Best Practice for the Nurse Practitioner teaching adult patients how to manage symptoms of asthma based on symptom monitoring or peak expiratory flow measurements

BEST PRACTICE

FOR

THE NURSE PRACTITIONER

TEACHING ADULT PATIENTS

HOW TO MANAGE SYMPTOMS OF ASTHMA

BASED ON

SYMPTOM MONITORING

OR

PEAK EXPIRATORY FLOW MEASUREMENTS

SUBMITTED BY PROBLEM STATEMENT

Asthma is a common affliction of the human respiratory tract in which the airways get constricted and inflamed with excessive amounts of mucus . Asthma occurs often in response to exposure to an environmental stimulant called allergen , cold air , physical exercise or psycological stress 'Asthma can be controlled by modern medications . Asthmatic susceptibility is often attributed to

genetic inheritance ,developmental and environmental factors .The disease asthma is probably not a single disease , but rather a complex of multiple , separate syndromes that co-exist ( HYPERLINK "http /www .ncbi .nlm .nih .gov /entrez /query .fcgi ?db pubmed cmd Search itoo l pubmed_AbstractPlus term 22Wenzel SE 22 5BAuthor 5D " \o "Click to search for citations by this author " Wenzel SE ,2006 . The factors that cause asthma are sometimes referred to as `triggers .The asthmatic symptoms on account of narrowing of airways of the lungs includes wheezing ,shortness of breath , tight chest and cough .The disease is a chronic recurring inflammatory condition in which the airways become hypersensitive to various stimuli with bronchial hyper-reactivity inflammation , excessive mucus and intermittent airway obstruction .The asthmatic symptoms can range from mild to life threatening and can be controlled by drugs and changes in the environment . It is important to identify the underlying causative factors and the recent novel therapeutic approaches such as the targeting of immunoglobulin E and tumor necrosis factor alpha with biological agents that show the need for careful phenotyping of patients with severe disease ( HYPERLINK "http /www .ncbi .nlm .nih .gov /entrez /query .fcgi ?db pubmed cmd Search itoo l pubmed_AbstractPlus term 22Holgate ST 22 5BAuthor 5D " \o "Click to search for citations by this author " Holgate ST , 2006 . Varius theories have been postulated which offer explanations to asthma .According to the Beta Adrenergic Theory of Asthma ( Andor Szentivanyi ,1968 ) blockage of the Beta-2 receptors of pulmonary smooth muscle cells causes asthma . Demonstration that IgE blocks beta-2 receptors and overproduction of IgE is central to all a diseases ,have complemented this theory . Recent studies suggest that T (H ) 1 /T (H ) 2 and T (C ) 1 /T (C ) 2 cell imbalances are implicated in asthma pathogenesis ( HYPERLINK "http /www .ncbi .nlm .nih .gov /entrez /query .fcgi ?db pubmed cmd Search itoo l pubmed_AbstractPlus term 22Shirai T 22 5BAuthor 5D " \o "Click to search for citations by this author " Shirai T , 2006 . The theory of Pathogenesis postulates that asthma is a disease of hygiene .According to this theory "switching on " of the TH1 lymphocytes that are produced with infection occurs when babies are exposed to infectious agents like bacteria soon after birth . Any insufficient stimulus due to modern clean environments leads to the predominance of TH2 cells leading to asthma and other allergic reactions .Asthma is often coorelated to air pollution .Asthma due to pathogenic microbes like Chlamydia pneumoniae is also under investigation . A study to investigate the association...