Asthma in Relation to Inability to Breathe: A Case Study Case Study

Case Study

Roger Nowak is a 76-year old Caucasian man, presenting to the hospital’s emergency care unit with complaints, chief of which is Shortness of breath, and body weakness. Roger is reportedly an alcoholic, with a bleeding GI and a loss in kidney functions, presented in anemia. Roger has a past medical history of diabetes, hypertension, gastroesophageal reflux disease (GERD), and hyperlipidemia, and is currently on medication including Metformin, Victoza, Lisinopril, atorvastatin, aspirin, prilosec, and pepto Bismol as needed. Upon further assessment and analysis of results, the patient is found to have a reduced hemoglobin count as well as MCV counts, which might have developed the inability to breath, and general body weakness, and anemia.

Diagnosis

The patient is diagnosed with shortness of breath with weakness in asthma.

Etiology of Shortness of Breath in the Patient

Shortness of breath(SOB) can be caused by many, though most of the Shortness of breath results from cardiovascular and lung conditions, as the main organs involved in the transfer of oxygen to various body tissues while eliminating carbon dioxide (Nair et al., 2017). Shortness of breath can, therefore, be either be chronic from cases such as Asthma or acute from cases instances as COVID-19, Asthma, or as a result of blockages in the breathing system (Azer, 2020). Because As Rogers presents with hyperlipidemia, diabetes, and hypertension, the shortness of breath experienced might have resulted from pulmonary hypertension. This is because pulmonary hypertension affects an individual by limiting the supply of oxygenated blood to the lungs and can cause serious challenges, including heart failure or death. The shortness of breath is known to be a primary cause of Asthma, whereas the asthmatic state of an individual also has the capabilities of influencing shortness of breath as a result of the lung irritations associated with asthma (Anzueto & Miravitlles, 2017).The patients inability to breath properly has further affected the Red blood cells production, given the the oxygen supply to the body has reduced remarkably, thus preventing the full production of red blood cells in the body.

Pathophysiology of SOB

Several reasons come in to invoke changes in an individuals breathing system, as a result of an allergic reaction, or due to a developing or an acute attack to the breathing system. According to Azer, (2020) Asthma presents in airway inflammation, hyper-responsiveness, and increased release of mucous leading to the blockage of the bronchial tubes, thus obstructs airflow to the lungs, causing shortness of breath. Hypertension causes inflation in the respiratory system, straining the respiratory muscles which then becomes shorter thus leading into Shortness of breath (Anzueto & Miravitlles, 2017). According to Anzueto and Miravitlles, (2017), hyperinflation of the respiratory muscles causes the radius of the diaphragm to increase the respiratory motor output leading to Shortness of breath. This process may happen either as an acute or as a chronic manner thus influencing the actions of the lungs to negatively affect health.

Diagnostic tests for SOB

The patient would need to undergo a series of tests, including a chest X-ray or a CT scan, and undertake a lung functions test or an echocardiogram.

Management of SOB

The management of shortness of breath is likely to lean towards managing the asthmatic state through the use of both pharmacological, and on-pharmacological mechanisms. Behavior Change modification is one non-pharmacological angle of consideration aimed at controlling tobacco smoking and a change in dietary practices by reducing the consumption of foods with low-density lipoproteins food sources. However, behavior change modification must be coupled with medication treatment to deliver desirable results. The management must also focus on changing the patients anemic state, by increasing the rate of oxygen supply to the lungs.

Conclusion

Rogers’s condition is highly manageable despite being surrounded by many comorbid conditions such as hypertension, diabetes, and anemia. Prompt treatment and adherence to treatment regimen will go a long way in addressing the situation to correct the negative effects of the disease. Body weakness can be corrected by the management of the anemic condition through the restoration of the hemoglobin counts.

Questions

1. What diseases are affecting Roger’s kidney functions? How do you know his kidney function has decreased?
   1. Rogers kidney functions are being affected by the anemic condition, in reduced red blood cell production. The reduction of Roger’s kidney functions is evidently shown by the reduced glomeruli filtration rate, with creatinine levels at 1.4 units.
2. How is Roger’s kidney disease affecting his RBC production?
   1. In chronic kidney disease, the production of erythropoietin is altered and the restriction of iron absorption by hepcidin-mediated limitations affects the red blood cells production, thus limitng iron absorption and realising stored iron from the body, leading to anemia.
3. How is Roger’s chronic alcohol use affecting his anaemia?
   1. Alcohol consumption deteriorates the liver functions through progressive damages leading to the inflammation of the liver or causing liver cirrhosis. The liver is the main organ in the production of iron, therefore a damaged liver means decreased iron production, which results in anemia. Alcohol increases the rates of hemolysis, therefore leading to the development of anemia in kidney patients.
4. What are some of the possible things that could be causing Roger’s GI bleed, especially if he is drinking daily?
   1. With progressive alcohol consumption, the liver is continually damaged, leading to impaired platelet functions, thus triggering the possibilities of hemorrhage, including GI bleeding.
5. Explain how the SOB and weakness are explained by Roger’s condition
   1. Shortness of breath is a probable case in Roger’s scenario that is likely to have developed as a result of the proportionate destruction of red blood cells leading to anemia. In anemia, the oxygen supply throughout the body, which is critically needed for aerobic functions, remains limited. This causes general body weakness, dizziness, and, in some cases, shortness of breath. This was the case with Rogers’ condition.
6. Type the references you used in APA 7^th edition format
   1. Adawy, Z. R., Mohamad-Saleh, R. A., & Ismail, T. A. A. M. (2017). Is bronchial asthma a risk factor for chronic kidney disease?. Al-Azhar Assiut Medical Journal, 15(1), 27.
   2. Atkinson, M. A., & Warady, B. A. (2018). Anemia in chronic kidney disease. Pediatric Nephrology, 33(2), 227-238.
   3. Gkamprela, E., Deutsch, M., & Pectasides, D. (2017). Iron deficiency anemia in chronic liver disease: etiopathogenesis, diagnosis and treatment. Annals of Gastroenterology, 30(4), 405.

References

Anzueto, A., & Miravitlles, M. (2017). Pathophysiology of dyspnea in COPD. Postgraduate Medicine, 129(3), 366-374.

Azer, S. A. (2020). COVID-19: Pathophysiology, diagnosis, complications, and Investigational therapeutics. New Microbes and New Infections, 100738.

Nair, P., Martin, J. G., Cockcroft, D. C., Dolovich, M., Lemiere, C., Boulet, L. P., & O’Byrne, P. M. (2017). Airway hyperresponsiveness in asthma: measurement and clinical relevance. The Journal of Allergy and Clinical Immunology: In Practice, 5(3), 649-659.