This paper throughly explores the care administered to the cases study Zachy a seven year old boy who has presented to the hospital following the an exacerbation of asthma. Discussed throughout is the pharmacological management of Zachy’s asthma including the pharmacodynamics of these prescribed medications and what affect these medications have on the pathophysiology within the respiratory tract.
It is within the first 24 hours of Zachy’s admission prioritised care for the patient Zachy should be established. This ensures holistic management of Zachy’s presentation can be achieved and further deterioration is avoided. The first step to the prioritised care is establishing a diagnosis. After physical assessment and the collection of objective
…show more content…
This pharmacodynamic drug interaction works in a way that allows the occurrence of bronchodilation, however both medications work by stimulating a different pharmacological mechanism. For instance Ipratopium works by blocking the vagal reflexes which mediate bronchoconstriction (Bullock and Marinas, 2014). This mechanism is stimulated by parasympathetic stimulation of the bronchiole, which is due to a nerve impulse. This differs from Salbutamol which triggers the relaxation of smooth muscle within the bronchioles. Zachy is prescribed both medications, Ipratopium is prescribed to inhibit and provide partial protections agains histamine and allergen induced bronchospasm which occur within the bronchioles during exesabation of asthma. However these medications are given at different times. Ipeatopium is a slow acting medication and was given to Zachy at 0610 on presentation, where as Salbuomol was given at 0800hrs. This indicates a progression in Zachys asthma, thus Salbuomol to give a synergic effect. Ipratopium should not be used on its own to assist in the reduction of asthma symptoms in patients at the risk of; urinary retention, constipation or people prone to gastrointestinal motility disturbances (Bullock and Marinas,
R.S. has been using the recommended treatment for his condition, which inlcude inhaled short-acting Beta-2 agonist and Theophylline, a bronchodilator, to control his respiratory disease.
Asthma is a chronic inflammatory disease of the airways. It is a reversible airway obstruction, occurring 8 to 10% of the population worldwide. According to a study in 2005, asthma affects over 15 million Americans, with more than 2 million annual emergency room visits. Asthma patients have a hyper-responsiveness in their airways and generally and increase in their airway smooth muscle cell mass. This hyperplasia is due to the normal response to the injury and repair to the airway caused by exacerbations. The main choice of therapy for asthma patients is β2- adrenergic agonists. Racemic albuterol has been the drug of choice for a short acting bronchodilator for a long time, but since the development of levalbuterol, there is the question of which drug is a better choice for therapy. Efficacy and cost of treatment must both be taken into consideration in each study of these therapies to determine which is best for the treatment of asthma.
In the article "The Effect of Theophylline and ß2 agonists on Airway Reactivity" it says that more airway responsiveness occurs in asthma, chronic bronchitis, cystic fibrosis, and other diseases. Theophylline and ß2 agonists are used commonly for maintenance therapy for symptoms associated with the increased responsiveness. Both can reduce airway responsiveness to a variety of chemical irritants.. (Ahrens 15S)
For Ventolin to work optimally, situations that may trigger an asthma attack must be avoided. These situations include exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet fur or pollens. Relating to the case study, a few of these may apply to the patient, such as exercising in the cold morning air and perhaps breathing in dust and allergens such as pollens or maybe from the eucalyptus in the Blue Mountains might have had an effect on his condition.
These risk assessments include, pressure injury assessment, nutritional status, fluid balance charts, falls risks assessment, and double checking of the right medication. These are all a set of examinations that are done throughout every day of the patients stay and depending on the individual it may be assessed every 20-30 minutes or every other hour. For Mr Azikiwe, each of these assessments must be made throughout the day as his flu-like symptoms are worsening, he lacks energy and does not feel like eating. With his lack of energy and weakening body it may lead Mr Azikiwe to be dehydrated, malnourished and have pressure injury sores from lack of movement. Through the help of these risk assessments, it can be determined exactly where Mr Azikiwe is with his health and come up with possible ways to improve it. A pressure injury assessment would be crucial because at this age his skin is more prone to pressure sores, and due to his lack of energy, he will need to be checked on and turned at least every 2 hours. Other things that may reduce his chances of getting pressures injuries are by keeping the skin clean and dry, protecting the skin by applying talcum powder or cushioning at friction points. Due to the fact that Mr Azikiwe does not feel like eating much, his nutritional status and fluid balance will need to be assessed daily. By keeping track on these, it will help in achieving a healthy nutritional status and fluid balance chart so that he may regain his energy. In addition, because of Mr Azikiwe’s condition, a set of falls risks assessment must be made each time before leaving the room to ensure there is no chance of him accidentally falling in the absence of a nurse. Along with this, it is crucial that he receives
Imagine a young child competing with his or her fellow classmates during recess and immediately losing the ability to breathe normally. He or she stops in the middle of the competition and falls to the ground while holding his or her chest trying to find air. When you are young, being able to keep up with your peers during recess and sporting events is very important, however, having asthma restricts this. Asthma has a significant impact on childhood development and the diagnosis of asthma for children 18 years and younger has dramatically increased over the years. Asthma is known as a “chronic inflammation of the small and large airways” with “evident bronchial hyper-responsiveness, airflow obstruction, and in some patients, sub-basement fibrosis and over-secretion of mucus” (Toole, 2013). The constant recreation of the lung walls can even occur in young children and “lead to permanent lung damages and reduced lung function” (Toole, 2013). While one of the factors is genetics, many of the following can be prevented or managed. Obesity, exposure to secondhand smoke, and hospitalization with pneumonia in the early years of life have all been suggested to increase children’s risk of developing asthma.
Li, James T., ed. Pharmacotherapy of Asthma. Vol. 212. New York: Taylor and Francis, 2006. Print.
Asthma is a condition of the bronchial tubes characterized by episodes of constriction and increased mucous production. A person with asthma has bronchial tubes that are super sensitive to various stimuli, or triggers, that can produce asthma symptom.In other words, asthmatics have special sensitivity that causes their lung tissue to react far more than is should to various stimulating factors or triggers. For this reason, people with asthma are said to have "twitchy airways."Some symptoms that people with asthma commonly experience are chest tightenings, difficulty inhaling and exhaling, wheezing, production of large amounts of mucous in their windpipes and coughing.Coughing can be frequent or intermittent, and can be loose-reflecting extra mucous secretion in the airways or dry and deep-reflecting tight bronchospasms. Not all these symptoms occur in every case of asthma.Sometimes people may have coughing without and symptoms for months or even years before it's realized that they are asthmatic. Interestingly enough, asthma symptoms are most severe at night, while we're lying down our airways narrow as a result of gravity changes. Also our lungs do not clear secretions as well at night, which leads to mucous retention, and that can increase the obstruction to air flow.
Asthma is chronic inflammatory disorder of the airways characterized by recurring episodes of wheeling and breathlessness. It often exists with allergies and can be worsened through exposure to allergens. In fact, asthma is complicated syndromes that have neither single definition nor complete explanation to the point. In light of its treatment, it is worthwhile to notice that asthma cannot be cured, instead can be only managed by avoiding exposure to allergens and/or by using medications regularly.
Asthma is a disorder of the respiratory system in which the passages that enable air to pass into and out of the lungs periodically narrow, causing coughing, wheezing, and shortness of breath. This narrowing is typically temporary and reversible, but in severe attacks, asthma may result in death. Asthma most commonly refers to bronchial asthma, an inflammation of the airways, but the term is also used to refer to cardiac asthma, which develops when fluid builds up in the lungs as a complication of heart failure. This article focuses on bronchial asthma.
Asthma is a serious ongoing disease that affects the airways of both adults and children.5 It is a type of inflammatory disease in your lungs with multiple triggers which may include the flu, indoor allergies, pets, dust mites, exercise, and tobacco smoke. Asthma has been recognized since ancient Egyptian times. Researchers found prescriptions written in hieroglyphics. Aretaus of Cappadonia an ancient Greek master clinician wrote the initial clinical description of asthma. Aaezein is the Greek word from which the current medical term Asthma come. The original Greek term mean ' sharp breath'. There are many people who have this chronic disease. Approximately 7.1 million children are diagnosed, and 18.9 million adults; 8.2 percent of the population of the United States.
Asthma is a disease that affects the breathing passages of the lungs (bronchioles). People who have asthma always have difficulty breathing. In the United States alone, over twenty-five million Americans are diagnosed with asthma. According to the Centers for Disease Control and Prevention (CDC), asthma is known to be the third most common disease as well as a leading cause to hospitalization in America. In 2008, one in two people were reported to have asthma attacks which is roughly about twelve million asthma attacks a year. In 2007, the United States spent more than fifty-six million dollars on medical costs, lost school and work days, and early deaths from asthma. Asthma is not visible to the human eye, so it is difficult in an emergency situation for the lay responder to tell whether the victim is having trouble breathing or having an asthma attack. Unlike people who are diabetic and have to wear medical ID bracelets, people with asthma are not required to wear them, but it should be recommended to help the lay responder, the doctors and the paramedics identify the situation they are dealing with at hand. For hours, days or even months a person may be normal but then an attack may suddenly happen out of nowhere.
Most of you may not think of asthma as a killer disease, yet more that 5,000 Americans die of asthma each year. According to the Mayo Clinic web page, asthma also accounts for more that 400,000 hospital discharges annually. As the number of people with asthma increases, the more likely you are to come in contact with a person who has the disease. As far as I can remember, I have had asthma my whole life. My mother and one of my sisters also have asthma, so I have a first hand experience with it. This morning, I will discuss some interesting facts about asthma, I will specifically focus on what it is, warning signs, symptoms, causes, and the treatments that are used.
Asthma is a disease that currently has no cure and can only be controlled and managed through different treatment methods. If asthma is treated well it can prevent the flare up of symptoms such as coughing, diminish the dependence on quick relief medication, and help to minimize asthma attacks. One of the key factors to successful treatment of asthma is the creation of an asthma action plan with the help of a doctor that outlines medications and other tasks to help control the patient’s asthma ("How Is Asthma Treated and Controlled?"). The amount of treatment changes based on the severity of the asthma when it is first diagnosed and may be the dosage may be increased or decreased depending on how under control the patient’s asthma is. One of the main ways that asthma can be controlled is by becoming aware of the things that trigger attacks. For instance staying away from allergens such as pollen, animal fur, and air pollution can help minimize and manage the symptoms associated with asthma. Also if it is not possible to avoid the allergens that cause a patient’s asthma to flare up, they may need to see an allergist. These health professionals can help diagnosis what may need to be done in other forms of treatment such as allergy shots that can help decrease the severity of the asthma ("How Is Asthma Treated and Controlled?").
The treatment priorities of the registered nurse upon admission to the emergency department are as follows; within the first 10 minutes of Mr. Bronson’s arrival to the emergency department begin a 12 lead ECG. Assess Mr. Bronson’s vitals heart rate, blood pressure, respiratory rate, oxygen saturation, and administer oxygen 2-4 liters via nasal cannula (Sen, B., McNab, A., & Burdess, C., 2009, p. 19). Assess any pre hospital medications, and if he has done cocaine in the last 24 hours. At this time, the nurse should assess Mr. Bronson’s pain quality, location, duration, radiation, and intensity. Timing of onset of current episode that brought him to the emergency room, any precipitating factors, and what relieves his chest pain.