Respiratory Pathophysiology

Title of Assignment:

Module 8: Respiratory pathophysiology

Purpose of Assignment:

This assignment will help the student evaluate of a respiratory disorder, which, if untreated, can be a serious condition. Students need to understand respiratory complications and how it can impact ventilation and respiration is important to the study for maintaining homeostasis in the body.

Course Competency(s):

• Evaluate pathophysiologic alterations that affect the neurologic and respiratory systems.

Content:

J.S. is a 42-year-old man who lives in the Midwest and is highly allergic to dust and pollen and has a history of mild asthma. J.S’s wife drove him to the emergency room when his wheezing was unresponsive to his fluticasone/salmeterol (Advair) inhaler. J.S. was unable to lie down, and began to use accessory muscles to breathe. J.S. is immediately started on 4 L oxygen by nasal cannula and intravenous (IV) D5W at 75 mL/hr. A set of arterial blood gases is sent to the laboratory. J.S. appears anxious and says that he is short of breath.

Vital signs

BP = 152/84                        HR = 124 bpm                    RR = 42 Temp = 100.4⁰F

ABGs

pH = 7.31                             PaCO₂ = 48                          HCO₃ = 26            PaO² = 55

Instructions:

Investigate the pathophysiology of asthma and the clinical manifestations of the disease. Analyze the case study provided and determine what symptoms support the diagnosis of asthma. Identify the treatment provided in the emergency department and determine what additional therapies are needed to mitigate the asthma symptoms and return the client to wellness.

1. Do you have any concerns with the numbers above?
2. Identify what may be causing (etiology) J.S. to have an exacerbation of asthma.

Prepare a 3-5 page paper outlining the causes of asthma, the symptoms that the client presents and the management of the disorder. Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides.  Be sure to cite your sources in-text and on a References page using APA format.

You can find useful reference materials for this assignment in the School of Nursing guide: https://guides.rasmussen.edu/nursing/referenceebooks

Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa

Grading Rubric:

ANSWER

Respiratory Pathophysiology

Respiratory ailments are among the common long-term conditions affecting various patients in the United States. Its evaluation, diagnosis, and treatment are significant components of patient care. Factors ranging from gender, age, and ethnicity, and socioeconomic have a severe effect on both the disease’s outcome and growth. When taking care of patients suffering from this disease, fundamental nursing techniques are involved in interpreting diagnostic testing and accurately managing care. Respiratory engages two primary body systems: the cardiovascular system and the respiratory system, both controlled by the nervous system. The respiratory system presents oxygen from the atmosphere to the bloodstream and delivers carbon dioxide from the atmosphere’s blood. The paper, therefore, evaluates a case study of the pathophysiology of asthma and the clinical manifestation of the ailment.

Symptoms Supporting the Diagnosis of Asthma

One of the symptoms from the case study is that the patient is short of breath. When a person breathes naturally, the bands of muscles around the airways are relaxed, and the air gets in and out freely (Akoumianaki et al., 2014). However, when one has asthma, the muscles tighten, making it difficult for the air to pass through. Another symptom demonstrated from the study is a wheezing sound from the patient. A whistling sound when a person breathes is a sign of asthma. The third sign is linked with the use of accessory muscle breathing, which suggests respiratory problems. During an attack, more pressure is required to push air through the bronchus, which leads to escalated use of accessory muscles to breathe. These muscles are customarily located or attached to human ribs, neck, and shoulders. From the study, having a history of allergy to dust and pollen is another symptom of approving asthma diagnosis. Noticeably, not every individual has a similar sign in the same way because a person might not have all the mentioned symptoms in the study or may have diverse characters on different occasions.

Treatment Provided

The patient was given fluticasone at the emergency department, and a salmeterol inhaler is typically used to stop and treat wheezing and shortness of breath caused by asthma. This combination is generally in powder form and an inhalation remedy to inhale by mouth using a specially designed inhaler. The patient was also given oxygen through the nasal cannula, which is used when small amounts of supplemental oxygen are needed minus stiff control of respiration, such as in oxygen treatment. Numerous cannulae are designed to provide oxygen at low flow degrees of up to 5L per minute and giving out oxygen concentration of approximately 29 to 45 percent. The intravenous treatment method was also used to deliver medications directly to the patient’s vein. The process is frequently used for rehydration or nutrition provision for patients who cannot feed on the mouth.

Additional Therapies

Returning the patient to wellness requires more techniques which range from nebulization with short beta-adrenergic agonist hourly to ipratropium. Salbutamol is a therapy used to reduce the sign of asthma and other chronic ailments, including wheezing, coughing, and feeling breathless (Akoumianaki et al., 2014). It operates by relaxing the muscles of the airways into the lungs, making it easier to breathe. Also, ipratropium bromide inhalation is another additional remedy that could be used to treat the patient. The inhaler is utilized to calm and stop wheezing and shortness of breath symptoms linked with asthma. For stopping signs of a lung ailment, this medication should be used frequently to be effective. Azithromycin is another medication that could be used to return the patient to wellness. It is used to treat chest infections, including pneumonia which affects the breathing system of a person.

Concerns with the Numbers

I am concern with the presented numbers, which indicate extreme levels of respiratory rate. This is a suggestive sign of tachypnea, a medical term used to describe shallow and fast breathing. The client’s heart rate is also high, a sign of tachycardia resulting from hypoxia and salmeterol. The blood pressure recorded is high, increased heart rate and respiratory rate indicate a respiratory problem. His arterial blood gas is also atypical; this procedure is used to measure the acidity and oxygen levels in the blood from an artery. The test is also significant in checking how effectively a patient’s lungs can transmit oxygen into the blood and excrete carbon dioxide from the blood. The patient’s acidity is low, a sign of acidosis (Zanni et al., 2010). The lungs and kidneys have a balance of chemicals known as bases and acids in the body. Acidosis happens when acid is concentrated in the blood and bicarbonate reduced. Respiratory acidosis occurs when there is excess carbon dioxide in the body. In summary, it is affirmative that the patient in the case study has asthma and the figure presented is worrying. The proposed remedies ought to be used under the strict help of a qualified individual.

References

Akoumianaki, E., Maggiore, S. M., Valenza, F., Bellani, G., Jubran, A., Loring, S. H., … & Brochard, L. (2014). The application of esophageal pressure measurement in patients with respiratory failure. American journal of respiratory and critical care medicine, 189(5), 520-531.

Zanni, J. M., Korupolu, R., Fan, E., Pradhan, P., Janjua, K., Palmer, J. B., … & Needham, D. M. (2010). Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project. Journal of critical care, 25(2), 254-262.