cafazzo, J. A. (2015). The use of behavior change theory in Internet-based asthma self-management interventions: a systematic review. Journal of medical Internet research, 17(4).
Coelho, A. C. C., de Souza-Machado, C., & Souza-Machado, A. (2017). School intervention in asthma for adolescents: it is time to act. Paediatric respiratory reviews, 23, 50-52.
Koinis Mitchell, D., Kopel, S. J., McQuaid, E. L., Boergers, J., Esteban, C., Seifer, R., … & Klein, R. B. (2016). Asthma-Related Co-Morbidities In Urban Children With Persistent Asthma: Contributors To Disparities In Asthma, Sleep And Academic Outcomes. In D14. IMPROVING CARE AND REDUCING DISPARITIES IN ASTHMA AND SLEEP (pp. A6430-A6430). American Thoracic Society.
Martin, M. A., Floyd, E. C., Nixon, S. K., Villalpando, S., Shalowitz, M., & Lynch, E. (2016). Asthma in Children With Comorbid Obesity: Intervention Development in a High-Risk Urban Community. Health promotion practice, 17(6), 880-890.
Morrison, D., Wyke, S., Agur, K., Cameron, E. J., Docking, R. I., MacKenzie, A. M., … & Mair, F. S. (2014). Digital asthma self-management interventions: a systematic review. Journal of medical Internet research, 16(2).
Pearson, W. S., Goates, S. A., Harrykissoon, S. D., & Miller, S. A. (2014). Peer Reviewed: State-Based Medicaid Costs for Pediatric Asthma Emergency Department Visits. Preventing chronic disease, 11.
Raun, L. H., Campos, L. A., Stevenson, E., Ensor, K. B., Johnson, G., & Persse, D. (2017). Analyzing Who, When, and Where: Data for Better Targeting of Resources for School?Based Asthma Interventions. Journal of School Health, 87(4), 253-261.
Yawn, B. P., Rank, M. A., Bertram, S. L., & Wollan, P. C. (2015). Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from The Asthma Tools Study. NPJ primary care respiratory medicine, 25, 15058.

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