Improving

In asthma we have reversible narrowing of the bronchioles. When they narrow they swell, so it gets hyper responsive, the airway tends to remodel, and they tend to look differently when you look at them. This is due to all the chemical mediators at are released. And because these mediators are released it is how we look at the meds. Chromin is for you mask cell. Singular is your…show more content…
Yellow, they should take a short acting rescue inhaler. If they are in the red zone they need to go to the ER and call their physician immediately. They need to get help. It is also good to keep a diary to keep track of what triggers these episodes of asthma attacks. There is a component of stress involved as well with asthma. So is you get upset you tend to breathe, faster, you get excited and their vessels constrict. Some complications that can occur with asthma. The meds are the same: albuterol, atrovent, advair, they tend to get the same type of meds. Steroids with a severe attack, same thing. And if they are a bad asthmatic, or bad enough COPD person they get chronic steroids meaning PO. They are basically always on steroid inhalers either combo or individual. The most severe thing they can get is status asthmatics. This is a severe, persistent asthma attack that you can’t break. They give them back to back meds, they give them steroids and they are wheezing, and they are wheezing, and they are wheezing. The pulse ox is dropping, they are getting more and more SOB, and they are getting more and more fatigued, you can’t break the treatments. You might give epinephrine SQ, but one of the things you need to watch for (as the nurse) is those breath sounds. If you listen to an asthmatic, and you don’t hear good air exchange, you want to hear wheezes, do don’t want to hear a quite chest. If their breath sounds change to quite you want to call Improving Asthma Management In Schools Essay

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Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs.

If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.Improving Asthma Management In Schools Essay

For many asthma sufferers, timing of these symptoms is closely related to physical activity. And, some otherwise healthy people can develop asthma symptoms only when exercising. This is called exercise-induced bronchoconstriction (EIB), or exercise-induced asthma (EIA). Staying active is an important way to stay healthy, so asthma shouldn’t keep you on the sidelines. Your physician can develop a management plan to keep your symptoms under control before, during and after physical activity.

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.

Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.Improving Asthma Management In Schools Essay

An allergist / immunologist is the best qualified physician in diagnosing and treating asthma. With the help of your allergist, you can take control of your condition and participate in normal activities.

Asthma is a common chronic respiratory disease with a global prevalence of more than 200 million. It is a heterogeneous disease identified by reversible airflow obstruction, bronchial hyperresponsiveness (BHR) and inflammation. Treatment of inhaled corticosteroids (ICS) and/or combination of long acting ??-agonist (LABA) may deviate in dosage depending on the measure of severity among patients. Asthma can also be classified into two categories; extrinsic (atopic) and intrinsic (non-atopic) asthma (Fahy, 2014). For this case study, I would be discussing some characteristics of asthma, diagnosis and treatment recommendations and current research in stratified medicine.Improving Asthma Management In Schools Essay
ETIOLOGY
Atopic asthma is triggered by environmental stimuli such as allergens (e.g. pollen, pet hair, dust mites etc.), air pollution, weather change and childhood exposure to tobacco smoke. Less than 15% of children with continuous wheezing would develop asthma in adolescent while others with eczema, obesity, atopic rhinitis and dermatitis are at higher risk of developing asthma. These comorbidities may complicate asthma management in adulthood (Subbarao, 2009). Furthermore, there is a higher prevalence of asthma among boys than girls, and a higher incidence among women than men, due to hormonal factors. Boys generally undergo asthma remission as a result of enhanced lung development and airway growth (Spahn, 2008) whereas hormonal influences could affect asthma control in pregnancy (Padmanabhan, 2014).
Other risk factors which could affect the immune system in new-onset asthma are exercise, emotional stress and occupational exposure to chemical substances such as paint, hair dyes, cleaning liquids and the use of marijuana. Viral infections affecting the lungs in childhood (e.g. bronchiolitis) could also affect airway epithelial cells, thus resulting in the development of T-helper (TH2) related asthma (Fahy, 2014).
PATHOPHYSIOLOGY
Asthma is characterized by a cumulative loss of lung function over time. Changes to airway structure and composition such as thickening of basement membrane, increased bronchial vascularity, smooth muscle hyperplasia and hypertrophy and goblet cell hyperplasia, which leads to mucous hypersecretion, also promotes to airflow obstruction. This is known as airway remodelling (Tschumperlin, 2011).Improving Asthma Management In Schools Essay
As a result of allergen exposure, inflammatory cells invade airways and releases mediators such as leukotrienes, histamine, cytokines and chemokines triggering bronchoconstriction, airway remodelling and hyper-reactivity, as shown in Table 1 (Padmanabhan, 2014).
SIGNS AND SYMPTOMS
Patients experience wheezing, cough, dyspnea and chest tightness. Symptoms may vary in frequency if treatment is received, depending on their severity and displays hypersensitization to allergens that could trigger exacerbations. The difficulty with this disease is that its symptoms often overlap with other allergies (e.g. allergic rhinitis) making it strenuous to determine the primary cause and relieve symptoms (Padmanabhan, 2014).
DIAGNOSIS
Symptoms that are alleviated by bronchodilators indicates asthma as the underlying cause. Therefore, it’s critical that tests are performed while patients are symptomatic allowing accurate diagnosis.
The age on asthma-onset should also be considered. Although asthma in children and adults share similar characteristics, there are significant differences between them. For example, adult-onset asthma develops sensitization to occupational factors and are often misdiagnosed for COPD or chronic bronchitis (Holgate et al. 2006).
As it is a hereditary disorder, a detailed patient history is required to determine whether there are any signs of family history, atopy or long-term chemical exposure. Asthma displays a decrease in FEV1 (forced expired volume in 1 second) and a reduced FEV1/FVC ratio (<70%) through analysis of spirometry (Fahy, 2014). Asthma could be detected by monitoring exhaled nitric oxide and inspecting sputum counts for bacteria or fungi infecting lungs and airway passages. Patient’s response to metacholine provocation, a positive skin prick response to allergens and a fall in peak expiratory flow (PEF) are also signs of asthma (Sears, 2008). Likewise, sputum, bronchoscopic or blood analysis could indicate eosinophilic asthma by observing the abnormal eosinophils counts in blood (Wenzel, 2012). TREATMENT One of the major problems of treating asthma is the patient’s noncompliance, poor inhaler technique and adherence to their treatment. Adherence results in low mortality while overuse of medication that relieve symptoms but doesn’t treat the underlying cause, increases mortality among patients (Padmanabhan, 2014). Most asthma phenotypes are reversible through the use of anti-inflammatory drugs such as ICS and ??2-adrenoceptor agonists (Holgate et al. 2006). Other forms of treatment that monitors asthma and reduce symptoms are leukotriene modifiers for allergies, anticholinergics, chromones and anti-IgE. Glucocorticoids are the optimal first-line treatment which could be administered orally, as ICS or injected during exacerbations (Ortega, 2015). STRATIFIED MEDICINE IN CURRENT PRACTICE OR RESEARCH Unlike other disease, asthma has no accurate test for diagnosis and is often misdiagnosed in around 30% of patients. This is because diagnosis relies heavily on the existence of symptoms which may be variable and is caused by numerous factors (Padmanabhan, 2014).Combination of ICS and long acting ??2-adrenoceptor agonists (LABA) are the gold standard treatment, however <10% of the population are unresponsive to this treatment (corticosteroid-resistant asthma) Improving Asthma Management In Schools Essay . The aim is to use pharmacogenetics in order to identify risk progression and predict treatment that would either provide efficacy or result in adverse events. Studies relating to glucocorticoids, leukotriene and ??2-adrenergic receptor pathways are based on searching for genes that affect the patient’s responsiveness (Ortega, 2015). Current research aims to categorize asthma into endotypes to enhance patient outcomes. In particular, lebrikizumab, an anti-IL-13 monoclonal antibody displayed improved FEV1 among patients with high IL-13 activity while mepolizumab, an anti-IL-5 monoclonal antibody, minimized eosinophil levels and exacerbations for severe asthma patients (Poon and Hamid, 2012). . CONCLUDING REMARKS Asthma is a modern disease that has achieved a few improvements yet remains high prevalence over the years. To help fully overcome this disease, proper diagnosis and treatment of asthma endotypes should be made, based on biological guidelines, instead of empirical approaches, as shown in Table 2. This is why asthma is an excellent example of how stratified medicine would benefit this disease. By assessing the biological pathways and molecular characteristics, better diagnosis and treatments could be developed for the future.

Self-management is crucial in order to have optimal asthma control. However, asthmatic children
tend to quit playing sports completely and do not follow instructions that are given during an appointment
by their doctor. Therefore, it is important to promote asthma education and physical activity amongst
children with asthma and their parents to improve their asthma control. This graduation project focusses on
designing a serious game on the interactive playground in the waiting room of the hospital to support selfmanagement of asthmatic children.Improving Asthma Management In Schools Essay
In the beginning, some related research has been executed. Some information about designing for
children, making games, the interactive playground, the circumstances in the waiting room, and optional
asthmatic topics to educate the children and their parents about, has been gathered. In the second phase
a mind map was made based on the related research, including game characteristics such as repetition,
teamwork, immediate feedback and motivation and more aspects that should be taken into account such
as the target group and the use of colors when making a serious game for children with asthma to support
self-management. 30 concepts were discussed with the supervisors of this project, 5 concepts were
discussed with two medical professionals and finally one final concept has been realized on the interactive
playground in the waiting room of ‘Medisch Spectrum Twente’. The game that has been realized is named
Eldub’s Asthma Adventure. The player(s) has/have to protect Eldub, who is located in the middle of the
screen and has asthma, by destroying and dodging positive and negative triggers that move towards him.
The overall feedback, both by medical professionals and children with asthma, was very positive. The
children personalized the game by recognizing the triggers and especially enjoyed the score and feedback
that is implemented in the game. Additionally, they really like to play the game together with their parents
and siblings and were really motivated to win. The medical professionals are very excited to continue
working with this project and are, besides some very enthusiastic advices, in no way negative about the
game. The enthusiastic advices include more personalization and even more feedback. Sadly, the game
does have some bugs, so in order to continue this process these bugs should be fixed.Improving Asthma Management In Schools Essay

As far as asthma goes, triggers for asthma are: allergies, family history (because there is a genetic influence) dust mites, pet dander, dust, cockroaches, pollen, mold, anything like that, pollutions and factory immetions can trigger some allergies. And often your patient will give you a history of GERD and exema (especially when they were a kid).
In asthma we have reversible narrowing of the bronchioles. When they narrow they swell, so it gets hyper responsive, the airway tends to remodel, and they tend to look differently when you look at them. This is due to all the chemical mediators at are released. And because these mediators are released it is how we look at the meds. Chromin is for you mask cell. Singular is your…show more content…
Yellow, they should take a short acting rescue inhaler. If they are in the red zone they need to go to the ER and call their physician immediately. They need to get help. It is also good to keep a diary to keep track of what triggers these episodes of asthma attacks. There is a component of stress involved as well with asthma. So is you get upset you tend to breathe, faster, you get excited and their vessels constrict. Some complications that can occur with asthma. The meds are the same: albuterol, atrovent, advair, they tend to get the same type of meds. Steroids with a severe attack, same thing. And if they are a bad asthmatic, or bad enough COPD person they get chronic steroids meaning PO. They are basically always on steroid inhalers either combo or individual. The most severe thing they can get is status asthmatics. This is a severe, persistent asthma attack that you can’t break. They give them back to back meds, they give them steroids and they are wheezing, and they are wheezing, and they are wheezing. The pulse ox is dropping, they are getting more and more SOB, and they are getting more and more fatigued, you can’t break the treatments. You might give epinephrine SQ, but one of the things you need to watch for (as the nurse) is those breath sounds. If you listen to an asthmatic, and you don’t hear good air exchange, you want to hear wheezes, do don’t want to hear a quite chest. If their breath sounds change to quite you want to call Improving Asthma Management In Schools Essay

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