TABLE OF CONTENTS

Part I 2
1.0 Introduction 2
2.0 Components of Respiratory Assessment 3
3.0 Health Education 5
4.0 Conclusion 8
REFERENCES 10
Part II 12
Part I
1.0 Introduction
Asthma is a chronic respiratory disease that occurs at any age, e.g., a 13-year-old boy of Thai
origin called AA presenting to the Emergency Room with symptoms of chest tightness,
dyspnoea and wheeze following basketball game. His recurrent asthma symptoms and history
of asthma suggest an acute asthma exacerbation, which is common among kids suffering
from this problem (Cevhertas et al., 2020). However, AA’s management of his asthma seems
poor because of the fact that he belongs to a family that prefers alternative medicine and his
low English proficiency, which might hamper proper health care provision. This illustrates
how cultural perspectives on asthma, issues with communication, and individualised asthma
care should be considered in paediatric patients.

Asthma is a common chronic disorder with reversible bronchoconstrictive bronchitis,

exacerbated bronchial reactivity and bronchiolitis. Shortness of breath, chest tightness, as
well as wheezing are some of the characteristic features that usually lead people to seek
emergence care for an asthma exacerbation (Boonpiyathad et al., 2019). His highest reading
was 180 on the peak flow meter. This reading is much less than his normal reading of 425
and confirms severe airflow obstruction. Additionally, he has a room oxygen percentage of
10%, which points to poor gaseous exchange leading to acute respiratory distress syndrome,
necessitating intervention to relieve his distress and increase his oxygenation.

Additionally, irregular AA’s use of Serevent inhaler, a long-acting beta-agonist that prevents
asthma attacks emphasizes the need for complete asthma patients’ and their families’
education. There are a number of barriers that may limit AA’s family from obeying the
normal medical treatment. These could include cultural beliefs, issues with language, and
worries that a common treatment is safe and effective (Asher et al., 2020). However, the
health-care providers need to apply culturally customized learning approaches that will
enable AA and his family to identify the best evidence based treatments and understand why
compliance is a necessity.

Henceforth, this write-up will focus on respiratory examination as it concerns the emergency
aspect of A&E for AA . Further, it will specify the essential health education that the nurse
should administer to AA and his family at the onset of treatment in order for them to gain the
relevant information and abilities to appropriately handle and also avoid subsequent flare-ups
of AA’s asthma (Sockrider & Fussner, 2020).

2.0 Components of Respiratory Assessment

In order to successfully manage such a young patient as AA with signs of an asthma attack, a
thorough respiratory evaluation must be undertaken. Other than diagnosing the exacerbation
and addressing it immediately, this appraisal also forms a basis for future surveillance. Such
an extensive and systematic assessment is required for AA, who had some history of asthma
and severe symptoms (Pate et al., 2021). Respiratory assessment for AA contains
examination of his airways, breathing and oxygenation while also a scrutiny of his medical
history and present complaints. Apart from that, an approach that is culturally sensible that
recognizes AA’s race plus his family believes has to be utilized as it helps in good
communication and treatment. The components of the respiratory assessment for AA are as
follows:

Medical History Assessment:

To begin with, I shall take a detailed medical history from AA and his family members. The
review of asthma history of A includes an evaluation of age at onset, exacerbation frequency,
disease severity, and admission history into hospitals and/or emergency departments.
Furthermore, one needs to ask on some known triggers that lead to AA’s asthma. These
include, exercise, allergens and smoking respectively. In addition, ask AA about his current
and previous prescriptions he may be on. Inquire as well if the mother tried some alternative
therapies that might also help AA . The understanding of family cultural believes and beliefs
about health and illness can assist in understanding how the family is going to handle AA’s
asthma and allow for development of an appropriate plan of care (Wang et al., 2020).

Symptom Assessment:
Assessment AA’s presenting symptoms will help in determining how severe this asthma
exacerbation is. A detailed assessment is conducted in regard to his current symptoms at
present (chest tightness, shortness of breath, and wheezing) besides other accompanying
signs like coughing, producing sputum, and respiratory distress (Agache et al., 2021). These
characteristics include measuring the severity, extent (in terms of days) and number of times
(frequency) of these symptoms as they help determine the progression of the exacerbation
and what sort of intervention should be offered. Also, evaluating any new alterations of AA’s
symptoms as well as establishing possible triggers or exposure sites would help prevent
relapses.

Physical Examination:
Therefore, conducting a thorough physical exam will be critical for determining AA’s
respiratory condition and if any signs of respiratory distress or complications are present. He
will also record the respiratory rate, depth, and effort, observes accessory muscle use, and
look for respiratory fatigue. Auscultation of AA’s lung fields enables detection of any
abnormal respiratory sounds like wheezes, crackles, or diminished breath sounds, signifying
the extent and severity of airway obstruction or inflammation (Choi et al., 2020). Moreover,
taking AA’s heart rate, blood pressure and temperature helps towards determining whether
any systemic complications or comorbidities may be involved and possibly worsen/be
worsening his respiratory condition.

Oxygenation Assessment:
Therefore, monitoring AA’s oxigenation status will be important in evaluating the magnitude
of his asthma aggravation and provision of oxygen therapy. Pulse oxymetry is a measure that
determines the level of hypoxemia he has at any instance by examining his oxygen saturation
(Wechsler et al., 2021). The pulse oximeter value of AA’s at 90% on room air also reflects
inefficient movement of gases, making this an emergency as he needs immediate
interventions to enhance his oxygenation. Also, looking at AA’s skin colour and peripheral
perfusion gives an insight into the tissue’s perfusion state and whether adequate oxygen is
supplied to the tissues.

Peak Flow Measurement:

Peak flow monitoring during daily living is an essential part of taking care of AA. The
readings from these measurements tell us how well his lungs are working and to what extent
there might be blocked airways or breathlessness. Comparing AA’s peak flow meter reading
of 180 with his normal value of 425 which shows a marked decline and emphasizes how
severe the present exacerbation is (Menzies-Gow et al., 2021). Adding daily peak flow
readings to AA’s asthma action plan ensures monitoring and timely actions by evaluating the
severity of his breathing problem daily.
Allergy and Environmental Assessment:
It is important to identify potential allergens and environmental triggers because these are
some of the factors, which contribute to AA’s asthma exacerbations. Allergy screening plays
a key role in identifying specific triggers for AA and aggravating its lung symptoms. Finally,
looking at the in-home exposures that might trigger asthma attack like dust mites, pet dander
and mold may assist with recommendation on environmental adjustments as well as the way
of avoiding the allergens that may result in future occurrence of the condition in AA (Carli et
al., 2020).

Cultural and Language Considerations:

The cultural beliefs and value system of AA’s family needs to be considered because they
had limited level of mastery of English and preferred other therapy techniques to Western
Medicine. However, AA’s asthma management might be improved by adopting a culturally
competent approach that values and incorporates the families’ cultures and beliefs in their
communication (Grant et al., 2021). It is important to communicate with AA using a medical
interpreter or a bicultural doctor.

Conclusively, a complete respiratory assessment plan for AA should include medical history
in depth, assessment of symptoms, complete physical exam, oxygenation analysis, peak flow
measurements, allergy and environmental investigation, and thoughts about culture and
linguistic needs (Reddel et al., 2021). Adding these aspects in AA’s care strategy can assist in
proper management and therapy of his acute asthma, improve respiration outcomes and
encourage family-centered approach to asthma care, which will be consistent with the
family’s beliefs and desires.

3.0 Health Education

Management of asthma should be comprehensive so as to facilitate control and prevent
exacerbations. It is important that AA and his family members are educated in an
individualized manner so that they can be equipped with the information and expertise
needed for managing his asthma and optimizing respiratory health. In light of the fact that
they are low in English proficiency and past use of alternatives therapies, there should be
clear, culturally appropriate health information which address their issue and concern (Choi
et al., 2020). The following educational interventions can be implemented at the time of AA's
treatment initiation:
Understanding Asthma Pathophysiology:
It is necessary to educate AA and his family on the simple pathophysiology of asthma to
promote their understanding in relation to the condition. They will understand that asthma is
a chronic inflammatory disorder of the airways characterized by bronchial
hyperresponsiveness and reversible airflow obstruction that results in AA’s symptoms
(Menzies-Gow et al., 2021). Using straightforward layman’s terms that are easily
comprehensible by a patient like AA, the nurse can elaborate on how some triggers such as
allergens, exercises, and respiratory infections cause airway inflammation and
bronchoconstriction culminating in the symptoms associated with

Asthma Triggers and Prevention Strategies:

The sharing of common asthma triggers (allergens, air pollution, tobacco smoke, and
respiratory infection), allow AA & family to identify possible exacerbations & institute
preventative measure. It assists in reducing AA’s exposure to known triggers. For instance,
using allergen-proof covers on mattresses and pillows, regular house cleaning aimed at
eliminating dust mites, and restriction of pet ownership are among the practical guidelines
(Menzies-Gow et al., 2021). It is also essential to stress the need for smoke-free surroundings
as well as hand washing to avoid any more respiratory infections which could lead to an
increase in the severity of asthmatic symptoms in the future.

Proper Inhaler Technique and Medication Adherence:

Proper demonstration and reinforcement of correct inhaler technique are crucial towards
ensuring AA reaps maximum benefit from the medication prescribed for astma. The
provision of hands on training on correct inhaler usage as directed by AA’s manual such as
hand lung coordination and breath hold technique improves medication delivery to AA’s
airways (Cevhertas et al., 2020). The significance of following the ordered medical plan
consisting of an airway rescue agent and a controller drug can highlight to AA and his family
for the purposeful function each medication contributes towards controlling the symptoms
and avoiding episodes. In addition, talking about the possible adverse effects of drugs and the
need for frequent checkups will dispel doubts and foster compliance with the treatment plan.

Development of an Asthma Action Plan:

It helps AA and his family to work together in developing asthma action plan for him and to
actively participate toward his condition management while giving them a clue about his
worsen symptom (Carli et al., 2020). Providing information on the action plan’s elements,
such as personalized top flow zones, symptom surveillance, and appropriate drug dosage
adjustment according to the degree of severity of symptomatology, allows AA and his family
to know how to react to changes. Giving written guidelines in their mother tongue and with
the aid of pictures enhances comprehension and offers guidance to them on ways to use in
asthma attacks or crises.

Emergency Preparedness and Recognition of Red Flags:

Early signs and symptoms of an upcoming asthma attack must be told to AA and his family
so that immediate action can be taken, which will in turn lead to avoidance of respiratory
complications. They point out the warning signs like recurring aches, high-pitched noise in
their throat, and low flow rate of air exhaled (Pate et al., 2021). Explaining to them what
needs to be done in case of an asthmatic emergency like inhalation of a rescue inhaler or
obtaining the help of a caregiver and calling for assistance from the nearest emergency
service.

Communication Strategies and Support Resources:

Informing AA’s family of support resources like asthma support groups and online education
material related to asthma, as well as community health services, would enable them to obtain
extra guidance and aid in management of asthma for AA. This facilitates open
communications channels among the health care team, AA, and his family, which makes for
a collective approach to care, and it enables them to raise any questions or concerns they
might have about his asthma treatment (Pate et al., 2021). Providing interpreter services as
well as bilingual health professionals can increase their understanding of the information, so
that they understand it clearly and actively involved in the treatment of their loved one.

Lastly, providing a thorough and culturally tailored educational experience about asthma for
AA and all his family members should be done as AA initiates treatment in order to enlighten
them about proper asthma management which is aimed at facilitating their active
participation in AA’s care (Grant et al., 2021). Through giving specialized training on the
pathophysiology of asthma, triggers and control measures, correct use of inhalers, dosage
taking adherence, development of a personalized management strategy, preparation for
emergency response, appropriate communication approach towards the family members by
the nurse, It can be possible to use a cooperative and linguistically responsive approach
accounting for asthmatic’s culture orientations when informing on appropriate measures of
the disease control.

4.0 Conclusion
Conclusively, the case of AA, a 13-year old Thai descendent presenting an acute asthma
attack is emphasizing the need for holistic and culture sensitized approach in evaluation and
health education concerning respiratory issues. However, asthma management for AA
patients and their families is critical as it requires an understanding of the different processes,
triggers, and appropriate interventions.

For AA, the respiratory assessment includes medical history, symptoms, physical exam,
oxygen saturation, peak-flow assessments, allergen exposure, and environmental triggers.
Moreover, recognizing the family’s cultural and linguistic preferences in the assessment
process improves communication between healthcare provider and AA on asthma
management strategy.

There are five major elements that make up the health education interventions provided to
AA and his family. Through equipping AA and his family with the needed information and
capabilities to control his asthma, healthcare professionals enable participation in his
treatment and pre-emptive measures to minimize chances of further attacks.

Furthermore, it becomes essential to tackle language barriers and incorporate cultural aspects
in the healthcare interventions so as to enable open communication thereby creating a
healthcare setting which is amenable to the familial preferences and norms. Healthcare
providers should acknowledge and appreciate family’s culture so that they may gain trust
with the family for increased participation of AA in AA’s Asthma management program thus
improvement treatment adherence and health outcomes.

Finally, the holistic respiratory assessment and health education for the AA and his family
illustrate how care should be provided taking into account each patient’s and family’s
peculiarities. The health care providers should strive for better communication while offering
comprehensive education which will foster an integrated partnership among the healthcare
team and the family for AA’s asthma management and total wellness.

The integrating of culturally sensitive practice along with patient centered care model will be
useful in improving the quality care, as well as helping the children suffering from asthma
cope with their condition positively.
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Part II
The first among the many challenges could be involving complexities associated with
catering for a pediatrics patient suffering from asthma in terms of culture, language, as well
as other basic needs. Successful communication among the health care team, the patient, and
their family determines the success of care delivery. However, with communication barriers,
giving correct information can be hard and one may misinterpret information provided or
have problems executing proposed treatment plans.

Navigation of cultural barriers related to health belief system is also challenging when it
comes to matching treatment suggestions with parents’ choices and attitudes. Such incidents
must be taken seriously because having a culturally sensitive approach to them can help
establish rapport and facilitate care processes.

Besides, dealing with this inadequate compliance to evidence based treatment as evidenced
by AA’s situation after his family adopted uncontrollable alternative therapies is also not a
walk in the park. It is important to consider the balanced integration of alternative methods
together with conventional medical management, such that it is safe and effective and
communicate with the family accordingly.

The incident with AA demonstrates that in cases of a patient’s asthma worsening as the result
of physical exercise, it is essential to stress proper asthma therapy during sports activities.
Enlightening the patient and his family on preventive actions that include sufficient warm-up
and proper medication intake before engaging in exercises will play a crucial role in reducing
the chances of occurrence of EIAE.

Further, on a wider perspective, caring for patients suffering chronic respiratory diseases such
as asthmatic attacks can also be emotional draining to healthcare providers. Healthcare
providers could experience difficulties witnessing the hardships and suffering the patents as
young individuals such as AA would go through because of their airway diseases.
In the end, combating with these challenges demands a patient-oriented approach which puts
forward good communication skills, cultural awareness, and jointly made determination.
Healthcare professionals should create an understanding and supportive health care
environment so that they have the potential for improving treatment adherence rates and
health outcomes among patients such as AA and family members.