Introduction
Like any other common disease, asthma is a disease characterized by chronic inflation within the airways of the breathing system. Asthma symptoms vary in that, in some people, the disease affect air flow and in others, it causes bronchospasm. Some of the common symptoms associated with asthma include chest tightness, severe coughing, panting and inability to breathe well. Nevertheless, nurses have deployed new medical scientific and technological ways of preventing asthma. This is one area that affects nurses most. They are moderators whose actions will see asthma develop or cease to develop. Not single times, medical nurses use corticosteroids to treat asthma and disseminate people affected by asthma due to preference. However, nurses always take caution when using corticosteroids as a drug for treating asthma patients because; it has diverse side effects. (Fanta, 2009, pp. 1000-10006).
Worldwide, millions of people are suffering from asthma and the number keeps on increasing each year. According to United States statistics, seven percent of Americans suffer from asthma while in United Kingdom; about six percent of the population is suffering from asthma. Overall, every year, over 4000 people die in United States alone and the figure might be high especially in developing countries like in Africa and Asia. It is not asthma only that affects the breathing system. There are many other diseases more chronic than asthma and can cause more pain as compared to asthma. Perhaps this is the reason as to why; nurses do not classify asthma as chronic obtrusive pulmonary impairment. This is because; obtrusive diseases comprise of many diseases like bronchiecstasis, emphysema and bronchitis all less than one bracket. As for asthma, some of these symptoms can be absent making it, chronic obstructive. Obstructive Pulmonary diseases like emphysema and bronchitis cause permanent airway obstruction. (Gatahun, Demissie & Rhoads, 205, pp. 373-376).
Nonetheless, in asthma, the scenario is different. Persons invaded by asthma can have their airway obstruction reversed on condition that, nurses and doctors attend it as quickly as possible. In cases where, a patient fails to discover and treat asthma, the disease result into chronic inflammation especially in the lungs and with time, asthma becomes an obstructive pulmonary disease. Interestingly, emphysema and asthma affect one common area and this is the alveoli.
Prevalence
The disease has drawn much attention worldwide especially in developed countries where, people’s preferences result into catching asthma. Asthma is common in developed countries and statistics reveal that, children are twice likely to be affected than older people. Due to its chronic changing nature, medics and nurses have classified asthma in three major areas. Clinically, this depends on the frequency of asthma symptoms. For example, one class composes of asthma characterized by high expiratory volume popularly known as (FEV1). Another class of asthma characterise with forced air inflow, which causes pain when breathing. In some cases, based on allergens, asthma can either be extrinsic or intrinsic and in this case, allergens act as carriers. Asthma symptoms can be intermittent, mild persistent, severe persistent or moderate persistence depending on what caused it. (Koskela, 2007, pp. 90-98).
In many cases, there can be a combination of two phenotypes of asthma resulting into stringent and relentless attack. Medics classify these phenotypes as Type 1 and Type 2. This is because; the severe attacks depend on the resistibility of a patient to such attacks and ability to exhale. Patients with controlled exhaling variability (peak expiratory flow rate), fall under Type 1 and those with varying peak expiratory flow rates form Type 2. However, the advantage with Type 2 is that, patients and doctors can control asthma symptoms and inmost cases, the disease does not affect impair lungs completely. Sometimes due to changing asthma symptoms, Brittle asthma does not respond well to treatment by drugs irrespective of the high doses of corticosteroids or beta-2 agonist therapies. A small percentage of people suffering from brittle asthma fail to treat it and end up staying with it. (Ayres, Jyothish and Ninam, pp. 40-44).
Signs and Symptoms
Asthma causes severe pains to patients. However, depending on the patient’s immunity, the disease can be either chronic or less chronic. One notable symptom among all asthma patients is that of airflow obstruction. Thus, there are two major states of asthma. Asthma that has static symptoms classify into steady-state asthma while asthma with varying symptoms form acute asthma. The two states have different symptoms in a patient. Nevertheless, whether invaded by steady-state asthma or acute asthma, there are common symptoms exacerbate in all asthma patients, for example coughing. Patient experiencing shortness of breath, have difficulty in breathing during the night, cough persistently during the night, have severe chest pains and experience throat-clearing are suffering from steady-state asthma. Insidiously, these symptoms can increase into a state where, patients became exacerbated. Where symptoms have caused exacerbation (asthma attack), asthma symptoms become varied. For example, patients suffering from asthma attack experience wheezing, coughing characterised by sputum, chest pains (chest constrictions) and dyspnea.
On the other hand, asthma signs include gasping, higher heart beat rate, funny sound from the lungs (rhonchous) and extremely long expirations. Under asthma attack, accessory muscles protrude outside to show some tissues above the clavicles and sternum. Additionally, patients experience paradoxical pulses during breathing. Due to problems associated with breathing hence, oxygen failure, the skin of asthmatic patients may turn blue. Other notable asthmatic signs include consciousness, chest pains during coughing and cold feet. (McFaden, 2004, pp. 1508-1506).
Causes of Asthma
Medics have established genetic and environmental factors as prime causers of asthma. These factors are the one that determines the severity of asthma and how patients will retort to drugs.
Environmental Factors
Environmental factors such as smoking tobacco can cause wheezing and asthma morbidity. Thus, smoking tobacco heightens chances of catching asthma. On the other hand, exhaust fumes from factories, vehicles and general pollution can cause asthma morbidity although, scientists are yet to prove this scientifically. Nevertheless, there is some light at the end of the tunnel as research indicates pollution to be the architect of childhood asthma. Psychological stress is also one agent that triggers asthma invasion. Although it does not cause asthma directly, psychological stress excites some magnitudes into the immune system, which lead to airway inflammatory hence; allergens and irritants responsible for causing asthma. Some antibiotics can alter gut flora within the immune system to cause hypothesis, principal cause of asthma. No wonder, today medics deny patients from using paracetamol, which they believe causes asthma.
Genetic Factors
Scientific research done by medical practitioners indicates that, there are over one hundred biological genes, which cause asthma. By 2009, scientist had successfully identified 25 of them successfully. Captivatingly, these genes fall in the immune system or are responsible in modulation. Research does indicate that, nucleotide polymorphisms falling in 17q21c genes cause childhood asthma. What happens here is that, genes combine to produce toxic endotoxin, a bacterium, which causes asthma. However, the toxicity of endotoxin varies because; people have different genes and depending on environmental factors, the symptoms can be diverse or chronic. There are also other factors neither generic nor environmental), which cause asthma. For example, strong perfumes, cockroach allergens, dust and mites can cause exacerbation hence, asthma. (Martinez, 2007, pp.178-184).
Risk Factors
Certain activities can lead to asthma. For example, skin test allergies and a conceptual addition of immunoglobulin E, increases the probability of asthma attack among children. On the other hand, prolonged allergen reaction torments adults into having asthma. In developed countries, some houses favour allergens, which then increase chances of childhood asthma. Availability of home mites that produce dust allergens increase chances of asthma especially among infants who feel modesty when playing with home mites. There is one theory- hypothesis theory perceived to be the root cause of asthma. This is because, with the rising allergies among people, there is a great possibility of having asthma due to genetic interactions. Unhygienic conditions can also be paramount to asthma invasion. In highly populous nations where pollution is high and hygiene standards compromised, there are high chances of contacting causative agents of asthma.
There are high chances of males catching asthma causative agents than female counterparts. However, in males, the disease can treat during childhood and on the other hand, continue to very mature stages in females. Currently, a high number of asthma patient constitute females because; females do undergo hormonal changes more than male.
Socioeconomic Factors
People who come from low backgrounds are twice likely to get infected by asthma than those coming from well-off families. This is because; poor backgrounds characterise with unhygienic standards tipped to be principal causative agents of asthma. Additionally, some medics indicate that, cockroaches common in low-income families, cause asthma. Additionally, these families do not have enough money to treat asthma patients. Issues such as environmental racism among low-class members exacerbate chances of having asthma. When the rich people built their houses in environmental friendly areas, the poor build their near polluting factories due to poverty. Consequently, pollution fumes and toxic gases from factories and industries increase chances of developing asthma through gene interactions and environmental allergens. Waste products from these factories increase chances of developing asthma further among children and adults. (Environmental Protection Agency, 2008, pp. 1-3).
Nurses Respiratory Therapists and Doctors
These are medical practitioners responsible for educating the public, diagnosing asthma and treating those who are suffering from asthma. In most cases, without these medics, asthma development would be high. These professionals perform the following roles meant to alleviate asthma as a disability.
Asthma Diagnosis
Since asthma resembles other obtrusive pulmonary diseases to a large extent, it is advisable for one to undergo medical check-up to identify asthma whether it is asthma, emphysema or chronic bronchitis. All of these diseases have varied symptoms and signs. As for asthma, the symptoms range from wheezing to coughing. Nevertheless, the reversible airway obstruction characterised in asthma does so either by medication of spontaneous action. Doctors can diagnosis asthma through symptoms and signs. This is because; asthmatic persons have physical or invisible allergic and eczema traits, which can suggest asthma as extrinsic or intrinsic (inheritable). For example, asthma diagnosis among children appears simple in that, children suffering from asthma wheeze frequently and sometimes produce a high-pitched voice when they breathe out. They can also have consistent coughing at night. Normally, doctors subject these children into exercises, diverse environments, stress and smoky zones in order to identify asthmatic symptoms.
Nevertheless, in adolescents and adults, asthma diagnosis is complex. In this case, doctors use an instrument called a spiromerty to measure airway restriction rates. The spirometry records the amount of air inhaled and exhaled, which then lead into diurnal variation. Additionally, through spirometry readings, doctors can conclusively analyse reversibility resulting from bronchodilator medication applied to reverse inhalation rates. On the other hand, new technologies like a capnography, an instrument that measures the percentage volume of carbon dioxide exhaled by a patient, jointly with a pulse oximetry, can provide details of blood haemoglobin and then establish the relentlessness of asthma attack. (Tippets & Guilbert, 2009, pp. 1-2).
Prevention
Prevention of asthma can sometimes be complex in that; its development does not resemble the resultant episodes. Nevertheless, with the treatment of simple allergies through immunotherapy, there are less chances of asthma development. Doctors and respiratory therapists recommend inhaled corticosteroid as medication, which will alter inflammation by realigning the swollen airway linings. So far, allergen immunotherapy acts as a substantive method of preventing asthma. For example, as part of allergen immunotherapy, patients can beclomethasome, which is an example of inhale glucocorticoids to control asthma development in the lungs. Other drugs such as montelukast-leukotriene modifiers reduce inflammation and in most cases, they do not have side effects. Overall, allergy immunotherapy, which consists of administering drugs, proves the best asthma preventive method. (National Blood Lung Institute, 2008, pp. 1-5).
Medication
Doctors and nurses medicate asthma in two types. The first compose of medication meant to discourage chronic symptoms and those that thwart further exacerbation complications. For example, pharmaceuticals like terbutaline, salbutanol and tremors act on inhalation to bring normalcy in the lungs. Although there can be side effects, these drugs act as anti-inflammation agents hence, healing asthma. On the other hand, doctors use adrenergic agonists like epinephrine tablets, in order to stop asthma inflammations. Under long term m medication, glucocorticoids, β2-agonists and albuterol help in reducing exacerbation cased by asthma causative agents. (Rodrigo, Nannini, 2006, pp. 218-220).
Conclusion
People should identify causes of asthma and look for means and ways of preventing them. For example, the availability of allergens heightens chances of asthma development. People can treat asthma by avoiding asthma triggers such as tobacco smoking, pollutants, unhygienic conditions and certain antibiotics. Those diagnosed with asthma should receive either long term or short term medication by applying glucocorticoids and bronchodilators respectively. Nurses and doctors have a big role in ensuring that, asthma stops developing amongst populations.
Reference List
Ayres, J., Jyothish D. & Ninan, T. (2004). Brittle asthma. Pediatric Respiration Review, 5 (1), 40–44.
Environmental Protection Agency. (2008). Cockroaches and Pests: Indoor Environmental Asthma Triggers. Web.
Fanta, C. (2009). Asthma. New England Journal of Medicine, 360 (10), 1002–14
Getahun, D., Demissie, K. & Rhoads, G. (2005). Recent trends in asthma hospitalization and mortality in the United States. Journal of Asthma, 42 (5), 373-376.
Koskela, H. (2007). Cold air-provoked respiratory system: the mechanisms and management. International Journal of Circumpolar Health, 66(2), 90–98.
Martinez, F. (2007). Genes, environments, development and asthma: a reappraisal. Journal of European Respiration, 29 (1): 179–184.
McFadden, E. (2004). Asthma: Harrison’s Principles of Internal Medicine (16th ed.). New York: McGraw-Hill.
National Blood Lung Institute. (2008). Guidelines for the Diagnosis and Prevention of Asthma. Web.
Rodrigo, G. & Nannini, L. (2006). Comparison between nebulized adrenaline and beta2 agonists for the treatment of acute asthma. A meta-analysis of randomized trials. American Journal of Emergency Medicine, 24 (2), 217–220.
Tippets, B. & Guilbert, T. (2009).Managing Asthma in Children: Part 1: Making the Diagnosis, Assessing Severity. Consultant for Pediatricians, 8 (5), 1-3.