Asthma Case Study.docx - Case Study Asthma Rachel Sims...

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Case Study: AsthmaRachel SimsNRP/507: Advanced PathophysiologyMay 2nd, 2020Julie Hettig
Synthesize Nancy’s overall social and medical history, clinical symptoms and clinical assessment to classify her asthma using EBG. Which of the four categories (intermittent, persistent – mild, persistent – moderate, persistent – severe) does she fall under? Explain your justification. Nancy is a 35-year-old diagnosed with asthma when she was 20 years old. She has only been using albuterol for symptom control of her asthma. Her asthma flared up 2 weeks ago and she had been using her short-acting beta agonist (SABA) inhaler 3 to 4 times a day. Patient states that she is short of breath when she climbs stairs or walks to her mailbox. She also has orthopnea, which is evidenced by supporting herself on pillows to breath. She also stated that she had nighttime coughing spells every day during the past week. Based on the patient’s symptoms, she is suffering from severe persistent asthma. Nocturnal awakening due to coughingspells every day, using the SABA inhaler several times a day, shortness of breath when doing normal activities such as walking to the mailbox, and a spirometry value of 58% are evidence of severe persistent asthma. According to Fanta (2020), “Severe persistent asthma is manifest by the presence of asthma symptoms throughout the day, nocturnal awakening due to asthma nightly, reliever medication needed for symptoms several times/day, or activity limitation due to asthma”.From a pathophysiological perspective, what is the danger with her current treatment plan execution regarding her SABA use? Explain your answer. The core defects of asthma include airflow obstruction, bronchial hyperresponsiveness and inflammation. The patient is currently using albuterol several times a day to help her asthmasymptoms. Albuterol only addresses the short-term effects of bronchodilation of the lungs.
Chronic daily use of only beta agonists to relieve her asthma symptoms makes it difficult to control asthma. Monotherapy of beta agonists is not an effective treatment because tolerance andtoxicity can occur due to the down-regulation beta-2 adrenergic receptors. According to GINA (2020), “Although SABA provides quick relief of symptoms, SABA-only treatment is associated with increased risk of exacerbations and lower lung function.

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