Asthma and COPD, Research Paper Example

Asthma Pathophysiological Mechanisms and Clinical Manifestations: Asthma is a complex respiratory condition that involves narrowing of the airways and the formation of mucus that contributes to difficulties in breathing and increases the risk of coughing, shortness of breath, and wheezing in patients (Mayo Clinic, 2015). Asthma is often attributed to conditions that include allergies, genetic predisposition, respiratory infections at a young age, and exposure to viruses and other irritants that impact breathing function (National Heart, Lung, and Blood Institute, 2015). Asthma may also be caused by factors associated with the “hygiene hypothesis,” whereby young persons who are not exposed to environmental irritants due to increased hygienic methods may develop differences in their immune systems that make them susceptible to developing asthma (National Heart, Lung, and Blood Institute, 2015). This is a consequence of an ever-changing surrounding environment in which there is limited exposure to different irritants that are likely to increase the immune response in patients who have had this exposure over time (National Heart, Lung, and Blood Institute, 2015).

For patients who exhibit the signs and symptoms of asthma, the most common issues include coughing, tightness in the chest, wheezing, and shortness of breath; however, patients may not always exhibit all of these symptoms or a combination thereof, and some symptoms may be a result of allergens, sulfites, irritants, respiratory infections caused by viruses, and exercise, among other variables (National Heart, Lung, and Blood Institute, 2015). Therefore, it is important to recognize the various symptoms of asthma in order to address the underlying condition as best as possible and to provide a cohesive treatment plan moving forward for these patients.

Chronic Obstructive Pulmonary Disease Pathophysiological Mechanisms and Clinical Manifestations: COPD is a chronic condition that creates airflow obstructions from the lungs, thereby creating poor respiratory function and a host of other conditions such as cough and sputum production (Mayo Clinic, 2015). The primary cause of COPD is smoking, but fumes related to cooking and heating may also be contributing factors in some cases (Mayo Clinic, 2015). When bronchial tubes and alveoli lose their elasticity, air becomes trapped and is very difficult to release through exhalation (Mayo Clinic, 2015). Emphysema and chronic bronchitis are typical factors associated with COPD, whereby mucus formation is increased and difficulty breathing is the norm (Mayo Clinic, 2015). Patients with COPD experience coughs, tightness in the chest, shortness of breath, low energy, respiratory infection, and mucus buildup, among others (Mayo Clinic, 2015). These symptoms, also known as exacerbations, may have devastating effects for patients and may reduce quality of life during some periods.

A shift of the Oxyhemoglobin association/disassociation curve to the right may indicate chronic lung disease, congestive heart failure, and anemia in patients (Open Anesthesia, 2015). This is characterized by an increase in P50 and a reduced affinity by hemoglobin for oxygen; therefore, oxygen is released to tissues (Open Anesthesia, 2015).

Evidence-based practice protocols to treat asthma involve an understanding of the services provided in emergency departments in order to effectively manage the disease, using standardized protocols such as the following: the use of steroids as needed; the use of b-agonist treatment for cases where severe asthma has been identified; the use of inhaled anticholinergics for patients with severe asthma; and timely administration of these treatments (Li, To, Parkin, Anderson, & Guttman, 2012). Furthermore, patients should be discharged and prescribed steroids over the short term, along with instructions regarding a care and treatment strategy for the home environment (Li et.al, 2012). Guidelines for care and treatment are typically evidence-based and support a dynamic whereby healthcare providers adopt these guidelines in order to promote symptom alleviation and improved respiratory function in patients (Dexheimer, Borycki, Chiu, Johnson, & Aronsky, 2014). Asthma-related treatments are represented by a series of guidelines that must be addressed and under which symptoms may be alleviated and greater control of the condition is achieved (Dexheimer et.al, 2014).

Evidence-based protocols for COPD are represented by an ability to alleviate exacerbations associated with the disease state, using tools such as bronchodilators to limit these events, along with systemic glucocorticosteroids as a means of addressing lung function and to lower hypoxemia (Burt & Corbridge, 2013). Furthermore, antibiotics may be used to address conditions where bacterial infection is present, while oxygen therapy is often required in order to effectively manage hypoxemia or acidosis (Burt & Corbridge, 2013). Noninvasive ventilation may be effective in some cases where acidosis or hypoxemia are moderate, but more serious cases would require invasive mechanical ventilation (Burt & Corbridge, 2013). At discharge, patients must be provided with a treatment plan that will be adequate to meet their needs and which will offer comfort and access to the required equipment that must be used within the home environment (Burt & Corbridge, 2013). It is important to recognize the value of these differences in treatment in order to be effective in managing the condition and in addressing symptoms in a timely manner.

For patients with Asthma or COPD, it is important to develop an understanding of the condition and to possess the knowledge that is required to treat the condition effectively in order to alleviate symptoms and improve quality of life. Patient education is critical in this regard so that patients and their family members are prepared to execute plans of care in the home environment without disruptions or delays in medication administration as required. This reflects the importance of developing a strategy for patients and their families as a guide in understanding the need for timely treatments to minimize symptom risk and to further expand knowledge regarding these diseases and their symptoms. From a nursing perspective, educating patients is a critical component of the treatment process and requires their knowledge, expertise, and full attention towards patients with the objective to improve their quality of life through a coordinated treatment strategy. Most importantly, nurses must serve in an educational capacity but also balance this process with a high level of compassion and support for these patients, particularly if they are experiencing symptoms and require immediate treatment for their condition. This process is essential to the discovery of a nurse-led education program that is based upon evidence-based practice and the support that is required to meet expectations and impact change within a patient’s life.

Aspiration: This condition is characterized as a form of pneumonia in which the large airways of the lungs become infected, thereby increasing breathing difficulties and when substances such as food and vomit get into the lungs, rather than moving through the esophagus and into the stomach (MedlinePlus, 2015). This type of pneumonia may be caused by several different forms of bacteria, depending on a number of factors, including the surrounding environment and overall health status (MedlinePlus, 2015). It is believed that the risks associated with this condition are related to factors such as coma, aging, excessive alcohol consumption, a lower level of alertness, and difficulty swallowing, among other concerns that influence patient health and a greater risk of developing this condition under the appropriate circumstances (MedlinePlus, 2015). Common symptoms include chest pain, fever, fatigue, and shortness of breath, and the condition is detected by physical examination and sputum culture, among other alternatives that will determine a definitive diagnosis and subsequent treatment strategy (MedlinePlus, 2015).

References

Burt, L., & Corbridge, S. (2013). COPD Exacerbations: Evidence-based guidelines for identification, assessment, and management.

Dexheimer, J. W., Borycki, E. M., Chiu, K. W., Johnson, K. B., & Aronsky, D. (2014). A systematic review of the implementation and impact of asthma protocols. BMC medical informatics and decision making, 14(1), 82.

Li, P., To, T., Parkin, P. C., Anderson, G. M., & Guttmann, A. (2012). Association Between

Evidence-Based Standardized Protocols in Emergency Departments With Childhood Asthma Outcomes: A Canadian Population-Based Study. Archives of pediatrics & adolescent medicine,166(9), 834-840.

Mayo Clinic (2015). Asthma. Retrieved from http://www.mayoclinic.org/diseases-conditions/asthma/basics/definition/con-20026992

Mayo Clinic (2015). COPD. Retrieved fromhttp://www.mayoclinic.org/diseases-conditions/copd/basics/causes/con-20032017

MedlinePlus (2015). Aspiration pneumonia. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/000121.htm

National Heart, Lung, and Blood Institute (2015). What causes asthma? Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/causes

Open Anesthesia (2015). P50 of hemoglobin: factors influencing. Retrieved from https://www.openanesthesia.org/p50_of_hemoglobin_factors_influencing/