Running head: UNDERSTANDING ASTHMA 1 Understanding Asthma
Michele R. Moritz
Walden University
April 3, 2016 UNDERSTANDING ASTHMA 2
Understanding Asthma Several people are affected by asthma. Asthma is a disorder that affects the lungs and can
happen at any age. Asthma is a lung disease that causes inflammation of the airways, and is
often caused by distinct triggers for example; air pollution, dust, respiratory infections, and
physical activity (NIH, n.d.). An asthma attack can lead to difficulty breathing, and without
immediate treatment can become a medical emergency. According to Huether and McCance,
(2012), asthma causes constriction of the airways which can lead to hyperventilation; which then
leads to hypoxemia. According to the National Current Asthma Prevalence 2013 report made
available by Center for Disease Control and Prevention, (2015), there were 1.8 million visits to
the emergency department for asthma. This paper will discuss the pathophysiological
mechanisms of chronic and acute asthma exacerbations, how the relate and differ from one
another; different factors that impact these disorders, and the diagnosis and treatment options
available.
Pathophysiology of Chronic and Acute Asthma Exacerbation
Asthma is a lifelong lung disease that can be an acute or chronic condition; however, in
people with acute asthma the airways are fairly normal between episodes where people with
chronic asthma always have narrowing of their airways (NMIHI.com, 2012). According to The
Lung Association, (2015), there are many different types of asthma; however, in each type the
lungs react alike. “The mechanisms involved include direct stimulation of airway smooth muscle
and indirect stimulation by pharmacologically active substances from mediator-secreting cells
such as mast cells or nonmyelinated sensory neurons” (Morris, 2016, para. 3). In asthma,
inflammation and the hyperresponsive reaction of the smooth muscle, the airways become
narrowed causing a decrease in airflow distribution (The Lung Association, 2015). According to UNDERSTANDING ASTHMA 3 Morris, (2016), some of the cells involved in airway inflammation are mast cells, eosinophils,
epithelial cells, macrophages, and activated T lymphocytes. When the airways are narrowed
from bronchospasms, and microvascular leakage develops from swelling, resulting in increased
secretions and impairment in the clearing of mucus (Lynn & Kushto-Reese, 2015). The increase
in production of mucus may also cause a mucus plug further obstructing the airflow.
How Behavior Impacts the Pathophysiology of Asthma
There are many factors that contribute to the pathophysiology of asthma, but not all are
preventable. Some ways that one can change their behavior and lifestyle to decrease the
incidence of asthma can be to quit smoking, avoid second hand smoke, decrease the amount of
time spent outdoors when there is increased pollen in the air, and limit exposure to strong odors
(The Lung Association, 2015). It is important to know what triggers asthma as each person may
have a different trigger. People that do not take prescribed medications for asthma as directed by
their physician are at risk of having an asthma attack. One way a person can improve their
behavior when it comes to asthma is to develop and follow a treatment plan (Asthma and Allergy
Foundation of America, n.d.). Patient education is a big part of providing quality care to
patients. By helping patients develop a treatment or action plan for asthma patients can better
manage their disease. According to Booth, (2012), developing a plan that is specific to each
patient will help them better manage symptoms, and reduce emergency treatment.
Diagnosis and Treatment of Asthma
Asthma is a chronic lifelong condition with no cure. Diagnosis of asthma is relatively the
same for all types. The patient’s history of allergies and how often they are having symptoms of
asthma is very important in the diagnosis (Huether & McCance, 2012). Some different signs and
symptoms of asthma include cough, wheezing, shortness of breath, chest tightness, use of UNDERSTANDING ASTHMA 4 accessory muscles to breath, and diminished breath sounds (Kuschner, 2015). Different
diagnostic tests to consider are peak flow measurement, oxygen saturation, short-acting
bronchodilator trial, arterial blood gasses, and chest x-ray (Kuschner, 2015). Treatment for
chronic and acute asthma are a little different. With acute asthma a bronchodilator and oxygen
are used, and sometimes intravenous steroids and muscle relaxants are necessary (NMIHI.com,
2012). Patients with acute asthma can also have severe attacks requiring hospitalization and
different types of positive-pressure ventilation (NMIHI.com, 2012). In chronic asthma the
patient also uses a bronchodilator; however, they also may require inhaled steroids, mast cell
stabilizers, muscle relaxants, and oral steroids on a long-term basis (NMIHI.com, 2012). In both
cases having a asthma treatment plan in place would be beneficial.
Summary
Asthma is a chronic lifelong condition that requires a treatment plan and ongoing medical
treatment. Asthma has no cure but symptoms may be reduced if patients avoid asthma triggers
as much as possible. As with any diagnosis it is important to provide patients with education on
the disease process and treatment plan. Both acute and chronic asthma can be life threatening it
is very important for patients to have a treatment plan. UNDERSTANDING ASTHMA 5
References Asthma and Allergy Foundation of America. (n.d.). Asthma. Retrieved from
http://www.aafa.org/page/asthma.aspx
Booth, A. (2012). Benefits of an individual asthma action plan. Practice Nursing, 23(12), 594-602 9p.
CDC Centers for Disease Control and Prevention. (2015). Most recent asthma data. Retrieved from
http://www.cdc.gov/asthma/most_recent_data.htm
Holt, P. G., & Sly, P. D. (2012). Viral infections and atopy in asthma pathogenesis: new rationales for
asthma prevention and treatment. Nature Medicine, 18(5), 726-735. doi:10.1038/nm.2768
Kuschner, W. (2015). Acute asthma exacerbation in adults. Retrieved from
https://online.epocrates.com/diseases/4511/Acute-asthma-exacerbation-in-adults/Key-Highlights
Lynn, S. J, & Kushto-Reese, K. (2015). Understanding asthma pathophysiology, diagnosis, and
management. American Nurse Today, 10(7), 49-51. Retrieved from
http://www.americannursetoday.com/wp-content/uploads/2015/07/ant7-Asthma-622.pdf
Morris, P. J. (2016). Asthma. Medscape. Retrieved from http://emedicine.medscape.com/article/296301overview#a4
NMIHI.com Online Health Information (2012). Asthma long-term lung disease. Retrieved from
http://www.nmihi.com/a/asthma.htm
The Lung Association. (2015). What is asthma? Retrieved from http://www.on.lung.ca/page.aspx?
pid=397 UNDERSTANDING ASTHMA 6 ACUTE ASTHMA CLINICAL
PRESENTATION
PATHOPHYSIOLOGY Airway inflammation, Intermittent
airflow obstruction, Bronchial
hyperresponsiveness
(Morris, 2016) EPIDEMIOLOGY More prevalent in African
Americans than in whites.
Affects 23.4 billion people.
Male-to-female ratio of 2:1
until puberty.
(Morris, 2016) Cough, wheezing,
shortness of breath, chest
tightness, use of
accessory muscles to
breath, and diminished
breath sounds (Kuschner,
2015). DIAGNOSIS
History of allergies and how often symptoms are
present (Huether & McCance, 2012). diagnostic
tests to consider are peak flow measurement,
oxygen saturation, short-acting bronchodilator trial,
arterial blood gasses, and chest x-ray (Kuschner,
2015). TREATMENT
Bronchodilator and oxygen therapy.
Intravenous steroids & muscle relaxants
(NMIHI.com, 2012). Severe attacks
require hospitalization and different types
of positive-pressure ventilation
(NMIHI.com, 2012). UNDERSTANDING ASTHMA 7 CHRONIC ASTHMA
CLINICAL
PRESENTATION PATHOPHYSIOLOGY Airway inflammation, Intermittent
airflow obstruction, Bronchial
hyperresponsiveness
(Morris, 2016) EPIDEMIOLOGY Cough, wheezing, More prevalent in African
Americans than in whites.
Affects 23.4 billion people.
Male-to-female ratio of 2:1
until puberty.
(Morris, 2016) shortness of breath, chest
tightness, use of
accessory muscles to
breath, and diminished
breath sounds (Kuschner,
2015). DIAGNOSIS
History of allergies and how often symptoms are
present (Huether & McCance, 2012). diagnostic tests
to consider are peak flow measurement, oxygen
saturation, short-acting bronchodilator trial, arterial
blood gasses, and chest x-ray (Kuschner, 2015). TREATMENT
Bronchodilator and oxygen therapy, inhaled
steroids, mast cell stabilizers, muscle
relaxants, and oral steroids on a long-term
basis (NMIHI.com, 2012).