Allergic Asthma for Chronic Conditions- myassignmenthelp.com

Question: Discuss about theAllergic Asthma for Chronic Conditions in Australia. Answer: Introduction The current paper is a discussion of a patient case study with a view of understanding the clinical scenario offered. The case study is that of Tegan Smith, a 6-year-old girl with asthma. In the context of the case, the type of asthma will be identified, and its pathophysiology and treatment highlighted in the Australian perspective. Lastly, the Australian standards of asthma management education for parents and children will be discussed. Type of asthma presented. The types of asthma include allergic asthma, late-onset non-allergic asthma, cough variant asthma, occupational asthma, exercise-induced asthma, and nocturnal asthma (Mukherjee Zhang, 2011). This is due to the different presentations and causes of asthma in different individuals. Tegan Smith has allergic asthma. This is because; 1) Her asthma is an early onset asthma which is usually due to allergy. She developed symptoms at 6 years of age (Guibas, Mathioudakis, Tsoumani, Tsabouri, 2017). 2) Her asthma attack is accompanied by some allergic signs and symptoms. In addition to the common symptoms of a cough and wheezing, Tegan had allergic symptoms including watery eyes, postnasal drainage and an allergy like prodrome. This ties in with allergic asthma being linked to other allergic conditions including allergic rhinitis that gives post nasal drainage and allergic conjunctivitis that manifests as watery eyes (Van Aalderen, 2012). 3) There is a familial history of atopy. Atopy, which is a genetic predisposition to allergy, is hereditary. Following the history that shows Tegans mother having allergy, sinusitis and nasal polyps, it is plausible to say she inherited the atopy. 4) The disease is triggered by environmental allergens including pollen, foods, animal dander or dust just to mention a few (Janssens Ritz, 2013). This corresponds to Tegan and his family moving to Mount Buller Alpine resort prior to the symptoms starting. This being a highland area is teaming with environmental allergens including pollen. Pathophysiology of allergic asthma Asthma is a chronic condition characterized by airway hyperresponsiveness to allergens, bronchoconstriction, acute and chronic inflammation and airway remodeling (Kumar, Abbas Aster, 2015). There is an interplay between genetics shown by atopy and environmental factors shown by environmental triggers. The initial event is exposure to the allergen or trigger leading to Th2 immune response with production of IgE antibodies (Kumar, Abbas Aster, 2015). On repeated exposure crosslinking of IgE leads to mast cell degranulation with release of cytokines (Bonsignore et al, 2015). This is the reason for the hyperresponsiveness to various stimuli. The release of inflammatory mediators leads to two phases of reactions, an early phase, and a late phase. During the early phase, there is bronchoconstriction, mucosal hyperstimulation leading to overproduction of mucus and vasodilation (Kumar, Abbas Aster, 2015). The early phase reaction is due to mast cell degranulation with release of mediators including histamine. Bronchoconstriction is due to direct influence of the mediators on vagal receptors. The late phase is due to recruitment of neutrophils, eosinophils and more T cells (Bonsignore et al, 2015. There are repeated episodes of inflammation leading to changes in the bronchial smooth muscle termed airway remodeling. It involves deposition of collagen, hypertrophy of smooth muscle in the bronchial walls and increased glands (Kumar, Abbas Aster, 2015). This process is what underlies the presentation of asthma with a cough due to increased mucus production, wheezing due to bronchoconstriction and airflow obstruction (Ldrup Pijnenburg, 2015). Treatment options for asthma The treatment of asthma involves the use of medications, lifestyle modifications and control of risk factors including avoidance of triggers (Queensland Health, 2015). The initial intervention is an assessment of the pattern of symptoms in order to stratify the severity of asthma (National Asthma Control Council of Australia, 2018). In Tegans case, this is her initial diagnosis and no prior records of asthma control are available. Monitoring after prescription of drugs will help in this regard. The initial treatment requires the prescription of a reliever that is taken in case of a flare up and a controller that is taken daily as a preventive measure (National Asthma Control Council of Australia, 2018). This is coupled with education to parents and the child that these medications are to make sure the disease does not interfere with the daily activities of the child. Recommended relievers include salbutamol 2 -4 puffs (100 mcg per puff) via a pressurized metered dose inhaler or terbutaline for children over 6 years, 1-2 puffs (500 mcg per puff) via a breath- actuated powder inhaler (National Asthma Control Council of Australia, 2018). The choice of using a controller depends on the severity of asthma. In infrequent intermittent asthma, a controller is not needed and control of risk factors alone and treatment of acute attacks is enough. In frequent to severe asthma, however, controllers are needed. They should include an inhaled corticosteroid, Montelukast, and sodium cromo glycate (National Asthma Control Council of Australia, 2018). The pattern of treatment is stepwise, increasing doses if the medication does not work or gradually reducing doses if good control is achieved (National Asthma Control Council of Australia, 2018). Standard asthma management education. According to the National Asthma Control Council of Australia, (2018), the recommended education for parents and children involves information on asthma, explaining that it is a chronic condition, the causes, severity, warning signs of an impending asthmatic attack and triggers of asthma. The medications are explained as relievers that help during an attack or before attacks are imminent, controllers help prevent the attacks and should be used regularly. The side effects and alternative choices of the inhaled corticosteroids should be explained. The next piece is education on inhaler devices. The parents and child should be taught how to use a puffer and spacer or any other inhaler device properly. The education should be via demonstration with the parents and child repeating the process to evaluate the outcome of teaching. Also, in this regard, the cleaning and care of inhalers are taught. The final issue is to provide a written action plan for them and for any institution the child is in including school and explain to them how to use it. A written action plan makes it easier to follow management goals set and includes a list of medications and actions to take in several scenarios (National Asthma Control Council of Australia, 2018). Conclusion In conclusion, Tegan has allergic asthma due to his presentation and family history of atopy. Allergic asthma is a chronic condition that is characterized by airway hyperresponsiveness to allergens, bronchoconstriction, acute and chronic inflammation and airway remodeling leading to symptoms of wheezing, cough, associated allergic rhinitis, allergic conjunctivitis, and eczema. The treatment options for asthma include reliever and controller medication coupled with avoidance of triggers and reduction of risk factors. A standard asthma education is given before discharged to help in self-management of asthma by the parents and child. References Bonsignore, M. R., Profita, M., Gagliardo, R., Riccobono, L., Chiappara, G., Pace, E., Gjomarkaj, M. (2015). Advances in asthma pathophysiology: stepping forward from the Maurizio Vignola experience. European Respiratory Review, 24(135), 30-39 Guibas, G. V., Mathioudakis, A. G., Tsoumani, M., Tsabouri, S. (2017). Relationship of Allergy with Asthma: There Are More Than the Allergy Eggs in the Asthma Basket. Frontiers in Pediatrics, 5(92). Janssens, T., Ritz, T. (2013). Perceived Triggers of Asthma: Key to Symptom Perception and Management. Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology, 43(9), 1000-1008. Kumar, V., Abbas, A. K., Aster, J. C. (2015).Robbinsand Cotran pathologic basis of disease. (Ninth edition.). Philadelphia, PA: Elsevier/Saunders Ldrup Carlsen, K. C., Pijnenburg, M. W. (2015). Monitoring asthma in childhood. European Respiratory Review, 24(136), 178-186. Mukherjee, A. B., Zhang, Z. (2011). Allergic Asthma: Influence of Genetic and Environmental Factors. Journal of Biological Chemistry, 286(38), 32883-32889. National Asthma Control Council of Australia. (2018). Australian asthma handbook. Melbourne, Australia: National Asthma Council Australia Queensland Health, (2015). Chronic Conditions Manual: Prevention and Management of Chronic Conditions in Australia. (1st Ed.). The Rural and Remote Clinical Support Unit, Torres. Van Aalderen, W. M. (2012). Childhood Asthma: Diagnosis and Treatment. Scientifica, 2012, 18