Nursing Interventions for Poppy Assignment Sample

Traumatic Complex Health Condition

Introduction

An excessive lower reaction to surrounding environmental exposure is due to asthma exacerbations. Also, infection with respiratory viruses is the most popular exposure to the atmosphere to cause serious asthma. As such, inflammation of the airways is a key component of lower asthma reaction and occurs with restriction of circulation and an improved reaction of the airways. The patterns of inflammation in the airways vary depending on the factor that causes the exacerbation. For instance, Poppy, a 9-year-old female, has an acute exacerbation of asthma and is now at ICU waiting for medical care. Pathogenesis, oxygen titration, and nursing interventions will aid in solving Poppy’s asthma condition.

Question 1. Pathogenesis

Asthma is characterised by episodic signs and variable blockage of the airflow arising randomly or in response to exposure levels to the surrounding environment. Current clinical strategies focus on knowledge of the airway reaction to allergens, reduce asthma's everyday variation when optimally implemented, and result in a significant standard of living improvements (Arakawa et al., 2020). Nonetheless, people with asthma remain distressed by their illnesses. These exacerbations are often caused by respiratory breathing infections, and current treatment strategies are of limited utility. As such, this shows that an asthma exacerbation is of a different kind and highlights the need to recognise the mechanisms to improve its care.

An excessive lower reaction to environmental exposure is due to asthma exacerbations. According to Korematsu et al. (2018), the most frequently occurring causes of severe asthma exacerbates are environmental conditions such as pollutants, allergens, and viral infections among many others. For Poppy’s case, this serious condition leading to ICU admission might mean that it was a viral infection. Inflammation of the airways is a crucial component of lower asthma reaction and occurs with restriction of circulation and an improved reaction of the airways. The cycles of inflammation in the airways vary depending on the factor that causes the exacerbation.

There are no entirely understood explanations for the excessive reaction of asthmatic airways, but recent research has described a significant mechanism for viral infection predisposition. From Doshi et al. (2017) perspective, the exacerbation of asthma can be serious and requires medical care, whether it is as an emergency room visit, hospital admission, or an unplanned doctor visit. Like in the Poppy’s situation, she was taken to ICU (emergency department) meaning that there is a high likelihood, it is a viral infection. The majority of asthma ED participants (63 per cent) occur to children. For Australian children, the ED incidence ranges from 35 to 240 visits per capita for asthma exacerbation.

Question 2. Sitting Posture and Oxygen Titration

Sitting Poppy in high fowlers position

The positioning of the susceptible medication in high fowlers manner is commonly used to boost the oxygenation of acute respiratory distress syndrome (ARDS) clients. There is a short-term effect of improving the patient’s effective flow of oxygen in the respiratory system, as in poppy’s case. While the overall mortality gain has never been recorded by randomised controlled trials with an inclined role, there has been a trend in patients who suffer from serious ARDS towards better survival (Pilar et al., 2017). A good physiological justification supports the use of the propensity role, and in around 75% of ARDS patients, there is a substantial improvement in oxygenation level.

In ARDS, the client’s oxygenation is usually aligned with the upright posture of high fowler’s position. According to Okubo et al. (2017), PaO2/FiO2 ratio of ARDS positioning significantly increases in relation with the multiplicative effect obtained with the supine location (94 ± 33 versus 142 ± 49 mmHg, P < 0.0032). With regard to Poppy’s case, there might be a substantial increase in the assessed later part-expiratory lung volume, along with improvements in chord conformance after the transition. Based on physiological research, oxygenation changes are mainly based on a pulmonary reallocation induced during high fowlers positioning by decreased ventral chest walls (CW) compliance. In contrast, an increase in pulmonary volume (recruitment) during upright positioning seems more pronounced. The combination of responsive and upright positions is helpful in extreme ARDS patients like Poppy’s who has been admitted to ICU due to their synergistic action processes.

Also, the high fowler positioning method helps to raise lung volume, thus an additive beneficial effect on oxygenation stunts. In addition to the influence on oxygenation, other advantageous outcomes from high fowler positioning can potentially be expected. While the evidence is poor, a decline in ventilator-associated conditions such as pneumonia development is expected in high fowler patient positioning. From Okubo et al. (2016) perspective, an adjuvant impact of both methods is possible, but pathophysiological pathophysiology of ventilator-connected pneumonia is complex. In addition, head height is found to increase tolerance to enteric feeding in clients ventilated to high fowler position.

Applying oxygen titration

In Poppy’s acute exacerbation asthma condition, oxygen will be delivered by nasal cannula device. Oxygen titration by nasal cannula will be supplied to reach 88-92 per cent target pulse oximetry saturating and to drive air via nebulizer bronchodilator. From Duenas et al. (2016) perspective, the use of oxygen as emergency treatment is also known as extra oxygen medication. Therefore, this may include low blood oxygen, exposure of carbon monoxide, migraines and oxygen to be preserved as anaesthetics are inhaled. For those who have chronically low oxygen, such as extreme COPD, long-term oxygen is often useful. Oxygen therapy will help Poppy in boosting her cell metabolism.

Question 3. Nursing Interventions

Salbutamol works by releasing airway muscles out of the lungs, making breathing easier. Asthma and COPD symptoms, such as coughing, wheezing, and breathing that Poppy is experiencing will be relieved by Salbutamol. Hydrocortisone is as efficient in treating acute, extreme asthma as 200 or 500 mg of hydrocortisone, followed by high doses of Ipratropium Bromide four times a day for two days (Stefan et al., 2016). They will help Poppy in reducing the severity of her acute asthma condition and thus, recovery from ICU.

Nursing interventions and clinical responses

Treatment is very normal for a client with an acute asthma aggravation or disease asthma in intensive care. Nurses should understand clearly the pathophysiology and management of severe asthma intensification so that they be prepared to track the Poppy's reaction to the care. Poppy can mitigate the respiratory condition when given a high amount of additional oxygen. According to Nowak et al. (2015), the patient might also face oxygen toxicity if they obtain a fraction of the influenced concentration of oxygen (FIo2) over a prolonged period greater than 0.5 to 0.6.

However, the benefit of oxygen control (relieving hypoxemia in acute asthma aggravation) could outweigh the hazards. Near supervision of the patient to minimize risks and titration the oxygen. It is effective for nurses to control the bronchodilators as required for rapid-acting inhalation. Beta2-agonists activate smooth muscle beta2 receptors, alleviate bronchoconstriction, improves breathing activity, and decreases airflow resistance. Beta2-agonists for short-acting (SABAs) are used to alleviate Broncho-continuity and suggested for acute outbreaks and chest infections. Salbutamol and pirbuterol are commonly prescribed by SABA and are helpful in Poppy’s ICU condition.

Conclusion

In summary, the purpose of asthma treatment is to regulate asthma. Asthma treatment is based on the severity of asthma and is tailored to the routine monitoring of asthma control. It is recommended to identify and prevent exposure to possible asthma. Also, it is advisable to design and commit to an individual asthma program to keep the patient’s severe conditions under control. Poppy, a 9-year-old was diagnosed with ASDS and is being given salbutamol and hydrocortisone for effective medication.

References

Arakawa, H., Adachi, Y., Ebisawa, M., Fujisawa, T., Ebisaw, M., Akasawa, A., ... & Shimojo, N. (2020). Australian guidelines for childhood asthma 2020. Allergology International.

Doshi, V., Shenoy, S., Ganesh, A., Rishi, M. A., Molnar, J., & Henkle, J. (2017). Profile of acute asthma exacerbation in drug users. American journal of therapeutics, 24(1), e39-e43.

Duenas, M.E., Jaramillo, C. A., Correa, E., Torres-Duque, C. A., Garcia, C., González, M., ... & Delgado, M. D. P. (2016). Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation. Journal of Asthma, 53(3), 253-260.

Korematsu, S., Nagashima, K., Sato, Y., Nagao, M., Hasegawa, S., Nakamura, H., ... & Fujisawa, T. (2018). “Spike” in acute asthma exacerbations during enterovirus D68 epidemic in Japan: a nation-wide survey. Allergology International, 67(1), 55-60.

Nowak, R. M., Parker, J. M., Silverman, R. A., Rowe, B. H., Smithline, H., Khan, F., ... & Molfino, N. A. (2015). A randomized trial of benralizumab, an antiinterleukin 5 receptor α monoclonal antibody, after acute asthma. The American Journal of Emergency Medicine, 33(1), 14-20.

Okubo, Y., Michihata, N., Yoshida, K., Morisaki, N., Matsui, H., Fushimi, K., & Yasunaga, H. (2017). Impact of pediatric obesity on acute asthma exacerbation in Japan. Pediatric Allergy and Immunology, 28(8), 763-767.

Okubo, Y., Nochioka, K., Hataya, H., Sakakibara, H., Terakawa, T., & Testa, M. (2016). Burden of obesity on pediatric inpatients with acute asthma exacerbation in the United States. The Journal of Allergy and Clinical Immunology: In Practice, 4(6), 1227-1231.

Pilar, J., i Alapont, V. M., Lopez-Fernandez, Y. M., Lopez-Macias, O., Garcia-Urabayen, D., & Amores-Hernandez, I. (2017). High-flow nasal cannula therapy versus non-invasive ventilation in children with severe acute asthma exacerbation: An observational cohort study. Medicina Intensiva (English Edition), 41(7), 418-424.

Stefan, M. S., Nathanson, B. H., Lagu, T., Priya, A., Pekow, P. S., Steingrub, J. S., ... & Lindenauer, P. K. (2016). Outcomes of noninvasive and invasive ventilation in patients hospitalized with asthma exacerbation. Annals of the American Thoracic Society, 13(7), 1096-1104.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

You Might Also Like

Flawless Nursing Assignment Help by experts
Mental Health Act (MHA 2014) - Reducing Restrictive Interventions (RRI) - Nursing Assessment Answer