a complicated interaction involving an individual’s genetic susceptibility and environmental factors (Huether, and McCance, 2017). When asthma flares or attacks the symptoms can range in degree from mild to needing immediate emergency treatment as with status asthmatics. Symptoms include coughing, chest tightness, expiratory wheezing, rapid breathing, and shortness of breath (Asthma and Allergy Foundation of America, 2015). Other symptoms include accessory muscle use, anxiety, barrel chest, clubbing, dyspnea, nasal flaring, pulsus paradoxus and head bobbing in infants (Huether, and McCance, 2017). Pathophysiology The pathophysiology of asthma in children is similar to that for adults. Asthma is one of the obstructive lung diseases. Most asthma is considered allergic asthma and has type I reaction mediated by T helper two lymphocytes cells (Th2) (Huether, and McCance, 2017). Antigen exposure causes the Th2 cells release cytokines (bradykinins, histamine, interleukins, leukotrienes and prostaglandins) that activate mast cells, dendritic cells, B-cell with IgE presenting antigens, and eosinophils causing the inflammatory response, bronchospasm, impaired mucociliary function, mucus production, thickening of airway walls, and vascular congestion (Huether, and McCance, 2017). The remodeling in asthma causes airway obstruction, which increases resistance to airflow and decreases flow rates (Huether, and McCance, 2017). Impaired expiration causes increased work of breathing due to air trapping, distal hyperinflation of alveoli, and decreased perfusion. The impaired respiratory function causes variable and uneven ventilation-perfusion relationships resulting in hypoxemia, decrease in tidal volumes, increasing carbon dioxide retention resulting in respiratory alkalosis and respiratory failure (Huether, and McCance, 2017).
WEEKLY DISCUSSIONS 8 In asthma, the cough, dyspnea, and wheeze are due to variable airflow obstruction and the inflamed airway causing bronchospasms (Asthma and Allergy Foundation of America, 2015). In Cough variant asthma, the cough may be the only clinical manifestation of asthma and is the most widespread of a chronic cough worldwide (Niimi, 2011). Typically, in asthma, the cough is dry or minimally productive. Gender and Age Approximately 24 million Americans have asthma, 6.3 million of affected individuals are children (Asthma and Allergy Foundation of America, 2015). Asthma is the most prominent reason for missed school, the third leading cause of hospital stay for children, and the most prevalent chronic disease in children (Asthma and Allergy Foundation of America, 2015). Earlier exposure to allergens such as air pollution, cockroaches, cats, dust mites, and tobacco smoke; preterm birth; childhood obesity; recurrent respiratory tract infections increase the risk for acquiring asthma (Huether, and McCance, 2017). Avoiding triggers is one of the most important treatments for asthma. Asthma symptoms overlap with other respiratory illnesses, and is often underdiagnosed and undertreated (Huether, and McCance, 2017). Furthermore, one's gender is a risk factor for asthma. Asthma is more prevalent in women than men (Asthma and Allergy
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- Fall '17
- keisha lovence