Asthma in Children: Evidence-Based Practice

This paper presents a discussion on asthma and its aspects to provide a background for the project that discusses the role of nurses’ education in the reduction of asthma exacerbations in children. In the report, the disease is defined, and its epidemiology, clinical presentation, complications, and diagnostic methods are outlined. Based on the discussed issues, nurses’ role in the elimination of the symptoms is suggested, and the PICOT question is presented.

Definition

Asthma is a chronic respiratory disease that can occur in all age groups. However, most commonly it starts in childhood (World Health Organization, 2018). The condition is caused by the inflammation of air passages, which results in nerve endings’ sensitivity and irritation. During the asthma attack, the air passages in the lungs swell, which results in the narrowing of the airways. Consequently, the airflow reduces and the patient experiences shortness of breath and other symptoms discussed below.

Epidemiology

Currently, around 8% of individuals living in the United States have asthma; the disease has affected about 4% of the population worldwide (Centers for Disease Control and Prevention, 2018; Croisant, 2014). Moreover, the disease is more prevalent in children (almost 10%) than adults (around 8%) (Moorman et al., 2012). Bryant-Stephens (2009) notes that asthma significantly affects minority groups and people of low socioeconomic background as they may have reduced access to care and poor living conditions.

Clinical Presentation

There are several characteristics of asthmatic symptoms, which occur in episodes. They include cough, breathlessness, chest tightness, and wheezing (Singh & Singh, 2014). Cough is usually dry and may be associated with white or green sputum; wheezing is polyphonic. Notably, many patients report asthmatic attacks that occur mainly at night or in the morning. The symptoms may develop within several days or weeks, as well as occur abruptly (Singh & Singh, 2014). The triggers associated with the disease may be allergic and non-allergic; the first group may include pollen and pets, while the second one is related to air pollution, diet, and physical activity, as well as psychological and climatic factors.

Complications

Poorly treated and controlled asthma may lead to decreased quality of patients’ life. Although respiratory complications occur rarely, it is vital to consider possible risks and prevent the acquisition of related conditions. Potential complications include respiratory failure, pneumonia, lung collapse, and severe asthma attacks. For children, the symptoms of the disease may be particularly challenging as their presence may cause psychological and learning problems, as well as an inability to exercise or be involved in physical activities.

Diagnosis

According to the Asthma and Allergy Foundation of America (2015), diagnosis may include a lung function test, such as peak airflow, spirometry, a provocation test, or fractional exhaled nitric oxide (FeNO) test. Moreover, an X-ray of the lungs, chest, or sinuses may be required as well. Additional diagnostic measures may include allergy tests, as allergies may cause the disease. For children, it is also vital to consider the present symptoms, such as non-atopic wheezing (Singh & Singh, 2014).

Conclusion and PICOT Question

The report shows that asthma is a condition that may cause severe complications and should be controlled properly. The disease can reduce the quality of children’s life particularly due to their higher levels of physical activity, as well as its impact on their learning abilities. Primary care nurses’ role in the prevention and control of asthma in children is vital, as they ensure that patients receive timely and appropriate care. The project will aim to discover the role of nurses’ education in the elimination of asthma exacerbations.

Thus, the PICOT question is: In children with asthma between the ages of 5 and 19 (P), does a combination program consisting of nursing self-management education in the primary care setting and a daily controller medication (I) compared to only using controller medication (C) reduce asthma exacerbations (O) over one year (T)? The current standard of care includes education. The use of a controller without education would not be appropriate as this would be less than the current standard of care. Self-management education will allow primary care nurses to provide patients and their families with the information that may be used to control exacerbations, improve children’s adherence to medication, and recognize early symptoms timely.

References

Asthma and Allergy Foundation of America. (2015). Asthma diagnosis. Web.

Bryant-Stephens, T. (2009). Asthma disparities in urban environments. Journal of Allergy and Clinical Immunology, 123(6), 1199-1206.

Centers for Disease Control and Prevention. (2018). Prevalence of asthma, asthma attacks, and emergency department visits for asthma among working adults — National Health Interview Survey, 2011–2016. Web.

Croisant, S. (2014). Epidemiology of asthma: Prevalence and burden of disease. In A. R. Braiser (Ed.), Heterogeneity in asthma (pp. 17-29). Boston, MA: Humana Press.

Moorman, J. E., Akinbami, L. J., Bailey, C. M., Zahran, H. S., King, M. E., Johnson, C. A., & Liu, X. (2012). National surveillance of asthma: United States, 2001-2010. Vital and Health Statistics 3, 35, 1-58.

Singh, N., & Singh, V. (2014). Clinical presentations and investigations in asthma. The Journal of the Association of Physicians of India, 62(3), 7-11.

World Health Organization. (2018). Asthma: definition. Web.