Medical Assignment: Treatment & Care of Asthma Patient

Question

Task: To prepare this medical assignment, you should describe and critique the care and treatment of a person living with asthma, using current evidence to support your discussion. You should link theory and practice and demonstrate how undertaking this module has influenced your practice. You should provide a case study of an individual who is living with asthma as an appendix on which to base your critical discussion.

Answer

Background of medical assignment
Asthma is a condition in which the airways of an individual become narrow and swell. This particular condition also may produce extra mucus. There are several critical consequences of Asthma, such as breathing difficulties, trigger coughing, wheezing, and shortness of breath. According to some people, Asthma might be a minor problem, but majority of the experts feel that it is a serious problem, which hampers daily activities. In several cases, it is identified that asthma attacks can create life-threatening situations. Asthma cannot be cured, but it is important to understand that the symptoms of Asthma can be controlled through medicines, life style changes, and mediation. Doctors often advise that people living with Asthma need to develop effective action plans through which the symptoms of asthma can be controlled. People with Asthma are exposed to several risk factors. People having a blood relation with asthma patient can increase the possibilities to have asthma in near future. Overweight and being smoker are also considered as risk factors for people living with Asthma. Most importantly, exposure to the occupational triggers also increases possibilities of developing Asthma in the near future. As it is a life-threatening disease, it is important for the patients living with Asthma to follow four important steps for better management and control of Asthma. First of all, tracking of symptoms of the patients is important. Secondly, recording of the functioning of the lungs is also important for better management and control. Thirdly, it is also essential for the patients to adjust their treatments according to the asthma action plan. Last but not the least; effective interaction and consultation with doctors is also important for ensuring better management and better control of Asthma symptoms. Major objective of this essay is to describe and critique the treatment and care of a person living with Asthma. Theoretical framework has been used in this assignment to describe and critique the treatment and care process. Some recommendation plans for better management is also provided at the end of the essay depending on the identified issues and challenges related to care management and treatments.

Discussion
A Case of a lady, 31 years of age with poorly controlled Asthma has been described and criticised here. Frances Johnson is 31-year old woman. She visited her general physician with non-productive cough and mild shortness of breath. These symptoms become worse at night. Her symptoms also deteriorated slightly since last few weeks. However, she could not recover naturally and she also made complaints of sneezing, blockage of nose, and itchy eyes. Frances Johnson was diagnosed with Asthma at the age of 12 (Black Well Publishing, 2021). Doctors have recommended the use of bronchodilator, but it did not work as per expectations. The asthma symptoms of Frances Johnson appeared to be worsening following the recent respiratory tract infection. Two important issues need to be determined in the doctor consultation, which did not take place. First of all, it is important to know whether she is having an acute exacerbation of asthma severe enough to need hospital referral or oral steroid treatment. Secondly, it is also important here to determine how Frances Johnson is managing her chronic asthma attacks if she does not consider hospital referral or oral steroid treatment.

The general physician enquired about the respiratory rate, pulse rate, and peak expiratory flow rate. Based upon the consultation, Frances Johnson has come to know by her doctor that her respiratory rate is 20 beats/minute. On the other hand, her pulse rate is 90 beats/minute. Most importantly, the general physician has noticed that she is speaking in full sentences. On the other hand, the doctor also comes to know that the Peek Expiratory Flow Rate of Frances Johnson is 320L/Minutes. The general physician identified that she has a mild expiratory gasp to hear on auscultation of her chest. Hence, it is identified that the general physician has successfully enquired about the pulse rate, respiratory rate, and expiratory flow rate. However, the general physician might have forgotten to ask about the mode of treatment or care of asthma attack. This is an important aspect of asthma management plan.

Steps for Better Asthma Control and Management
Effective Asthma management or Asthma treatment requires routinely tracking of the symptoms. It is also important for the doctors and physicians to measure the working capability of the lungs. Active roles and responsibilities in Asthma management process might help an individual to enhance a successful long-term asthma control. Effective long-term asthma control plan allows the patients to minimise the frequencies of asthma attacks. Ultimately, this can help in avoiding different kinds of long-term health problems (Mayo Clinic, 2021). In such case, the general physician of Frances Johnson could have considered three important asthma control plans. These three asthma control plans are discussed below.

Tracking of Symptoms
It is already identified from the above discussions and case facts that Frances Johnson is suffering from shortness of breath. Limited wheezing is also experienced by Frances Johnson. In addition, Frances Johnson also felt different disruptions at workplaces due to mild breathing problems. She is suffering from asthma from the age of 12. Therefore, it is her responsibility to ensure better self-care. Moreover, she used to take inhaler to reduce the intensity of the asthma attack. In this case, Frances Johnson did not interact and consult with her general physician after getting several symptoms. Tracking of symptoms is considered as the major step of the asthma management (Kommaraju and Latif, 2021). In this case, Frances Johnson could not track her symptoms. Hence, it is considered as one of the major challenges for Frances Johnson in managing and controlling the asthma symptoms.

Recording of Capability and Working of the Lungs of Frances Johnson
It is important for the asthma patients to periodically record the results of the breathing tests. Keeping record of the results of the breathing test can be considered as an important task of lung function test. Frances Johnson should know it that her asthma cannot be controlled and managed properly if her lungs are not working properly. In this case, pulse rate, respiratory rate, and expiratory flow rate of Frances Johnson has been done. However, it was important here to conduct the Peak Flow Test and Spirometry Test in order to record the capability of lung function. The peak flow test is done through peak flow meter and the peak expiratory flow measurement indicates the capability of lungs in forcing air out of the lungs. The physician understood the importance of this test and conducted it. Hence, her physician did a great job by conducting this particular test. However, the Spirometry test was never conducted on Frances Johnson. The general physician also did not suggest the use of spirometer (Tesse et al., 2018). Looking into these aspects, it can be accepted that the general physician of Frances Johnson took great initiative to measure peak flow, but did not recommend the Spirometry test, which is an essential part of asthma management.

Adjustment of Treatment According to the Asthma Action Plan
In this case, it is identified that Frances Johnson has slight problem with her lungs’ functions. Therefore, it is the duty of the doctor to adjust the medication of Frances Johnson according to an effective control plan. In such scenario, it is also an important responsibility of the general physician of Frances Johnson to know about the history of the asthma management and asthma control activities. In this consultation process, the general physician did not ask about previous hospital referrals or past medical treatments. This can be considered as an important issue for the asthma management activity of Frances Johnson. There are several small symptoms of asthma apart from the large ones. For example, the situations get worsen during nights. In this case, the general physician has successfully enquired about this thing and Frances Johnson replied that her symptoms become worse during night-time. Hence, inquiry about the small incidents and small symptoms indicate that adjustment of treatment is enhanced according to the asthma action plan in this aspect. Generally, there are two types of medication processes to control the asthma, such as long-term medication process, and quick-relief inhalers (Price et al., 2017). In this case, it is identified that Frances Johnson is habituated with the quick-relief inhalers as she does not feel comfortable with long-term medication control. Overlooking the symptoms of Asthma can indicate that Frances Johnson is not comfortable with long-term medication process. In addition, it is also mentioned in the case facts that she used to take inhalers in order to get reliefs. Hence, lack of long-term control medication can be considered as a poor management approach for controlling asthma.

Working with the Physicians
From the attitude and behaviour of Frances Johnson, it can be acknowledged that Frances Johnson does not co-operate with the doctors. She does not meet the doctors and general physicians regularly. Major objective of frequent interaction with doctors includes minimizing exacerbations, controlling symptoms, achieving best possible lung functions, and minimising side-effects. In this case, lack of frequent consultation with doctors and lack of follow-ups are hampering the asthma management and asthma control process. On the other hand, the general physician did not demonstrate absolute professional approach by not asking past symptoms, history of the disease, and past management activities (Boulet et al., 2019). Hence, it is important for the people to enhance frequent consultation and strong interaction with doctors to enhance better asthma treatment.

Health Belief Model
Use of theoretical approach is also important for the future healthcare professionals and care givers to establish a sustainable asthma care and asthma management model. The principles of this health belief model state that a medical practitioner should conduct a diagnosis in order to share a belief among the patients or the family members of the patients to make them understand whether they are suffering from any kind of problem or not. In this case, proper diagnosis is not done. First of all, the past treatment records are not taken by the professional. According to the principles of health belief model, it is important for the management to do an accurate diagnosis and accurate diagnosis only can be done by asking the past history of the patients. In such case, it is important here to discuss that lack of knowledge on past challenges and past treatments, the physicians will face further challenges in future diagnosis and treatments. Secondly, the general physician of Frances Johnson has conducted the peak flow test for the functioning of lungs. Despite other tests, the general physician of Frances Johnson failed to conduct the Spirometry test through which the functionality of lungs regarding holing of air in lungs can be identified. This particular test is highly important in order to diagnosis the symptoms of asthma. Hence, the principles of Health belief model state that lack of Spirometry test can create issues and challenges in doctor-patient relationship (Bruhn, 2021). Last but not the least; the principles of the health belief model indicate that a strong relationship between the doctors and patients need to be created for better treatment and better care. In this case, it is identified that Frances Johnson is not habituated and comfortable with regular and frequent interaction with the doctors. Therefore, the mild symptoms of asthma of Frances Johnson were left untreated. Now, it is important here to discuss that her general physician has lost faith due to this casual approach of Frances Johnson. Hence, principle of health belief model states that Frances Johnson should have regularly and systematically attended the follow-ups for better asthma management and better long-term control (Ramsey et al., 2019).

Stakeholder Management
In asthma management, the associated stakeholders play an important role in managing the side-effects and critical symptoms of asthma. In this particular case, it can be accepted that the healthcare professionals are major stakeholders of the patients. In this particular case, he general physician of Frances Johnson was the major health care professions. She was treated and cared by her general physician, but lack of follow-up and casual approach hampered the stakeholder relationship between Frances Johnson and her general physician. In this situation, it was the responsibility of Frances Johnson to conduct a differentiation diagnosis to determine the efficacy of all the functions of lungs. Unfortunately, the general physician did not conduct the Spirometry test. Poor following-up was the major reason behind the poor relationship (Zhou and Hong, 2018). However, the general physician also did not ask about past medical records. It was the responsibility of the general physician, which could have been justified. In this case, the healthcare professionals and general physician was the major stakeholder of Frances Johnson in terms of asthma management activity. Lack of interaction and follow-up is considered as major reason behind the poor stakeholder management.

Family members of Frances Johnson also can be considered as important stakeholders in this asthma management plan. In this particular scenario, it is identified that the family members of Frances Johnson are also casual regarding the management of asthma control activity of Frances Johnson. Asthma can become life-threatening diseases, if it is left untreated. Most importantly, elderly members of a family take right and strict approaches to ensure positive response towards the asthma management plan. In this case study, active role of any family member is not mentioned (Rajan et al., 2020). Hence, it is quite clear that the intellectuality of patient and her family members is lacking in this particular situation.

Overall Poor Communication
An asthma management plan can become successful if involved stakeholders can successfully maintain a strong communication network. The established communication network should be transparent and error free in nature. In this particular case, it is identical that Frances Johnson is suffering from asthma since her childhood days. She was taking inhalers for reliefs. Despite this issue, the family members took the symptoms of Frances Johnson very lightly. In this case, poor communication process between the family members and her doctor might be a reason. Most importantly, different kinds of challenges are identified in which the process of diagnosis has become flawed (Bianco et al., 2021). The communication process between the patient and general physician is also challenging. Appropriate diagnosis is not done because Frances Johnson did not feel like sharing the past records and the doctor also did not ask the previous records. This poor diagnosis is the result of poor communication. On the other hand, lack of Spirometry test can be considered as major consequence of this poor communication process. Overall, this poor communication process might hamper the asthma management and asthma control plan development process in the near future.

Recommendations for Better Plan
First and Foremost, it will be essential for Frances Johnson to follow an in-detailed asthma action plan. An in-detailed asthma action plan is comprised of four important steps. In first step, it will be essential for Frances Johnson along with her family members and general physician to track different symptoms of asthma in the near future. There are different symptoms, such as wheezing, disturbed sleep due to shortness of breath, chest pain or chest tightness, inhaler use for quick relief, asthma symptoms during physical activities and exercises, and fever symptoms like runny nose and sneezing. These are common symptoms of asthma and these should be monitored closely by Frances Johnson, her family members, and her general physician. In second step, it is important for Frances Johnson to realise the functioning of her lungs. Already the peak flow test has been done by her general physician. Now, it is important to conduct a Spirometry test for better and in-detailed investigation. Third-step is to adjust best treatment according to the asthma action plan (Barrett et al., 2017). In order to ensure best treatment as per action plan, it will be important for Frances Johnson to share her total medical history with her doctor regarding asthma management. The last step in the asthma action management plan will be to interact with the general physician closely to get best possible medical services. Secondly, it is also important for the professionals and the general physician to get vaccine of pneumonia and influenza. It will definitely help in reducing the intensity of asthma. Frances Johnson has understood that the symptoms of asthma worsen during the night-time. On the other hand, this situation also goes out of control during the cold weeks. Despite these challenges, the casual approach of Frances Johnson did not let her consult with the physician. Jab of pneumonia or influenza vaccine will boost the immunity of the body to fight against asthma (Mayo Clinic, 2021). Hence, vaccination is also important for Frances Johnson.

Thirdly, it is also essential for Frances Johnson to find out and eliminate the possibilities of asthma triggers. The outside irritants and allergens are considered as major reasons behind the asthma triggers. Frances Johnson also might develop the tendency of asthma trigger in the near future if she does not develop a proper control plan. In this aspect, it will be important for Frances Johnson to find out future reasons behind possible asthma triggers. Several allergy tests can help Frances Johnson to know about the problematic irritants or allergens. For example, dust allergy or cold allergy can cause asthma trigger for Frances Johnson in near future. Hence, identification and avoidance is highly important in this case. Fourthly, monitoring of the breathing process is also important. Frances Johnson needs to consult with the general physician on regular basis. It will allow her to learn to identify the warning signals of impending attack. Slight coughing, shortness of breath, or wheezing might be considered as serious initial symptoms of asthma attack. Hence, constant monitoring and constant evaluation are important to make this asthma under control (Cloutier et al., 2020).

Fifthly, it will be essential for Frances Johnson to identify and treat the future asthma attacks very early. If Frances Johnson acts quickly by taking the help of family members and general physicians, she will be less likely to have serious attacks. Use of havoc medication to control a severe asthma attack may result in other types of side-effects. Hence, identification of symptoms and early treatment will be important here as it might help in using limited medicines. This will be good for health of Frances Johnson as early detection does not require many medicines. Sixthly, Frances Johnson needs to ensure that she is taking the prescribed medicines regularly. It is identified that Frances Johnson is very much casual regarding her asthma attacks and symptoms as she does not follow-up the treatment with great interest. As a result, she suffers frequently. Hence, following prescriptions and maintaining good reputation with doctors through frequent visits are important for Frances Johnson.

Last but not the least; it will be important for Frances Johnson to pay close attention to the increasing use of quick-relief inhaler as the resistance power of these medicines can be reduced. Hence, Frances Johnson cannot get benefits out of these medicines during the necessary hours.

Influence of the Undertaken Module
This module has made me understand that Asthma cannot be cured, but it can be controlled and the symptoms can be treated. The module also has made me understand that the symptoms of Asthma can be controlled through medicines, and proper action plans. Doctors suggest that people need to develop effective action plans through which the symptoms of asthma can be controlled. As it is a life-threatening disease, patients living with Asthma should follow four important steps for better management and control of Asthma. In future, I will keep some important aspects regarding Asthma management in my mind that monitoring of symptoms of Asthma is important. I will give importance to the analysis of functioning of the lungs as it is also important. Most importantly, I have realised that it is essential for the patients to adjust their treatments and care activities according to the asthma action plan. Overall, in-detailed consultation with physicians is important for better management and these facts are taught in my module. These facts altogether in this module has inspired me to adopt this research topic and it will also help me in my future career.

Conclusion
A Case of Frances Johnson has been discussed here. She was diagnosed with Asthma at the age of 12. Doctors administered the use of bronchodilator, but it did not work as per expectations. The asthma symptoms of Frances Johnson appeared to be worsening after the recent respiratory tract infection. The general physician did not reveal absolute professional approach by not asking past symptoms, history of the disease, and past asthma management activities. It is important for the general physician to do an appropriate diagnosis as accurate diagnosis only can be done by asking the past history of the patients. However, past treatment records are not taken by the general physician. Overall, poor communication process among stakeholders might hamper the asthma management and asthma control plan development process. It will be essential for Frances Johnson to follow an in-detailed asthma action plan. In addition, it is also vital for Frances Johnson to find out and eradicate the possibilities of asthma triggers. Most importantly, monitoring of the breathing process is also important. Frances Johnson needs to consult with the general physician on regular basis to minimise breathing problems and other challenges.

References
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Black Well Publishing., 2021. A 31-year-old woman with poorly-controlled asthma. [Online]. Available at: < http://www.blackwellpublishing.com/content/BPL_Images/Content_store/Sample_Chapter/ 9781405158954/9781405158954_4_texte.pdf>. [Accessed on October 25, 2021].

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Appendix

Figure 1: Snapshot of Case-Study