HEALTH ASSESSMENT REPORT

Executive summary:

Asthma is the health condition, in which patients have poor lung functions. This health condition is characterised by heavy cough, wheezing, chest tightness and breathing issues. Through carrying out the systematic process of health assessment it is possible to determine the current health needs of asthma patients which assists the health professionals to develop a relevant care plan in terms of promoting their health and wellbeing. This study is going to present the health assessment of a patient, Mr B who suffers from asthma. The study will present the baseline health report of this patient by discussing his current physical health condition, emotional and psychological wellbeing, medical history, pre-medical history and his living standard that are contributed to developing asthma in this patient. Finally, the report will make a short recommendation, in which it will recommend the suitable advice or strategies that need to be implemented by Mr B to become free from the issues of asthma, such as lifestyle changes and dietary changes.

Introduction:

Health assessment is the process by which the current physical status of a patient is evaluated by carrying out his or her physical examination and analysing the medical and premedical history. This study is going to present the health assessment of a patient, Mr B who suffers from asthma. The study will present the baseline health report of this patient by discussing his current physical health condition, emotional and psychological wellbeing, medical history, pre-medical history and his living standard that are contributed to developing asthma in this patient. The study represents the health assessment in which it will discuss what processes are followed systematically to assess the current health condition of Mr B and which care plan is developed based on the current health assessment. The report will make a short recommendation, in which it will recommend the suitable advice or strategies that need to be implemented by Mr B to have improved breathing condition, such as lifestyle changes and dietary changes. Finally, the study is going to present the summary of the entire discussion in which the main underlying aspects of the discussion would be presented.

Case study:

Mr B is a 49 years old man, who suffers from asthma. He is an average smoker who smokes 4 a day, which poses an adverse impact on his lung as he is asthmatic. Other health issues affect the normal living standard of Mr B such as he also has breathing difficulties, heavy cough and wheezing due to severe exposure into the cold weather. He also has high BP and hypertension which pose an adverse impact on his mental and emotional wellbeing. High blood pressure is also considered as the hypertension, in which the force that is cause by the blood flow that pushes against the inner wall of the blood vessels is relatively high (Flint et al. 2019). On the other hand, the low blood pressure is the health condition in which the forces applied by the blood against the inner walls of the blood vessel is relatively low. Smoking is highly dangerous for lung, especially while it comes to people with breathing issues such as asthma. People who are the regular smokers, their lungs inhale not only the nicotine but also various harmful chemicals which are associated with reducing the capability of the lung to maintain proper respiratory functions (Levitzky, 2018). In addition to this, excessive smoking can enhance the chances of lung cancer. People with asthma and COPD are highly vulnerable to lung cancer and poor function of the lung if they smoke at an excessive rate. Therefore, in the case of Mr B smoking is highly harmful that can enhance his vulnerability towards lung cancer and mortality.

Me. B is overweight with 78 kg (his height 5ft 6) but not obese. Overweight and obesity are the major health issues in recent years which occur due to the excessive accumulation of fats into the body. People are called overweight is they have a BMI [ body mass index] within the range 25-30 kg/m2. BMI is the measurement that is gained by dividing individuals’ weight by the square of the height of that person. Overweight is associated with many non-communicable health issues such as cardiovascular disease, pulmonary illness and lung dysfunction (Grieco et al. 2020). Clinical pieces of evidence suggest that overweight is associated with breathing difficulties in people who have poor lung capacity or some special breathing-related health issues such as asthma and COPD. Most of the clinical intervention on asthma highlights the fact that if a person is overweight, he or she is highly prevalent to breathing difficulties as there is chances of fat get stored in the inner wall of the veins and arteries, which then interfere with the blood flow in the lung which then leads to reduce the level of blood oxygenation. As mentioned by Al Sallakh et al. (2017), in case of obesity and overweight, excessive fats that cannot be stored by muscles and tissues are accumulated into the inner wall of alveoli which interact with smooth pulmonary function. Therefore, in the case study, the overweight of Mr B can contribute to deteriorating his overall breathing condition.

Drinker: Mr B is an average drinker and drinks more or less regularly. As mentioned by Nieman et al. (2018), alcohol is considered as the most harmful factors that impact the lung badly, especially in the case of people having asthma or COPD. PHE (2018) has mentioned that alcohol acts as the potential depressant that lowers the breathing rate of individuals. The evidence-based report suggested alcohol is distributed throughout the different body parts after consumption thereby disrupt the normal function of crucial organs including lung [PHE, 2019]. As Mr B is an asthmatic patient, alcohol consumption will interfere with the normal lung function thereby lowering the lung capacity and deteriorating the breathing rate. Therefore, he needs to stop alcohol consumption and consume healthy and nutritious foods for improving the muscle strength and functionality of internal organs.

Exercise: Mr B does not contribute any of this time to do exercise which is most important for the better functioning of the lung. Evidence suggests that exercise is highly effective for people with breathing difficulties as it enhances t capability of the lung to carry a large amount of oxygen thereby improving the breathing rate. However, in case people suffering from asthma and COPD, doctors recommend some social types of exercises that is developed particularly for improving the capability of lung and breathing condition of patients. These exercises are called aerobic exercises. Mr B needs to do aerobic exercises regularly that can improve his overall breathing condition and lung capability. Before doing any exercise he needs to consult with a pulmonologist to get the advice that which exercises would be relevant to improve his respiratory activities.

Diet:

Mr B is not concerned about his diet such as the selection of foods and nutritional intake, which impact adversely on his overall metabolic ad breathing condition. Mr B is reported to eat junk foods at a good quantity in every week that not only enhances his chances of obesity but also reduces the overall lung capacity due to accumulation of unsaturated fats into the inner walls of the blood vessels and arteries. Being an asthma patients Mr B needs to avid some foods such as cheese, inflammatory oils, eggs, wine with sulphites, dried fruits and beer. These foods can cause severe inflammation in the body that can interfere with the overall breathing activities in the body.

Mr B has high blood pressure and hypertension which is due to his overweight. Overweight is considered as the sauces of different health risk such as heart attack, damaging or narrowing of artery, coronary arterial disease, dementia and mild congenital impairment. As Mr B has both the high BP and hypertension, he is highly vulnerable to heart stroke and coronary arterial disease.

Impact of cold and damp weather on asthma patients:

In the case of asthma patients, their exposure to cold, damp weather can cause severe breathing issues, heavy cough and wheezing. Therefore, in the case of Mr B, he needs protection from the cold and damp weather overwise it can deteriorate his overall breathing condition. Cold and damp weather contributes to worsening of breathing rate and overall lung activity asthmatic patients. When an asthma patient like Mr B is exposed to the cold and damp weather the body immediately inhale the cold air. The air them passes through bronchioles and then reaches the lung (Levitzky, 2018). In this state, organs of the body including lug are in relatively high temperature as compared to the cold air that is inhaled into the body. Therefore, the reaching of the cold cause high rate of inflammation of the lung which then leads to wheezing, shortness of breath, heavy cough ad chest tightness. On the other hand, when cold air reaches the lung makes the lung shocked that leads to dryness of the airway. Dry and cold airways generally cause irritation in lung. In case of asthma patient, like Mr B the lung condition is very weak, in which the cold air causes high rate of irritation which then leds to prolong cough, high level of breathing difficulties and chest tightness.

Assessment report:

While it comes to analyse the current health condition of a patient, it is important to carry out an effective health assessment (Cushing et al. 2019). Immediate after placing Mr B on oxygen support, a proper physical health check-up of him has been done. The symptoms that Mr B has such as chest tightness, whizzing, shortness of breathing (dyspnoea and tachypnoea) and heavy cough, which represent that he has asthma. Here doctors and nurses need to use the APIE (Assess, Plan Implement and Evaluate) model in term of carrying out a systematic health assessment of Mr B.

Normal airways movement through lung:

The lung is associated with maintaining normal inhalation and exhalation process (breathing system) in the body thereby facilitates the supply of oxygen to every cell (Knight and Nigam, 2017). Deoxygenated blood goes to the alveoli of the lung from the right ventricle of the heart through the pulmonary artery. Here gaseous exchanges taken place and oxygen in the alveoli is transferred to the blood and CO2 comes out into blood vessel through diffusion. This is generated blood is them carried to the left ventricle from which the oxygen is supplied through the artery into the different body parts (Levitzky, 2018). The overall process of respiration ins maintained through the exhalation and inhalation.

Inhalation is the process in which air from the external environment enters into the lung. In this stage due to the contraction of the muscle in the diaphragm the volume of thoracic cavity increases which decreases the interalveolar pressure. Therefore, the air then enters into the alveoli through outside.

In the exhalation process, air comes out of the alveoli. Here the diaphragm muscle relaxes which leads to reduces the volume of the thoracic cavity thereby increasing the interalveolar presser. Then the air inside the alveoli comes out from lung and exit from the body.

Asthmatic lung and its pathology:

In the case of asthmatic patients like Mr B, the inner diameter and volume of the bronchiole get narrower which poses obstruction in the entry and exit of air to and from the lung.

In the case of Mr B, as he is asthmatic, the airways get smaller when passes through the bronchiole which makes it difficult for the bronchioles to get the sufficient amount of oxygen from the air. Therefore, the oxygen supply to the body parts decreases which leads to breathing issues in asthmatic patients.

When airways passage through alveoli, the muscle around the airways tightens up and swells that makes the airways partly closed. On the other hand, mucous secretion in excessive amount poses the potential obstruction in the airways (Grieco et al. 2020). Therefore, in the case of asthmatic patients such as Me B, as the airways get narrower the patients work hard to push the air to the lung during the inhalation which leads to developing the asthmatic episodes. Me B can experience the asthmatic episodes which are characterized by wheezing, chest tightness and a heavy cough.

Normal and asthmatic bronchiole:

As compared to normal bronchiole, in the asthmatic bronchiole the inner diameter of the bronchiole is comparatively very narrow which creates obstruction in the process on exhalation and inhalation (Mauro and Aliverti, 2016). As Mr B is asthma patient, in his case the mucous production is higher than in that in normal people which makes the muscle of bronchiole tighten and causes swelling of the lining of the air passages thereby reducing the overall airflow through the bronchiole tree.

Sign and symptoms of asthma:

• Chest pain and chest tightness
• Difficulties in breathing (dyspnea)
• Fatigue
• Wheezing
• Rapid breathing
• Heavy cough
• Shortness of breathing
• Fatigue
• Blue lips and fingernails

In the case of asthma patients, their exposure to cold, damp weather can cause severe breathing issues, heavy cough and wheezing. Therefore, in the case of Mr B, he needs protection from the cold and damp weather overwise it can deteriorate his overall breathing condition.

Recommendation:

• Mr B is recommended to perform regular aerobic exercises as instructed by the physiotherapists and pulmonologist. Aerobic exercises are important for improving the capacity of lung and breathing rate in an asthma patient.
• Mr B is recommended to have a healthy ad systematic lifestyle such as the early rise and early sleeping, intake protein enriched and nutritious meals, sufficient sleep, regular exercise, no skip of meals and timely intake of foods.
• It is also recommended that Mr B would be provided with proper knowledge of self-management, through which he will be independent in managing his health and wellbeing by devaluing healthy habits such as the timely taking of medicines, foods and regular health check-ups at home, do not expose to cold and avoid late-night office parties.

Conclusion:

From the overall discussion, it can be concluded that asthma is the health condition, in which patients have poor lung functions. This health condition is characterised by heavy cough, wheezing, chest tightness and breathing issues. Through carrying out the systematic process of health assessment it is possible to determine the current health needs of asthma patients which assists the health professionals to develop a relevant care plan in terms of promoting their health and wellbeing.

Take a deeper dive into Health Assessment for Edith: Integrating ECG, Respiratory with our additional resources.

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Appendix 1:

Lifestyle questionnaires for Mr B:

Name:…………… Mr B …………………………………. Date of Birth…………11/12/1971

Do you smoke: yes:[ ] No [ ]

If yes:

How many cigarettes per day?

Less than 1 cigarettes / day [ ]

1-9 cigarettes / day [ ]

10-20 cigarettes / day [ ]

20-39 cigarettes /day [ ]

40 cigarettes /day [ ]

Smoke pipe cigarettes /day [ ]

Smoke cigars cigarettes /day [ ]

If no:

Have you ever smoke Yes [ ] No [ ]

Give up smoking in last year [ ]

Having high blood pressure Yes [ ] No { ]

Having stroke ever Yes [ ] No { ]

Having genetic history of asthma or heart attack Yes [ ] No { ]

If yes:

Heart attack below the age 60 [ ]

Heart attack above the age 60 [ ]

Appendix 2:

Exercise:

Do you exercise:………………….. yes [ ] no [ ]

If yes:

What type of exercise you do:

Aerobic exercise [ ]

Yoga [ ]

Free hand [ ]

Cardio [ ]

Diet:

Eat meat, dairy products and fish [ ]

Eat only dairy products and meat [ ]

Eat both negatable and fish [ ]

Eat fruits [ ]

Mainly snacks and junk foods [ ]

Eat prescribed foods [ ]

Alcohol:

Never drink [ ]

Occasionally drink [ ]

Drink 1 unit/ day [ ]

Drink 2 unit/day [ ]

Drink 3 unit/day [ ]