Asthma

LOWER RESPIRATORY TRACT DISORDERS

TOPIC OUTLINE
(1) Definition
(2) Pathophysiology
(3) Signs & Symptoms
(4) Assessment
(5) Diagnostic Procedure
(6) Medical Management
(7) Nsg. Management

DEFINITION SIGNS & SYMPTOMS

Asthma is a condition that causes your
airways to narrow and swell, as well as
create excess mucus.

PATHOPHYSIOLOGY

ASSESSMENT
Inspection:
Fingers Cyanosis
 ↑AP diameter
Chest
 asymmetry of shape and movement
 RR, HR
 POSTURE
Work of  level of comfort, speaking full
breathing sentences, diaphoresis
 accessory muscle use, nasal flaring,
pursed lips
 tracheal tug
Palpation  symmetrically ↓ chest expansion
 ↓ tactile fremitus
 hyperresonance
Percussion
 ↓ diaphragmatic excursion
 listen to each lobe, compare L and R
 prolonged expiratory phase
Auscultation
 wheezing
 consolidation

 Determine presence of episodic symptoms of airflow

obstruction
 Obtain a positive family history
 Assess environmental factors, seasonal
changes, high pollen counts, mold, pet dander, climate
changes (cold air), air pollution, & occupation related
chemicals and compounds

DIAGNOSTIC PROCEDURE
1) Spirometry (inhale)
2) Peak flow meter (exhale)
Additional tests:
 Methacholine challenge
 Imaging tests

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Asthma
LOWER RESPIRATORY TRACT DISORDERS
 Allergy testing
 Nitric oxide test
 Sputum eosinophils
 Provocative testing
MEDICAL MANAGEMENT
Quick-relief (rescue) medications
Short-acting beta agonists
Anticholinergic agents
Oral & IV corticosteroids
Long-term asthma control medications
Inhaled corticosteroids
Leukotriene modifiers
Combination inhalers
Theophylline
Allergy medications
Allergy shots
Biologics
providers), outpatient follow-up care for patients, and
chronic management versus acute episodic care
ii. daily therapy as part of self-care management, with
input and guidance by his or her health care providers
Before a partnership can be established, the patient must
understand the following:
1. The nature of asthma as a chronic inflammatory disease
 albuterol 2. The definitions of inflammation and
bronchoconstriction
 levalbuterol
3. The purpose and action of each medication
 ipratropium
4. Triggers to avoid, and how to do so
 tiotropium 5. Proper inhalation technique
 prednisone
 methylprednisole
 fluticasone propionate
 budesonide
 ciclesonide
 beclomethasone
 mometasone
 fluticasone furoate
 montelukast
 zafirlukast
 zileuton
 fluticasone-salmeterol,
 budesonide-formoterol,
formoterol-mometasone
&
 fluticasone furoate-
vilanterol
Immunotherapy
 omalizumab,
 mepolizumab,
 dupilumab,
 reslizumab
 benralizumab

NSG MANAGEMENT
1. Assess history of allergic reactions to medications.
2. Monitor the patient’s vital signs and characteristics of
respirations at least every 4 hours. Assess breath sounds via
auscultation.
3. Administer fluids if the patient is
dehydrated.
4. Encourage coughing. Suction secretions as needed.
5. Elevate the head of the bed and assist the patient to assume
semi-Fowler’s position.
6. Administer the prescribed asthma medications (e.g.
bronchodilators, steroids, or combination inhalers /
nebulizers).

Promoting Home and Community-Based Care

a. Teaching Patients Self-Care
i. programs for asthma education (for patients and