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Asthma: Prepared by Fatima Hirzallah RN, MSN, CNS, PHD

Asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of wheezing, chest tightness, coughing and shortness of breath. The inflammation causes narrowing of the airways and increased mucus production. Symptoms are usually reversible either spontaneously or with treatment. Allergies are a major risk factor for developing asthma. Current treatment focuses on reducing airway inflammation through medications like inhaled corticosteroids and bronchodilators. Nursing care involves monitoring for worsening symptoms, administering medications, educating patients on self-management, and preventing exacerbations. Status asthmaticus refers to a severe, persistent attack that does not respond to usual treatment and requires close monitoring and supportive care.

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95 views21 pages

Asthma: Prepared by Fatima Hirzallah RN, MSN, CNS, PHD

Asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of wheezing, chest tightness, coughing and shortness of breath. The inflammation causes narrowing of the airways and increased mucus production. Symptoms are usually reversible either spontaneously or with treatment. Allergies are a major risk factor for developing asthma. Current treatment focuses on reducing airway inflammation through medications like inhaled corticosteroids and bronchodilators. Nursing care involves monitoring for worsening symptoms, administering medications, educating patients on self-management, and preventing exacerbations. Status asthmaticus refers to a severe, persistent attack that does not respond to usual treatment and requires close monitoring and supportive care.

Uploaded by

ناصر دويكات
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Asthma

Prepared by
Fatima Hirzallah RN,MSN,CNS, PhD
Asthma
As a chronic inflammatory disease of the airway
that causes airway hyperresponsiveness,
mucosal odema, & mucus production. The
inflammation lead to recurrent episodes of
asthma symptoms: cough, chest tightness,
wheezing, & dyspnea.

Asthma differs from other obstructive lung


disease in that its largely reversabile, either
spontaneous or with treatment. Pt may
experience symptoms-free period, which last
from minutes to hr or day.

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 Asthma can occur at any age and it most common
chronic disease of child hood.

 Allergy is the strongest predisposing factor for asthma.


Chronic exposure to airway irritants or allergens also
increases the risk for developing asthma. Condition of
the pt will change depending upon the environment,
activities, management practices & other

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Pathophysiology
The underlying pathology of asthma is
reversible and diffuses air way inflammation.

The inflammation leads to obstruction from the


swelling of membranes that line the airways
(mucosal odema), reducing the airway diameter
(brochospasm), causing further narrowing &
increase mucous production, which diminishes
airway size and may entirely plug the bronchi.

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The bronchial muscles & mucous gland enlarge:
thick, tenacious sputum is produced, and the
alveoli hyperinflate.

Cellthat play a key role in the inflammation to


asthma are mast cells,neutrophils, eosinophils,
& lymphocytosis.

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Mast cells when activated , released several
chemicals called mediators (its include histamine,
bradykinin, prostaglandin, & leukotrienes) causing:
Increased blood flow, vasoconstriction,
Fluid leak from vasculature,
Attraction of WBC to the area, &bronchoconstriction.

Regulation of these chemicals is the aim of current


research for treating asthma.

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S&S
Wheezing, (the sound of airflow through
narrowed airway).
 Cough, with or without mucous membrane.
Dyspnea.
 Chest tightness.

Expiration requires effort & become prolonged,


as the exacerbation progress,; diaphoresis,
tachycardia, widened pulse pressure may occur.

Hypoxemia is secondary to a ventilation


perfusion mismatch & readily responds to O2.
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Assessment and diagnostic finding
A complete family, environmental, &
occupational history.

A positive family history & environmental


factors, including seasonal changes, air
pollution…

Asthma is associated with occupational related


chemicals & compound as wood, metal, and
medication (aspirin, antibiotic…).

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Comorbid conditions that may accompany
asthma as eczema ,may elevated if allergy is
present.

ABGS; hypocapnea, respiratory alkalosis

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Prevention
Ptshould undergo tests to identify the
substances that precipitate the symptoms.

Pt instructed to avoid the causative agent


whenever possible. Possible causes are dust,
certain types of cloth, pets, horses, detergents,
soaps, certain foods.

Knowledge is the key to quality asthma care.

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:Complication

 Status asthmatics, respiratory failure, atelactasis

 Airway obstruction, particularly during acute


asthmatic episodes.

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Medical Management
Immediate intervention is necessary, because the
continuing & progressive dyspnea leads to
increased anxiety, aggravating the situation.

Pharmacological therapy: long acting control


medication.
◦ Corticosteroids are the most potent and
effective anti inflammatory medications. They
are effective in alleviating symptoms,
improving airway function.

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Long acting beta 2 adrenergic agonists are used
with anti inflammatory medication to control
asthma.

Theophilin are mild to moderate brochodilators


usually used in addition to inhaled
corticosteroid.

Leukotriene modifiers (inhibitor) or


antileukotrienes are new class of medication.
Dilate vessels & inhibit act by interfering with
leuktreine synthesis or blocking the receptor
where leukotreine exert their action.
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Short acting beta-adrenergic agonists are drug of
choice to relieve symptoms. They have rapid
onset of action.

Anticholinergic may bring added benefit in


sever exacerbations, but they are used more
frequently in COPD.

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NSG Management
The immediate nursing care of pt with asthma
depends on severity of the symptoms.

Family & pt frightened of dyspnea, the important


aspect of the nurse is a calm approach.

Nurse must assesses the pt respiratory status by


monitoring severity of symptoms, breath sound,
pulse oximetry, & VS.

Nurseobtains a history of allergic reaction to


medication, current use of medications before
administered the medication. Fluid may be required.

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 Promoting home & community-based care: teaching pt
self-care establishment of programs for asthma education,

. Multiple inhaler, different type, antiallergy therapy,


antireflex medication.

 The pt needs to understand the following:


 Nature of asthma, def. of inflammation, proper inhalation,
how to perform peak flow monitor, and when a seek
assistance.
.

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Status Asthmaticus .E
 Is serve and persistent asthma that doesn’t respond to
conventional therapy. The attacks can last longer than 24
hr.

 Infection,anxiety, nebulizer abuse, dehydration,


increased adrenergic blockage, and nonspecific irritants
may contribute to these episodes.

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S&S
The same as those with sever asthma: labored
breathing, prolonged exhalation, engorged neck
veins, & wheezing.

As the obstruction worsens the wheezing may


disappear, & this sign of respiratory failure.

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Assessment and diagnostic finding
Pulmonary function study.

ABGS if pt cannot perform pulmonary function


test..

Respiratory alkalosis is most common finding in


pt with asthma

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NSG Management
Nurse constantly monitors the pt for the first 12-
24 hr.

Assess dehydration, increase fluid intake to


loosen secretions, & facilitate expectoration.

Administer IV 3-4L per day.

Pt energy should be conserved, & room should


be quite and free of respiratory irritant.

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