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Respiratory Problems in Paediatric Patients: Pathophysiology of Respiratory Illness Assignment Answer

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This assessment relates to: Learning Outcomes 1-5

Discuss the pathophysiology of Asthma and link to the clinical manifestations of Zachy's presentation. Include the pathophysiology and clinical manifestation of Zachy's Asthma.

You must include a succinct introduction and conclusion, reference using APA style, use your prescribed texts and at least 8 peer-reviewed sources.

This section of the assignment is focused towards the science content and will be marked by the science team.

Answer

Pathophysiology of respiratory illness

Introduction 

The paper demonstrates the understanding of the respiratory disease, asthma and includes the related anatomy and physiology relevant to it. The paper also provides a comprehensive respiratory assessment based on the prevalence of respiratory problems in paediatric patients. The paper also offers proper planning of the health promotion strategies and their respective implementation for respiratory health and well being. 

LO 1 Demonstration of the understanding of Asthma

Anatomy and physiology 

When the muscles around the airways of the lungs become narrow, and the linings within the airways swell, then this condition is called Asthma (Valverde-Molina, 2018). This is the reason why Zachy was breathing heavily, coughing and wheezing. The fast breathing corresponds to the shortness of breath due to air passage swelling. The lungs secrete extra mucus which obstructs the air tubes as well as the lungs. 

Zachy has been exposed to probable irritants or allergens such as household chemicals, dust mites and other airborne substances like mold spores or cockroach waste that has triggered allergic reaction and symptoms of Asthma.

Pathophysiology 

Zachy’s change of airways have become exceedingly reactive to multiple intrinsic or extrinsic stimuli causing the narrowing of the airways thus reducing the airflow in his lungs. According to recent findings, asthma is an inflammatory disease which corresponds to the hypersensitivity of the airways (Bhat, Rehman & Mabalirajan, 2017). The airways inflammation is caused due to an augment in the amount of eosinophils, T cells as well as mast cells in the airway mucosa. Frequent inflammation is connected with the adjusting of the airways walls as a result of the creation of the goblet cells, smooth muscle hypertrophy, sub-epithelial fibrosis as well as the increase of sub-mucosal glands. 


Symptoms and sign

Zachy was coughing for some days and also having the mucus in his chest that cause heavy breathing problem. The problem become worse in the recent time when Zachy was unable to hold his cough and continues to have the problem. He is also having strange sound at the time of breathing and also his breathing is quite fast. Zachy is not really having the hot body temperature but he is little sweaty. He even looks like pile and weak as the cough is not stopping and he is having the continuous problem. 

Diagnostics 

To rule out other probable conditions like an infection in the respiratory glands, chronic obstructive pulmonary disease (COPD), the doctor will have to perform a physical examination of Zachy. He may also be subjected to other tests to determine lung function tests for air movement such as spirometry to assess the narrowness of the bronchial tubes and peak flow to measure the force of exhalation (Lopot et al., 2018). To confirm asthma, the doctors may include diagnoses such as methacholine challenge, nitric oxide test, imaging tests and allergy tests among others. From the diagnosis, asthma will classify from intermittent to persistent.

Pharmacokinetics 

Pharmacokinetics is the branch of pharmacology that describes the number of drugs disposed to the patient. It is the relationship between the drug dosage and the concentration of the drug in various body parts over time (Matera et al., 2017). The pharmacokinetics of the theophylline following injection to the vein of aminophylline is determined that children with asthma can take the drug and eliminate theophylline more rapidly than an average adult; therefore, Zachy who is of age seven can receive a dosage of the medication to relieve the breathlessness and muscle relaxation.

Pharmacodynamics 

The pharmacodynamics of corticosteroids comprises of the biological response of the body towards the drug and the slow commencement of the effects produced by the mRNA as well as protein synthesis. The deliberate dissipation of the steroidal effects is administered by the elimination of the steroids, receptor binding of KD and the required time for mRNA as well as the TAT enzyme to readapt to the standard conditions (Calzetta et al., 2016). The integrated role of the drug, biological response intermediary and receptors determines the function of time, dose and the type of corticosteroid in administering the pharmacodynamics of the agents. 

Use of medicines 

Quick-relief medications include albuterol and levalbuterol as a beta-agonist, as well as Ipratropium to relax the airways. Some oral and intravenous medications can also be provided for quick relief function such as corticosteroids, but due to long term side effects, they are rarely administered to children. The long term asthma control medications include inhaled corticosteroids like budesonide and ciclesonide among others (Lim, Kerr & Roughead, 2018). Oral medications like zileuton, beta-agonists such as salmeterol and formoterol need to be taken with inhaled corticosteroids to prevent the risk of severe asthma attack. Theophylline is also provided and should be considered as a pill daily to help keep the airways open. 

LO 2 Comprehensive respiratory assessment

Many studies have contributed to the knowledge of asthmatic compositions in children. Tuscon Children’s Respiratory prospective birth cohort study provides a detailed perspective of the history of asthma in the children during the first six to seven years since their birth (Jackson, Gern & Lemanske Jr, 2017). According to the study, there was little to no signs of persistent wheezing since birth to one year of age. However, the wheezing became persistent, and the expiratory flows became significantly low since the period of six to twelve years of age. The diagnosis of asthma in the paediatric patient is based on the medical history of the child and the family, physical evaluation as well as their response to the treatment. 

The clinical manifestations of asthma in childhood involve sporadic episodes of wheezing and cough which is called exacerbations as in the case of Zachy. Wheezing is most likely caused due to the disruptive air flow through constricted and enlarged central airways that causes vibration of the bronchial walls. Most exacerbations in asthma occur when the child gets exposed to viral infections and are subjected to allergens which increase the inflammation (Anderson et al., 2017). Allergic inflammation as well as viral respiratory infections can damage the airway epithelium and may work together to encourage exacerbations.

LO 5 Planning and implementing person-centered primary respiratory health care strategies 

Asthma is one of the leading causes of death in the world and certainly takes a levy on the health care structure. Recurrent asthma attacks accelerate the decline of the function within the lungs, increases the death rate and consumes significant sum of money in terms of annual health care spending.

Respiratory care action plans are intended to promote self-management of the aggravations that may otherwise necessitate tender care via the patient's early acknowledgment of aggravation and self-initiated involvements such as taking unprescribed drugs like antibiotics as well as oral corticosteroids (Krishnan et al., 2015). The health plans rely on the objectives to improve the mortality rate and benefiting the patients by providing special care. 

A proper respiratory health care strategy includes people with respiratory conditions to receive respiratory medications in an appropriate clinical setting near their houses. The collaboration of all the health care systems to meet the respiratory health standards of individuals and provide cost-effective treatment for the prevention of respiratory problems and provide timely access to specialists if required.

To implement these strategies, proper coordination among respiratory medication services is required to form an integrated service in partnership with key stakeholders. Use of advanced technology and location-based models must be promoted for proper care and treatment of the people. The services received by the people must be adequately backed by clinical researches and studies of health care professionals.

Conclusion 

The paper concludes that regarding the initial inspection the seven-year-old kid Zachy is suffering from asthma disease. The paper provides relevant anatomy of the respiratory illness and its effect as well as the medications which are to be provided by the health care professional after required diagnosis. The paper provides an assessment of asthma by the prevalence of the disease in children and also provides an ideal strategy to open health care facilities in every locality and collaboration of the medical companies and professionals to offer respiratory health care. 

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