Module 2 Assignment: Case Study Analysis

important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.Module 2 Assignment: Case Study Analysis

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

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Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

  • The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

NB: Include an intro and a conclusion

CASE STUDY: 11-year-old boy complains of wheezing and difficulty “getting enough air.” Notices it more when he is playing baseball and symptoms improve when exercise activity stops. He says that the symptoms are getting worse and the symptoms are even occurring at rest. The mother says the child is allergic to cat dander and his next-door neighbor in their apartment building recently began sheltering cats for the local humane society. Auscultation demonstrates wheezes on forced expiration throughout all lung fields.

This paper discusses an 11-year-old boy who presented with complaints of difficulty “getting enough air” and wheezing. The symptoms are reportedly noticeable when playing baseball and improve when the exercise activity stops. The symptoms continue to worsen and occur even at rest. The child is reportedly allergic to cat dander yet his next-door neighbor in the apartment started to shelter cats recently for the local humane society. On auscultation, there were wheezes on forced expiration in all lung fields.

Cardiovascular and Cardiopulmonary Pathophysiologic Processes

Asthma is a respiratory illness involving the inflammation of the bronchioles lining with subsequent narrowing and hypersensitivity of the airways with reversible airway obstruction. Asthma can develop at any age. Currently, in the US, there are more than six million cases among children and 17 million cases among adults. It has a genetic tendency, significant morbidity, a lower QoL, and excess utilization of healthcare resources (Zahran et al., 2018). The development of asthma usually begins in childhood with increased sensitivity to inhaled allergens. Common allergen examples include dust mite, fungi, pollen, and cockroaches. During exposure, there is an immediate and delayed response.Module 2 Assignment: Case Study Analysis

The immediate early exposure involves bronchoconstriction within the initial thirty minutes after exposure and can last up to three hours of post-intervention. The delayed response often starts between four to eight hours post-exposure with increased responsiveness of the airways (Selman et al., 2019).  In both responses, after the stimulation of inhaled allergens, there is a proliferation of type two T helper cells with subsequent production and release of interleukin IL-3, IL- 4, IL-5, IL- 6, IL- 9, IL-10, and IL-13, and Th2 cytokines. Antigen-processing dendritic cells take the allergens involved in sensitization and present it to T helper cells. These processes activate allergen-specific Th-2 cells that influence the development and progression of asthma.

Racial/ Ethnic Variables That May Influence Physiological Functioning

The highest asthma-related mortality rates are among adult African American females aged 65 years or older. The primary predictors and contributors to acute asthma exacerbations in most populations are race, socio-economic status, geography, and access to preventive care. For instance, in New York, children who dwell in neighborhoods with a low income have a high likelihood to be admitted for asthma and asthma-related incidences as compared to their counterparts living in affluent regions (Assari & Moghani, 2018). Similarly, ethnicity influences the development of asthma such that, its severity is higher in people with an African American and Puerto Rican descent. It is for this reason that African Americans account for most asthma-related admissions, ED visits, and mortalities in comparison to their white counterparts. Similarly, based on the statistics provided by the (CDC, 2016), Black adults and their children are twice likely to be diagnosed with asthma than whites.

Lack of income or health insurance negatively impacts the management of asthma by placing barriers to prompt diagnosis and management. The current advances made in the stepwise management of asthma in the short term and long term can worsen these inequalities since only those with affordable income or insurance coverage can access healthcare services. Besides, even for those who can seek professional assistance, they are less likely to afford drugs prescribed for management (CDC, 2016). For early intervention, patients should avoid allergens that influence hypersensitivity reactions such as pollutants from industries and dust mites. Initial management with corticosteroids and short-acting bronchodilators is also necessary to prevent exacerbations.

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How Processes Interact To Affect the Patient

Gould (2018) highlights exercise-induced asthma is a common presentation for many pediatric patients and is an indicator of poor disease control associated with a poor QoL due to poor symptom control. During physical activity, the child inhaled and exhaled cold and dry air. According to Selman et al. (2019), the airway muscles become more sensitive to the changes in humidity and temperature thus contract causing the airways to narrow.Module 2 Assignment: Case Study Analysis

 References

Assari, S., & Moghani Lankarani, M. (2018, June). Poverty status and childhood asthma in white and black families: National Survey of Children’s Health. In Healthcare (Vol. 6, No. 2, p. 62). Multidisciplinary Digital Publishing Institute.

Center for Disease Control and Prevention (CDC). (2016). Asthma’s Impact on the Nation; Data from the CDC National Asthma Control Program. Retrieved from: https://www.cdc.gov/asthma/impacts-nation/asthmafactsheet.pdf

Gould, C. F., Perzanowski, M. S., Evans, D., & Bruzzese, J. M. (2018). Association of exercise-induced wheeze and other asthma symptoms with emergency department visits and hospitalizations in a large cohort of urban adolescents. Respiratory medicine, 135, 42-50.

Selman, J. P., Lanza, F. C., Wandalsen, G. F., Solé, D., O’Donnell, D. E., Neder, J. A., & Dal Corso, S. (2019). Ventilatory Demand During Stepping and Running: Implications for Exercise-Induced Bronchoconstriction in Children. Respiratory care, 64(4), 445-452.

Zahran, H. S., Bailey, C. M., Damon, S. A., Garbe, P. L., & Breysse, P. N. (2018). Vital signs: asthma in children—the United States, 2001–2016. Morbidity and Mortality Weekly Report, 67(5), 149.

Module 2 Assignment: Case Study Analysis