• Subject Name : Nursing

Asthma in Children Aged 5-14

Case Study of Asthma

Rose a 12-year-old girl was recently admitted to the hospital after complaining about persistent chest pain and shortness of breath from the past week that now worsening day by day. She explained that for the past 3 days she is not able to sleep properly due to the coughing and she is breathing through the mouth due to the shortness of breath. Her family history reveals that her father has encountered asthma in his adolescence that is under control and her mother is a diabetic patient that is increasing her complication to care rose health condition. Vital of Rose indicate fluctuation like pulse rate 130 beat per min, blood pressure 120/70mmHg temperature is 39.5 degree, SpO2 94% and respiratory rate 32 beats per minute with loud wheeze. She is also allergic to the nuts that were mentioned by her mother and it was diagnosed when she was 7-year-old after she was found to be unconscious in the school canteen leading to hospitalization. After interviewing her parents it was revealed that she has been encountered with cold symptoms multiple time but it was controlled by the medication of the general practitioner but this is a serious condition.

Introduction to Asthma

Asthma is one of the most common respiratory issues that directly increase the complication of the individual and it led to a deteriorated condition due to shortness of breath. Paediatric setting experience case of asthmatic condition is expected to holistically assist the child in care to improve the wellbeing by reducing lifetime issue (Trivedi & Denton, 2019). Nurses in the paediatric setting are expected to work considering the developmental state of the children to assist the patient during nursing interventions. Incorporation of the family in the care process is actively supported in the paediatric setting as it helps to improve the understanding of the child toward the treatment process leading to better adherence to the care approach (Cowen et al., 2017). Rose case state reveals that she is majorly facing issue in breathing due to shortness of breath and chest pain which need urgent attention to stabilize the health state and there is fluctuation in the vitals of the patient. The report is going to cover different care aspect related to the Rose case study that can help to improve the understanding of Rose current condition and possible intervention that can be used to enhance the quality of care.

Prevalence in Australia and Impact

When it comes to Australia the prevalence rate in the 0-14 age group of children is approximately 10% which is about 460,000 children were reported to have asthma as a long-term condition. The prevalence rate of asthma indicates that children facing disability are at higher risk that is about 18% when compared to the children with no disability which is approximately 8.9%. Considering the age group, the prevalence rate in 0–4-year children is 10% followed by 5–9-year children boys have a prevalence rate of 15% followed by a girl which is 10% and the last is 10–14-year children 14% in the boys and 12% in the girls. There has been a minor rise in the prevalence rate when data is compared from 2007-2008 to 2017-18 that is from 9.3% to 11% (Australian Institute of Health and Welfare, 2020). Some of the short team complications for the children dealing with asthma is an issue while completing the daily activity, asthmatic attack, sick day leaves and coughing with painful breathing. The medium-term complication that directly impacts the children is airways inflammation, depressive episode and side effect of the medications. The long-term impact of asthma on the children is airways remodelling, weight gain, anxiety issue, learning disability and Obstructive sleep apnea (Dharmage et al., 2019).

Impact of Family, Culture and Environment

When it comes to the family impact over the children asthmatic condition it has both positive and negative aspect as they are the major surrounding individual to the children facing health issues. One of the negative impacts of the family is they increase the genetic risk factor for the individual to acquire the asthmatic condition when parents of the children have a medical history of the asthmatic or any respiratory issue (Barnes & Rowe, 2013). Another issue which is directly related with the poor health outcome of the children facing asthmatic condition is the poor family structure like lack of positive relationship or conflict. The poor family structure can lead to increased risk for mediate term effect over the children causing depressive episodes which lead to a poor health outcome. Increase participation of the family members in the care process of the children facing asthmatic issue positively impact the health status by increasing collaboration in improving coping skills (Barnes & Rowe, 2013). Cultural aspects directly increase the risk for the individual as they are unique for the particular group of population leading to increased risk for deteriorated health.

One of the impacts of the cultural factor is culturally minor group are considered to be at high risk to acquire a different illness or poor medical assistance due to lack of accessibility. Another factor which hampers the health of the children facing asthmatic condition related to cultural aspect is different of belief and practises considering the care process which directly restricts the use of relevant intervention in the patient care. The last cultural aspect is related to the increased belief over the home remedies or traditional practice which directly hamper the care process leading to deteriorated condition (Majellano et al., 2019). The environmental factor is the major source of the triggering factor related to the asthmatic attack which directly increases complication for the patient. Children who are exposed to dust; pollen grain, pollution or toxins directly face the inflammation of the airways leading to asthmatic attack which can be life-threatening if remain unaddressed for some time. On the other hand, less pollutant in the environment can be helpful for the children to heal with the asthmatic condition leading to better wellbeing (Gautier & Charpin, 2017).

Impact of Asthma Over Learning and Development

Rose is a 12-year-old girl that directly indicates that she is a school-going child and her asthmatic condition can directly hamper her ability to cope with the work and enhance the learning toward different domains. Article presented by Lundholm et al. (2020) added that learning is one of the major factors that get hampered due to asthmatic condition leading to poor ability to catch up in the group of peers. Children encountered asthmatic condition generally found to skip the school session due to the poor health status which directly doesn’t allow them to attend the classes. Due to the school skip and lack of concentration toward the studies hampers child’s learning ability leading to poor performance in the school which directly increase the stress of the student. The persistent poor health condition reduces the attention of the individual considering the studies leading to increase frustration which directly hampers the learning ability (Lundholm et al., 2020).

Children encountered asthmatic state at their early lifetime generally face slow or decrease developmental issue due to the inflammation of the lungs at an early stage leading to deteriorated state. Children are in their active development process thus any health issue in this phase of life directly hamper the development process leading to the poor cognitive ability of the child. The lungs and airways of the child face major issue in the developmental process if they have encountered asthma at an early stage leading to a poor stable lifestyle. Sometimes the medication related to the asthmatic condition negatively impact the growth of the children and it slows down the development process leading to poor wellbeing.

Communication Strategy

Nurses are the major care providers in the patient care process and when it comes to the paediatric setting nurses are expected to be extra careful to improve the conversation using the right communication technique. Interpersonal communication skills are considered to be important for the nurses to enhance the conversation with the patient and the family member in the paediatric setting (Mărginean et al., 2017). Interpersonal communication helps the nurses to use the verbal and non-verbal approach which help to develop rapport with the client and family member leading to enhances quality of care. Nurses using the interpersonal communication approach are expected to use the right tone and facial expression to effectively communicate their thought to the patient or family members.

Effective communication help to generate collaboration between patient, family and health care providers to improve the use of a person-centred approach in the care process (Mărginean et al., 2017). Nursing and Midwifery Board of Australia (2020) presented the standard of practice for nurses and Standard 2 to is Engages in therapeutic and professional relationships. The 2.2 aspects of the standard state that nurses are expected to use effective communication skills that value individual belief and preference in the care process. Anther standard is Standard 4: Comprehensively conducts assessments that state that nurses are expected to actively partner with the patient to improve the health outcome by addressing the health need of the patient. Considering Rose current health condition interpersonal communication will be useful to assist the patient family member to understand the care aspect to improve the adherence to the care approach.

Nursing Intervention

One of the nursing interventions that can be used to assist Rose asthmatic condition is lifestyle intervention that will be framed considering the almond allergy that was initially mentioned. The study presented by Stoodley et al. (2019) added that lifestyle intervention is helpful for asthmatic patient as it helps them to enhance the cope skills which help to reduce lifestyle complications. Lifestyle intervention helps them to set a routine of exercise which is important to enhance the respiratory pattern and enhance the physical activity to reduce the risk of any further health complication. Other aspects of the lifestyle intervention will be related to the dietary pattern that helps the patient to take nutritious food considering the health status. The fixed calories intake helps to reduce obesity or cardiovascular issue which can further enhance the health issue for the patient dealing with an asthmatic state.

The last aspect of the lifestyle intervention is a breathing exercise session which will address the shortness of breath of the patient by increasing control over the breathing pattern by different exercise (Stoodley et al., 2019). Moreover, the article presented by Smith & Jones (2015) added that psychological intervention is also very helpful to decrease the stress or frustration of the child facing an issue due to the asthmatic condition. The talk therapy session the children to express the health issue that is increasing due to the asthmatic condition and get the right solution that can be used to improve the wellbeing. Nurses are expected to collaborate with the patient during the therapy session so that they can help the patient to understand the different approach and implement it in the practice to reduce health issue.

Conclusion on Asthma in Children Aged 5-14

The report can be concluded by adding that asthmatic condition directly hampers the well-being of the children leading to poor learning and developmental ability which impact a lifetime. Rose condition directly impact that she is facing issue due to her asthmatic condition that is also evident in her family history and it needs to be addressed to reduce health issue. The prevalence indicates the burden of the asthmatic state over the children in Australia which need to be controlled and its impact on the health of the children. Different factors directly impact the asthmatic condition of the child which includes family, cultural and environmental aspects. Asthmatic condition directly hampers the learning ability of the child due to the deteriorated health state and it negatively impacts the individual development process. The interpersonal communication approach is considered to be the right method that can be used to address the health need of Rose and her family to increase their adherence to the care approach. The nursing interventions which can support Rose health status are lifestyle interventions and talk therapy to reduce any physical as well as a mental health issue 

References for Asthma in Children Aged 5-14

Australian Institute of Health and Welfare. (2020). Australia's children. Retrieved from: https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/asthma-prevalence-among-children

Barnes, M. & Rowe, J. (2013). Child, Youth and Family Health: Strengthening Communities. United Kingdom: Elsevier Health Sciences.

Cowen, K. J., Shaw, M. R., Bindler, R. M. & Ball, J. W. (2017). Principles of Pediatric Nursing: Caring for Children. United Kingdom: Pearson Education.

Dharmage, S. C., Perret, J. L. & Custovic, A. (2019). Epidemiology of asthma in children and adults. Frontiers in Pediatrics7(246), 1-15. https://doi.org/10.3389/fped.2019.00246

Gautier, C., & Charpin, D. (2017). Environmental triggers and avoidance in the management of asthma. Journal of Asthma and Allergy10, 47–56. https://doi.org/10.2147/JAA.S121276

Lundholm, C., Brew, B. K. & D’Onofrio, B. M. (2020). Asthma and subsequent school performance at age 15–16 years: A Swedish population-based sibling control study. Sci Rep, 10(7661), 1-15. https://doi.org/10.1038/s41598-020-64633-w

Majellano, E. C., Clark, V. L., Winter, N. A., Gibson, P. G. & McDonald, V. M. (2019). Approaches to the assessment of severe asthma: barriers and strategies. Journal of Asthma and Allergy12, 235–251. https://doi.org/10.2147/JAA.S178927

Mărginean, C. O., Meliţ, L. E., Chinceşan, M., Mureşan, S., Georgescu, A. M., Suciu, N., Pop, A. & Azamfirei, L. (2017). Communication skills in pediatrics - The relationship between pediatrician and child. Medicine96(43), 1-6. https://doi.org/10.1097/MD.0000000000008399

Nursing and Midwifery Board of Australia. (2020). Standard of Practise. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Smith, H. E. & Jones, C. J. (2015). Psychological Interventions in Asthma. Curr Treat Options Allergy, 2, 155–168. https://doi.org/10.1007/s40521-015-0051-3

Stoodley, I., Williams, L., Thompson, C., Scott, H. & Wood, L. (2019). Evidence for lifestyle interventions in asthma. Breathe (Sheffield, England)15(2), e50–e61. https://doi.org/10.1183/20734735.0019-2019

Trivedi, M. & Denton, E. (2019). Asthma in children and adults-What are the differences and what can they tell us about asthma?. Frontiers in Pediatrics7, 256. https://doi.org/10.3389/fped.2019.00256

Trivedi, M. & Denton, E. (2019). Asthma in children and adults—What are the differences and what can they tell us about asthma. Frontiers in Pediatrics, 7(256), 1-15. https://doi.org/10.3389/fped.2019.00256

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