Nursing Care in Patients with Brittle Asthma - Essay Example

Download file to see previous pages These circumstances influenced the creation of this paper where the author will discuss chronic asthma, emerging issues relative to the disease, and nursing approach to the identified issues to facilitate nursing care. Asthma attacks take the life of over 1,100 patients every year (Anderson 2007) and 0.05% of this population comprises of patients who suffered from brittle asthma (Ayres 1998). Brittle asthma is a phenotype classification of asthma coined by Turner-Warwick in 1977 as an asthmatic condition with maintained wide variation in peak expiratory flow (PEF) despite high doses of inhaled steroids. After Turner-Warwick’s revelation sprung several more definition from authors who aims to give the condition a more precise identity. Garden and Ayres (1993) claim that a more concise manner to define it would be “patients with a defined and persistent marked diurnal variation in PEF despite multiple drug treatment.” Nevertheless, this implies a chronic illness with no effective treatment available leaving the patient filled with pain and suffering from dyspnoea. Ayres (1998, p.315) classified brittle asthma into two. The first one is Type 1 brittle asthma, which is characterised by a sustained wide PEF variability over a period of at least 150 days regardless of extensive medical treatment. The other one is Type 2 brittle asthma considered as abrupt acute attacks taking place in less than three hours. This type may occur even on a seemingly normal airway function or a well-controlled asthma. Between the two, Type 1 patients are more likely to be on emergency and admitted on hospitals due to its severe acute attacks and its need for a more intensive treatment. This group of patients with brittle asthma requires greater amounts of medications compared to the other forms of asthma. Most needs prolonged oxygen therapy and higher doses for steroids and bronchodilators. Biomedical management mostly involve steroids, subcutaneous ?2 antagonist, long acting inhaled ?2 antagonist, and adrenaline, which are all costly if given in a longer period and higher doses. On the course of therapy, the patients often suffer from the effects of prolonged drug exposure such as osteoporosis, weight gain, and oesophageal reflux to name a few (Ayres 316). Physical morbidity is tantamount to all chronic illness and its psychosocial counterpart is always present too. Garden and Ayres (1993, p.503) discussed the psychosocial effects of brittle asthma to a person. They suggested that prolonged chronic illness develop traits such as anxiety, nervousness, sensitivity, denial, lower self-esteem and obsession. These trait alterations acclaimed to be due to extremely difficult management. Many of them have run out of therapeutic options and patience and eventually stop seeking medical consult from their physicians. Poor compliance and worsening condition follows from these actions of hopelessness. Studies found out that these patients lacks self confidence in managing attacks, believes their doctors less, and has an increased feeling of disgrace. Another testified that patients with highest morbidity from asthma often time hesitate in seeking help from clinicians during acute attacks while others do not strictly comply on usage of bronchodilators or still continue to do prohibited habits such as smoking or exposure to allergens (Smith, et al. 2005). “ ...Download file to see next pagesRead More