MEDICAL SURGICAL

Diagnostic Tests for Asthma

Physical exam:

 Checks nose, throat and upper airways

 Auscultate lungs
 Skin check

The physician would also ask you the following:

- Upon auscultating your lungs, if there is positive wheezing

- If you r coughing
- If you are experiencing breathing problems and chest tightness

Lung Function tests: ways to check how well your lungs are working. Doctors use them to diagnose
asthma and to monitor its progression. Monitoring asthma with lung function tests is helpful,
because you may not always be able to tell just from your symptoms whether your asthma is under
control.

 Spirometry: a is the most common. It's a simple, quick, and painless way to check your lungs and
airways. You take a deep breath and exhale into a hose attached to a device called a spirometer.
It records how much air you blow out (called forced vital capacity or FVC) and how quickly you
do it (called forced expiratory volume or FEV). Your score is lower if your airways are swollen or
constricted because of asthma or other lung diseases. Your doctor may want you to have several
spirometry lung function tests to monitor your asthma over time. You might have spirometry
before and after you take medication to see if the medication helps. Your doctor may also want
readings taken during exercise to see how your airways react to exercise
 Peak Flow meter tests: measures how well your lungs push out air. Although they are less
accurate than spirometry, these lung function tests can be a good way to regularly test your lung
function at home -- even before you feel any symptoms. A peak flow meter can help you know
what makes your asthma worse, whether treatment is working, and when you need to seek
emergency care. The peak flow meter is a handheld plastic tube with a mouthpiece on one end,
which you breathe into. Your doctor might ask you to use the peak flow meter each day and
write down the readings. After a couple of weeks, you report the results to your doctor.
 Challenge test: lung function tests used to help confirm a diagnosis of asthma. You inhale a small
amount of a substance known to trigger symptoms in people with asthma, such as histamine or
methacholine. After inhaling the substance, someone tests your lung function. Because
challenge tests can trigger an asthma attack, you should have them done only by someone with
experience.
 Exhaled nitric oxide test: measures the amount of nitric oxide in your breath. You’ll breathe into
a tube connected to a machine that measures the amount of nitric oxide in your breath. Your
body makes this gas normally, but levels could be high if your airways are inflamed.

 Gas and diffusion test: measures how well your blood absorbs oxygen and other gases from the
air you breathe. You breathe in a small amount of a gas, hold your breath, then blow out. The
gas you exhale is analyzed to see how much your blood has absorbed.

 X-rays: may tell if there are any problems with your lungs or if asthma is causing your symptoms.
High-energy radiation creates a picture of your lungs. You may be asked to briefly hold your
breath while you stand in front of the X-ray machine.

Reference: DerSarkissan, C. (2021) Asthma Diagnosis and Test. Retrieved from

https://www.webmd.com/asthma/diagnosing-asthma-tests

ASTHMA TREATAMENT
Fast-acting rescue medication, long-term treatments:

 Rescue inhalers ( quick-relief inhalers): relaxes muscles that tighten around your airways.

 Short-acting beta-agonists: includes: albuterol, epinephrine, and levalbuterol

 Anticholinergics: lessen mucus in addition to opening your airways. Longer to work than S-A B-A

 Oral corticosteroids: lower swelling in airways

  Combination quick-relief medicines: has both an anticholinergic and a short-acting beta-agonists

Preventive long-term medications: treats and prevent asthma attacks. Reduces the swelling and mucus
in airways so they’re less sensitive and less likely to react to asthma triggers.

 Inhaled corticosteroids: most effective long-term control medicines. These aren’t the same as
anabolic steroids that people use to grow muscle. They include beclomethasone (Qvar
RediHaler), budesonide (Pulmicort Flexhaler), ciclesonide (Alvesco), fluticasone (Flovent HFA),
and mometasone (Asmanex Twisthaler).

 inhaled long-acting beta-agonists: opens airway by relaxing the smooth muscle around them.
You’ll take this medication along with an inhaled corticosteroid. They include formoterol,
salmeterol, and vilanterol.

 Combination inhaled medicines: have an inhaled corticosteroid along with a long-acting beta-
agonist. This is an easy way to take them together. They include Advair, Breo, Dulera, and
Symbicort.

 Biologics: target a cell or protein in the body to prevent airways inflammation. They may be
shots or infusions you get every few weeks. They can be expensive, so you usually get them if
other medications don’t work. Biologics include benralizumab (Fasenra), dupilumab (Dupixent),
mepolizumab (Nucala), omalizumab (Xolair), and reslizumab (Cinqair).

 Leukotriene modifiers: relax smooth muscles around your airways and ease swelling. You can
take them as pills or liquids. These include montelukast (Singular), zafirlukast (Accolate), and
zileuton (Zyflo).

 Cromolyn: prevents your airways from swelling when they come into contact with an asthma
trigger. It’s a non-steroid medicine that comes in an inhaler.

 Theophylline: relaxes smooth muscles that narrows your airways. It comes as a tablet, capsule,
solution, or syrup.

 Long-acting bronchodilators:
  Corticosteroids: are a form of steroids used to treat swelling and inflammation from allergies, as
well as allergic asthma. Corticosteroids are different from the male hormone-related steroid
compounds that some athletes abuse.
 Asthma nebulizer: most common. This machine changes asthma medications from a liquid to a
mist so it’s easier to get the medicine into your lungs. It also has a mouthpiece or mask that
makes it a good option for infants, small children, older adults, or anyone who has trouble using
inhalers with spacers. It takes a few more minutes to use than an inhaler.

 Mast cell stabilizer: curb the release of chemicals that causes inflammation.

 Immunomodulator: injection given if you have moderate to sever asthma related to allergies or
other inflammation caused by the immune system that doesn’t respond to certain drugs.

Home remedies:

- Breathing exercise: can lower the amount of medication you need to control your symptoms
- Herbal and natural remedies: includes: black seed oil, caffeine. Choline, pycongenol

References: DerSarkissian, C. (2021) Asthma Medications. Retrieved from

https://www.webmd.com/asthma/asthma-medications

Nursing interventions:

- Assess medical history of the patient

- Assess respiratory status
- Assess medications
- Pharmacologic therapy
- Fluid therapy
- Encourage deep coughing/breathing
- Educate client on the different factors that can trigger that can cause asthma attacks
- Position the client’s chest semi-Fowler position
-

Reference: Belleza, M (2021) Asthma. Retrieved from

https://nurseslabs.com/asthma/#nursing_interventions