KC7 Scenario 7. Include Matching citations and references. APA style paragraphs. Scenario: A 12-year-old girl is brought to the emergency room (ER) by her mother with a complaint of shortness of breath, wheezing, tachypnea, tachycardia, and a nonproductive cough. The mother states they had just come from a fall festival, where the entire family enjoyed a hale ride. They also participated in the corn maze challenge. The symptoms began shortly after they left the festival , but got better a couple of hours after they returned home. The symptoms began again about six hours later and seemed to be worse. The mother states there is no history of allergies or frequent respiratory infections. The child is up to date on all vaccinations. The child was diagnosed with asthma. The nurse practitioner explained to the mother that her child was exhibiting symptoms of asthma, and probably had an early asthmatic response and a late asthmatic response. Question1 of 2. Explain early asthmatic responses and the cells responsible for the responses, then relate it to the scenario Question 2 of 2.

Question 1:
The early asthmatic response is the initial phase of an asthma attack that occurs within minutes after exposure to a trigger. During this phase, there is a release of inflammatory mediators, such as histamine, leukotrienes, and prostaglandins, from various cells in the airways (Busse, 2018). These mediators cause airway constriction, increased mucus production, and recruitment of immune cells to the airways. In the scenario described, the 12-year-old girl experienced symptoms of shortness of breath, wheezing, tachypnea, tachycardia, and a nonproductive cough shortly after leaving the fall festival, which is consistent with the early asthmatic response.

One of the major cell types responsible for the early asthmatic response is the mast cell. Mast cells are found in abundance in the lungs and airways and play a crucial role in allergic reactions and asthma. When exposed to an allergen or trigger, mast cells release histamine, which causes smooth muscle contraction in the airways and leads to bronchoconstriction. Mast cells also release other mediators, such as leukotrienes and prostaglandins, which further contribute to airway inflammation and constriction (Busse, 2018). In this scenario, it is likely that the 12-year-old girl was exposed to an allergen, possibly present in the fall festival environment, which triggered the release of these inflammatory mediators from mast cells, resulting in the early asthmatic response.

In addition to mast cells, other immune cells, such as eosinophils and T-helper 2 (Th2) cells, also contribute to the early asthmatic response. Eosinophils are white blood cells that are involved in allergic responses and are attracted to the airways following mast cell activation. Once in the airways, eosinophils release toxic proteins that cause further inflammation and damage to the airway tissues (Pelaia et al., 2012). Th2 cells, a subset of T cells, play a crucial role in allergic reactions and asthma. They release cytokines, such as interleukin-4 (IL-4) and interleukin-13 (IL-13), which stimulate mast cells, eosinophils, and other immune cells to promote airway inflammation and bronchoconstriction (Busse, 2018). These immune cells and the inflammatory mediators they release collectively contribute to the early asthmatic response seen in individuals with asthma.

Question 2:
In the scenario described, the nurse practitioner explained to the mother that her child was exhibiting symptoms of asthma and likely had an early asthmatic response and a late asthmatic response. The late asthmatic response is the second phase of an asthma attack that usually occurs several hours after the initial early asthmatic response. It is characterized by prolonged airway obstruction and inflammation (Holgate, 2012).

During the late asthmatic response, there is an infiltration of inflammatory cells into the airways, particularly eosinophils and Th2 cells. These immune cells amplify the inflammatory response initiated during the early asthmatic response, leading to persistent bronchoconstriction, airway hyperresponsiveness, and increased mucus production (Busse, 2018). The late asthmatic response is often associated with more severe symptoms and can persist for several days.

In this scenario, the 12-year-old girl experienced a temporary relief of symptoms after leaving the fall festival, but the symptoms recurred later and seemed to be worse. This could be attributed to the late asthmatic response, where the inflammatory process was ongoing and became more pronounced over time. The symptoms of wheezing, tachypnea, and tachycardia are indicative of persistent airway obstruction and inflammation, which are characteristic of the late asthmatic response.

In summary, the early asthmatic response is the initial phase of an asthma attack, characterized by the release of inflammatory mediators from mast cells, eosinophils, and Th2 cells. These mediators cause airway constriction and inflammation. The late asthmatic response is the second phase of an asthma attack, characterized by prolonged airway obstruction and inflammation. In the scenario described, the 12-year-old girl exhibited symptoms consistent with both the early and late asthmatic responses.