Tegan Smith Case Study

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Tegan Smith Case Study

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Questions:
1.Based on the information in the case study, which type of asthma is Tegan Smith likely to have suffered?

2.Discuss the pathophysiological changes in asthma.

3.Discuss different treatment options for asthma (Australian perspective).

4.List the standard asthma management education for parents and children before discharge (Australian perspective).

Answers:
1.Tegan’s type of asthma

Tegan is suffering from allergic asthma which is one of the common asthmas around the globe. The individual with such conditions have an immune system that overreacts to certain allergens through tightening of airway muscles thus becoming inflamed and thickened with mucus. This is signs or triggers of the asthma are caused by pollen grains, mold spores, animal dander, dust mites, smoke, air pollution, cold air, perfumes, dusty rooms and any other (Woolcock, Bastiampillai, Marks, & Keena, 2011). If the reaction is too much there can be watery eyes or postnatal drainage due to inflated lungs. These substances trigger the allergic reaction causing the individual to feel the signs and symptoms.
Zhu, Yan, Zhai, Yang, & Manxiang Li (2017) adds that this type of asthma is genetically related to an individual’s family lime. If one of both parents have allergies, then there is more likelihood for children to have allergies and the risk of developing asthma. For example, Tegan’s mother has a history of allergic reactions which may be the source of inheritance of her. She is characterized by sinusitis, allergy and nasal polyps which affect the reactions that she has with the environment. Children from allergic parents should be watched closely for early diagnosis of asthma symptoms so that the condition can be managed early to avoid severe complications. The condition is characterized by coughing, wheezing, shortness of breath, rapid breathing and tightening of the chest (Karin Lisspers, 2016). The severity of allergic asthma depends on the amount of pathogens that one has inhaled. Allergic asthma patients should therefore practice self-management through avoiding environments with triggers that can lead to reactions.
2.The pathophysiological changes in asthma
The pathophysiology of asthma can be traced to the changes in the disease the past twenty-five years. Being an inflammatory condition, asthma can be managed through therapeutic processes but has no cure. Patient centered approaches are used to assist patients manage the condition and later lead to immunity system changes that do not react to allergies (Russell & Brightling, 2017). However, the genetic history of the family is an issue that has not been addressed on how the genetic causes of the disease can be reduced by ensuring that children from allergic parents do not suffer from the allergy effect. This is seen in the case of Tegan where she seems to have inherited the condition from her mother who is characterized by allergic reactions. Family history is therefore important in tracing the source of allergic reactions in children. However, Castillo, Peters, & Busse, (2017) add that there are other related conditions like gastro-oesophagalreflux disease, air pollution during pregnancy and sleep apnea can increase or reduce the possibility of developing allergic reactions and the response to medication.
To understand the disease, practitioners have grouped the phenotypes of the condition using characteristics like inflammation and pulmonary function. This allows the grouping of patients in a hierarchical cluster method using the similarity between patients. (Bostantzoglou, et al. (2015) suggests that the Global Initiative for Asthma (GINA) to identify allergic asthma, non-allergic asthma, asthma with obesity, asthma with fixed airflow and late onset asthma. When identifying the phenotype and the nature of asthma that a patient is suffering from, the practitioner uses clinical physiologic changes, clinical history and airway differences to categorize the condition.

3.Treatment options in Australia
Asthma treatment is done through an action plan that focusses on reducing inflammation of the airways to achieve breathing and lead to improved outcomes. The National Asthma Council of Australia (2018) relivers and preventers are sued for the treatment of asthma in Australia. Relievers are used by all asthmatic patients who use the medicine to relieve the allergic reaction. These medicines include puffers or inhalers that can be bought by the patient over the counter. These include drugs like Flutiform, Fluticasone +, Breo, Symbicort, Seretide and Salmeterol Cipla* which exist inform of inhalers for reducing asthma signs. Preventers are used to reducethe effects of allergic reation in adults throughtakinga dose of corticosteroid to reduce inflammation of airways thus minimizing the allergic responses to pathogens. Asthma Australia (2018), reports that drugs like Pulmicort, Alvesco, Flixotide and Qvar can be used as asthma preventers that come inform of inhalers. Low daily dosages of these drugs repair airway cells thus reducing their sensitivity leading to reduced inflammation and mucus.
Further, allergen immunotherapy is sometimes used to treat asthma and prevent manifestations of the allergies. The process requires administration of corticosteroids through swallowing of tablets or inhalers on small doses and later increasing the doses with time (Mims, 2015). The outcome is improved airways which react less to allergens thus preventing the possibility of asthma attacks. The therapy runs for a period of two to three years after which the individual immune system will have developed enough to reduce inflammation and reaction to allergic pathogens.
4.Standard asthma management education for parents and children before discharge
The role of standard management education is to ensure that parents have enough care management knowledge that can be used to manage and control the condition in children (Tippets & Guilbert, 2009). Once a child has been treated, the allergic inflammation heals slowly thus the need for a management plan the parent uses to achieve the healing process and reduce future attacks. The following standards of education need to be given to parents.
Establishing of standard management goals for the child with parents to develop a personalized care plan for managing the condition.
Train the parent on early detection of trigger signs to reduce the possibility of an acute attack.
Education the parents with adequate knowledge on managing the healing process and future attacks to prevent readmission.
Offer training to the child for managing the condition and use of the inhaler during attacks or allergic reactions.
Educate parents with necessary medication that they need to have in their homes for use in case of attacks.
Take the parents through post management plan forty-eight hours before the child is discharged to psychologically prepare the parent on creating conditions that will increase the recovery process.
Provide referrals for the patient by linking the parents to a GP where they can seek assistance in case of attacks.

References
Asthma Australia. (2018, April). Your asthma medicine. Retrieved from Asthma Australia: https://www.asthmaaustralia.org.au/national/about-asthma/manage
Bostantzoglou, C., Delimpoura, V., Samitas, K., Zervas, E., Kanniess, F., & Gaga, M. (2015). Clinical asthma phenotypes in the real world: opportunities and challenges. Breathe, 11(3), 186-193.
Castillo, J., Peters, S., & Busse, W. (2017). Asthma Exacerbations: Pathogenesis, Prevention, and Treatment. Clinical Management Review, 5(4), 918-927.
Karin Lisspers, P. T. (2016). Are pharmacological randomised controlled clinical trials relevant to real-life asthma populations? A protocol for an UNLOCK study from the IPCRG. NPJ Primary Care Respiratory Medicine, 26(1).
Mims, J. W. (2015). Asthma: definitions and pathophysiology. International Forum of Allergy & Rhinology, 5(1).
Russell, R., & Brightling, C. (2017). Pathogenesis of asthma: implications for precision medicine. Clinical Science, 131(141), 1723-1735.
The National Asthma Council of Australia. (2018). Asthma & Allergy. Retrieved from National Asthma Council of Australia: Retrieved from National Asthma Council of Australia: https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/asthma-allergy#
Tippets, B., & Guilbert, T. (2009). Managing Asthma in Children: Part 1: Making the Diagnosis, Assessing Severity. Consultant for Pediatricians, 8(9).
Woolcock, A. J., Bastiampillai, S., Marks, G., & Keena, V. (2011). The burden of asthma in Australia. Medical Journal of Australia, 175(3), 141-145.
Zhu, Y., Yan, X., Zhai, C., Yang, L., & Manxiang Li. (2017). Association between risk of asthma and gene polymorphisms in CHI3L1 and CHIA: a systematic meta-analysis. BMC Pulmonary Medicine, 17(1).

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