ASTHMA

Asthma is a condition in which your airways narrow and swell and produce

extra mucus. This can make breathing difficult and trigger coughing, wheezing and

shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major

problem that interferes with daily activities and may lead to a life-threatening asthma

attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma

often changes over time, it's important that you work with your doctor to track your

signs and symptoms and adjust treatment as needed.

 It isn't clear why some people get asthma and others don't, but it's probably

due to a combination of environmental and genetic (inherited) factors.

Exposure to various irritants and substances that trigger allergies (allergens)

can trigger signs and symptoms of asthma. Asthma triggers are different from person

to person and can include:

 Airborne substances, such as pollen, dust mites, mold spores, pet dander or

particles of cockroach waste

 Respiratory infections, such as the common cold

 Physical activity (exercise-induced asthma)

 Cold air

 Air pollutants and irritants, such as smoke

 Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin

IB, others) and naproxen (Aleve)

 Strong emotions and stress

 Sulfites and preservatives added to some types of foods and beverages,

including shrimp, dried fruit, processed potatoes, beer and wine

 Gastroesophageal reflux disease (GERD), a condition in which stomach acids

back up into your throat.

Signs and Symptoms

Asthma symptoms vary from person to person. You may have infrequent

asthma attacks, have symptoms only at certain times — such as when exercising —

or have symptoms all the time.

Asthma signs and symptoms include:

 Shortness of breath

 Chest tightness or pain

 Trouble sleeping caused by shortness of breath, coughing or wheezing

 A whistling or wheezing sound when exhaling (wheezing is a common sign of

asthma in children)
 Coughing or wheezing attacks that are worsened by a respiratory virus, such

as a cold or the flu

Signs that your asthma is probably worsening include:

 Asthma signs and symptoms that are more frequent and bothersome

 Increasing difficulty breathing (measurable with a peak flow meter, a device

used to check how well your lungs are working)

 The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

 Exercise-induced asthma, which may be worse when the air is cold and dry

 Occupational asthma, triggered by workplace irritants such as chemical

fumes, gases or dust

 Allergy-induced asthma, triggered by airborne substances, such as pollen,

mold spores, cockroach waste or particles of skin and dried saliva shed by pets

(pet dander)

Medical Management
Immediate intervention may be necessary, because continuing and progressive

dyspnea leads to increased anxiety, aggravating the situation.

Pharmacologic Therapy

 Short-acting beta2 –adrenergic agonists. These are the medications of

choice for relief of acute symptoms and prevention of exercise-induced

asthma.
  Anticholinergics. Anticholinergics inhibit muscarinic cholinergic receptors

and reduce intrinsic vagal tone of the airway.

 Corticosteroids. Corticosteroids are most effective in alleviating

symptoms, improving airway function, and decreasing peak flow variability.

 Leukotriene modifiers. Anti Leukotrienes are potent bronchoconstrictors

that also dilate blood vessels and alter permeability.

 Immunomodulators. Prevent binding of IgE to the high affinity receptors

of basophils and mast cells.

Peak Flow Monitoring

 Peak flow meters. Peak flow meters measure the highest airflow during a

forced expiration.

 Daily peak flow monitoring. This is recommended for patients who meet

one or more of the following criteria: have moderate or severe persistent

asthma, have poor perception of changes in airflow or worsening

symptoms, have unexplained response to environmental or occupational

exposures, or at the discretion of the clinician or patient.

  Function. If peak flow monitoring is used, it helps measure asthma

severity and, when added to symptom monitoring, indicates the current

degree of asthma control.

Nursing Management

Assessment of a patient with asthma includes the following:

 Assess the patient’s respiratory status by monitoring the severity of the

symptoms.
 Assess for breath sounds.
 Assess the patient’s peak flow.
 Assess the level of oxygen saturation through the pulse oximeter.
 Monitor the patient’s vital signs.

Referrences:

https://nurseslabs.com/asthma/#Nursing-Management

https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-

20369653