Asthma Case Study

During Tina Jones health history assessment, Mrs. Jones stated she was diagnosed with asthma when she was two and half years old. She reports several hospitalizations due to asthma exacerbation, the last being in high school at age 16. Although Mrs. Jones is now 28 years old and has not had any further asthma related hospitalizations, it is apparent after completing her assessment that Mrs. Jones still struggles with asthma control.

Mrs. Jones’ struggle with asthma became evident through her responses when asked about her management and treatment. Mrs. Jones has stated that the need for her rescue inhaler has become more often and at a greater dosages then prescribed. Three days ago Mrs. Jones was exposed to cats, which triggered an asthma attack, and lead to the use of three puffs of the Albuterol inhaler instead of the normal two puffs. Mrs. Jones also reported that the increase use has been occurring two to three times a week. Mrs. Jones was then asked about what symptoms she experiences when around cats and her response was: wheezing, itchy watery eyes, sneezing and asthma exacerbation. She then stated that these symptoms do not typically subside until she has returned home to shower and change her clothing.

Other contributing factors for Mrs. Jones are: past history of asthma attacks, other environmental allergies, a sedentary lifestyle, and obesity.
Asthma, also called bronchial asthma, is a disease that constricts a person’s airway and lungs caused by inflammation, narrowing, swelling and mucus production making it difficult to breath. Wheezing, coughing, and the feeling of chest tightening and/or breathlessness, characterize it (Asthma, 2016). Nearly 26 million Americans have been diagnosed with asthma; it affects 1 in 11 children and 1 in 12 adults. It is most predominate among Caucasian, Non-Hispanic females between the ages of 35-64 and is more likely to be fatal among African Americans then any other ethnical group (Evidence Summary: Control Asthma, 2015).
Requiring medical diagnoses by ways of lab testing, imaging and lung function test, asthma is treatable with medicine and can be managed by avoiding triggers. Some common asthma triggers can be, but not limited to: smoking, environmental, pets, dust, mold, air pollution, and cockroaches. There are also two types of medicine, quick relief that is used during an asthma attack or long-term relief that will help during times of fewer and/or milder attacks (Management and Treatment, 2009). Most chronic asthmatics find a daily pill or maintenance inhaler, to be an easy way to reduce asthma symptoms. Asthma can be controlled through management; the most important tool in preventive care is having an action plan that is developed with medical professionals. Learning warning signs, avoiding triggers, and taking medicine as prescribed, should always play a role in the management planning to help avoid future asthma attacks (Asthma, 2016).
That fact is, asthma prevalence continues to rise every year and remains the highest among children, women, and low-income families.

From 2001 to 2010, asthma prevalence rose from 7.3% to 8.4%, reveling just a little over a 1% percent growth in nine years (Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001-2010, 2012). This does not appear as an enormous increase until we look at that 1%, as the millions of people affected yearly. In 2009, there was a reported growth of 4.7 million new asthma diagnoses. In 2010 reports showed that there was 10.5 million physician office visits and 1.8 million emergency department visits, responsible for 439,000 hospitalizations and 3,630 deaths (Evidence Summary: Control Asthma,

2015).
Better education and medical care is always needed to help prevent the continue rise in numbers. The federal, state and local government provides continues improvements by tracking rates and effectiveness of control measures, promoting influenza and pneumonia vaccinations and laws creating smoke-free areas to improve indoor and outdoor air quality. Heath care providers educate by monitoring and controlling a patient’s asthma: creating an action plan, avoidance of triggers and tobacco use, and teaching the correct use of inhalers and medicine. Asthmatics and their families can also take control through education. Asthma management is possible by keeping updated and ongoing doctor appointments, knowing triggers and avoiding them, not smoking and avoiding areas of high air pollution, and taking all medicines as prescribed (Asthma in the US, 2011).
Being that Mrs. Jones’ asthma is only partially controlled, this puts her at a general risk for breathing problems. A change to her medication and daily regimen is needed, as well as further education to decrease the likelihood of attacks occurring. Mrs. Jones’ asthma management plan will included: allergy testing to identify possible triggers, flu and pneumonia vaccinations to lessen the chance of illness, a maintenance inhaler to reduce the chance of asthma attacks and an exercise regiment to help boost activity and weight lose. Two main objectives will be set for Mrs. Jones’ management plan. First objective will be, addressing Mrs. Jones’ triggers and introducing ways to avoid them. Second objective will be, introducing yoga to assist in maintenance of weight loss and asthma control.
Mrs. Jones’s triggers where identified during her health history assessment as cats, dust, and exercise. She should not only be aware of her triggers, but also educated to why these triggers can worsen her breathing and how to avoid them. During trigger education, Mrs. Jones will be alerted to the fact that cats carry pet dander, which is considered either the skin flakes or saliva of the animal. Also beware that any animals with fur or feathers can carry pet dander. To avoid all contact, the best possible way is to not have a pet in the house. If this not possible, then the next best precaution would be to keep the animal out of sleeping areas and keep the doors shut. Followed by removing any cloth furniture and carpets or not allowing the animal to sit or lay upon them. The next trigger to address is dust mites, which are tiny bugs found in pillows, mattresses, blankets, carpets, clothing, stuff animals, upholstery and other fabrics. A few things can be done here for avoidance of dust mites. Covering the mattress and pillows with a dust proof covers, often wash blankets, stuffed animals and other fabrics in hot water 130 degrees or greater to kill dust mites, and if possible remove carpets and stuff animals from bedrooms. This is now where Mrs. Jones should be able to repeat back her triggers and identify which avoidance techniques she will be using at home (How Can Asthma Be Prevented, 2016).
The last trigger, exercise, will be addressed within the weight loss goal. Mrs. Jones needs to be educated on the fact that obesity is significantly linked to the increase of medicine use and asthma symptoms (Asthma and Obesity, 2013). Acknowledging that exercise is a trigger and weight loss is the primary objective for Mrs. Jones, a low cardio exercise such as yoga should be introduced. Explain to Mrs. Jones that studies show that yoga therapy can be used for the treatment of bronchial asthma. The benefit of yoga therapy offers asthmatics bronchial relief and is often recommended in adjunction to drug therapy. Practicing yoga creates an increase in oxygen deliver within the body; therefore, decreasing the amount of oxygen the body needs and lessening the reoccurrence of asthma attacks (Pandit D. P., & Vaidya, S. M., 2013).
Statics continue to reveals that yoga therapy practice by asthmatics shows a powerful gain in spriometric measurements. Starting parameters was reported FEV1/FVC value at 60.20%. After 3 months of yoga therapy the FEV1/FVC value was reported at 60.85% and after 6 months reported at 63.46%. If Mrs. Jones adheres to her daily regimen of avoiding triggers and yoga therapy, along with her asthma management tools, a review of here vitals should show weight loss, breathing improvement and less reoccurring attacks (Verrastro, G., 2014).
Extra Credit
Studies show that mental and emotional health of a caregiver can affect the care and adherence an asthmatic child receives. This care suffers significantly more if the child has been diagnoses with asthma alongside a development disability. The responsibility of the caregiver to take care of both diagnoses can create feelings of stress and depression. The emotions of the caregiver typically crosses over to the child causing delays in cognitive development, creates social and behavioral problems, and increases the chance of asthma occurrences (Koehler, A., Fagnano, M., Montes, G., & Halterman, J., 2014).
Regrettably, mental health issues often get overlooked due to the lack of training and the difficult factors of identify mental health issues. Mental health status is especially overlooked for the caregivers when medical care is being solely focused on the child ‘s needs. Further studies show that a simple questionnaire by the child’s doctor could assist in depression diagnoses and identify if another services and/or assistance can be offered to the family. Once mental health issues are discovered, regular doctor appointments should be kept to continue open communication between the doctor and caregiver about the progress of the child health status. Medical providers that stay involved can greatly improve the health outcome of the child.