Normal anatomy.

Its main structures includehuman voice, They also play a major role in airway a thin epithelium with cilia and mucus for trapping of foreign bodies inhaled together with air. It branches into two main branches namely the left and right primary bronchi which later branch into smaller ones namely secondary bronchioles, three directing to the right lung and a lesser number two, for the left lung in correspondence to their lobes. The division of secondary bronchi further gives rise to tertiary bronchi, then bronchioles. Bronchioles end up in a network of which together with the alveoli extent to form the respiratory bronchi which carry out the process of gaseous exchange.

which is elastic in nature. They vary slightly in anatomical orientation with the right lung be

Aided by changes in both atmospheric and intra-thoracic air pressures as well as contraction and relaxation of respiratory muscles, the lungs expand and contract to allow entry, exchange and expulsion of air out of them.

Altered physiology.

Asthma, a chronic airway disease, is characterized by varied and partial reversibility of airway obstruction to conduction air in and out of the lungs alters the normal physiological functioning of the respiratory system via different mechanisms (Asthma and allergy center 2013). First, the mucous secreting goblet glands found normally within the airway mucosal the airway reducing the efficiency of the airways in air conduction. The excessive mucous secretion results from hypersensitivity of the airway in response to environmental triggers including pollen grains, dust particles, odors, hair or fur which irritates the nerve endings along the canal.

The scarring causes thickening of the already thin walled bronchi and bronchioles, Followed by tightening of the smooth muscles around the lumen; the bronchioles narrow further, a process known as bronchoconstriction. Another product of respiratory inflammation process is extra.

Various signs and symptoms present in asthmatic patients. The patient reports tightness of chest and these symptoms worsen especially with body exertion, or during exposure to allergens such as dust, pollen grains, odors or fur (Pat, B.,2012)

Specific effects on the patient

WHO(2013) asserts that Asthma

induce an attack. Her play period should always be accompanied by a relative to catering for any emergency that may befall her in case of imminent or actual asthmatic attack.

In most families, chronic conditions are highly stigmatized. For Helens case, it may be worse due to the autism that in a way interferes with her formation of social bonds with other people either from the family or friends. The nature of her medical condition is also delicate. Owing to the fact an attack can occur following encounter of allergens, isolation for Helen is inevitable. Not by her choice, she is unable to attend some functions for the fear of allergen encounter or play with her peers since exercise to her is more harmful compared to the benefits she could have derived from it.

In the present and the future years, Helen’s functioning on the aspect of the occupation is grossly

Since asthma is a chronic condition, its medical management does not just involve a one-time treatment. One has to liv

Helen has autism, in itself a mental condition. the care. Continued mental health reviews and plan of care is necessary which may include cognitive therapy to enhance her cognitive ability as well as behavioral therapy to aid in molding her behavior.

with chronic illness and a concurrent lifetime condition, like for Helen, stress is inevitable. This is due to the nature of the activities involved in her daily care. She is dependent on the family members throughout, and this creates a caregiver role strain. The family needs realistic stress coping mechanisms such as continued counseling and reassurance as a way of stress reduction as well as a prophylaxis to stress related conditions such as hypertension and gastrointestinal ulcers and mental conditions such as depression.

Helen has a predisposition to other health conditions some related to the asthma itself, the autism as well as the increasing weight. For the asthma, it can lead to chronic obstructive airway disease affecting the patient entirely in her lifetime altering the respiratory system’s anatomy and physiology completely. Due to the chronic inflammation, Helen remains at a higher other airway infections such as bronchitis and pneumonia due to the altered integrity of the respiratory system’s mucosa. The treatment of asthma by use of corticosteroids causes reduced body immunity, with a reduced defense against body infections.

Due the autism’s related incidences of aggressiveness as well as hyperactivity, Helen predisposition to injury is more likely. This can be directed to self or others hence necessary interventions needed to reduce the risk of self harm as well as to others. Autism may also aggravate other mental conditions such as type II and hypertension. These can alter more her lifestyle and may make her living deteriorate further both for her and her family.

The environment of asthmatic patients requires some alteration. The living area and housing should be well aerated and free from allergens. The entire environment should be clean, free from pollution of whatever kind since these may exacerbate the condition.

Socialization is a key process in childhood development. learning new things.

Since she is already overweight,

form and maintain strong social ties. This has led to her being depressed as well as her family too. Due to lack of these ties as well as her mental condition, her sexual patterns are also affected and cannot establish and maintain a healthy sexual relation.

How I was involved in the care of Helen.

My involvement in the care of Helen was in an integrated health management approach, with all interventions aimed at improving her health

Nutritionally, I ensured t low in fats, low in sodium to avoid continued fluid retention. This was because Helen on treatment with corticosteroids and cause water retention. Sodium too causes more fluid retention, and this could worsen her condition.s to ensure balanced energy intake and expenditure. I stressed to the family exercise limits in order to avoid triggering an attack. During one of the asthmatic attacks, I initiated nebulization as per the requirements to enable dilation of the bronchioles. Oxygen was concurrently administered to ensure continued oxygen supply

During the period of the attack, I monitored her vital signs keenly with a continued analysis of the breathing pattern, her pulse rate, partial pressure since they are key determinants of respiratory improvement or deterioration.

I explained the family on the need to adhere to the prescribed medications, as well as their timely administration.Through family support center, I conducted a fortnight follow up care through which I could provide direct care to Helen in their home environment with the aim of evaluating the already initiated interventions.

With a goal of ensuring a good socialization process for Helen, I induced the family into joining two (2) local support groups, one for persons living with asthma and another for people with autism. This ensured a good blending with her peers and avoiding isolation. For the autism, I also ensured their appointments for psychotherapies were well adhered to for an optimally desired outcome.

Due to the reported episodes of aggressiveness, I taught the family on how to ensure safety through removal of harmful items near her which could precipitate an injury to self as well as others as well as restriction to ensure that he mobility was limited. I also educated the family on how to

For her injured hand, I demonstrated to the family members on how to do a proper home care to prevent the development infection.

Asthma is a chronic and inflammatory airway condition with an origin from childhood and progresses all through to adulthood according to WHO, (2014). Due to its nature and effects on the various aspects of individual’s lifestyle, its management is complex and holistic. Asthma appears more complicated when occurring concurrently with another disease as for the case of Helen than when it occurs as a single condition.

Due to the challenges it poses to the individual, involvement of the whole family in care and treatment of this patient is vital for a good prognosis and outcome of the care and treatment. Patients with asthma should always know the precipitating factors that can pose great danger to their health. Since it’s a lifetime physiological condition, adherence to the prescribed treatment into to account and be followed keenly. Since the caregiver has to take care of the patient for a long time, proper preparation and coping mechanism to the stress involved is key in avoiding caregiver role strain.

When occurs concurrently with other mental conditions such as autism, the management differs slightly for its treatment in cooperates other specific types of management such as psychotherapy and rehabilitation to enhance the normality of the individual the individual’s life. With the necessary support from the other family members, a patient with asthma can always lead a near normal lifestyle.

Christopher H. F, (2004). The Harvard Medical School Guide To Taking Control Of Asthma.

Emily, K.A, Asthma Management: 92 Tips for Dealing with the Symptoms and Treatment of Asthma Paperback

Retrieved online from http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/

National Heart lungs and Blood institute, topic asthma.

WHO- Asthma retrieved online from http://www.who.int/topics/asthma/en/,

Retrieved online from http://www.asthmaandallergycenter.com/w/asthma.mvc/Details/5

The Asthma and Allergy Center; Physiology of asthma.

Retrieved online from http://asthma.about.com/od/asthmabasics/a/basic

Pat B. (2011). Asthma Pathophysiology: What Changes Occur in the Lungs With Asthma?

Retrieved online from http://www.le.ac.uk/pa/teach/va/anatomy/case2/frmst2.html

Anatomy and physiology of the respiratory system, the university of Leicester lecture tutorials.

References

Retrieved from http://www.amazon.com/My-Top-Asthma-Management-Books/lm/,