CALAMBA DOCTORS' COLLEGE

Virborough Subdivision Brgy. Parian Calamba, Laguna

Bachelor of Science in Nursing

Case Presentation

BRONCHIAL ASTHMA
Maningas, Janina Mae
BSN2 – C G3
A. Current Trends

 It is recurring inflammatory disorder in the airways of breathing,

which undergoes variable expiratory flow and reversible broncho
constrictions, usually caused by trigger factors, that is different for
every patient. In an asthma attack, the lining of the airway swells,
and the muscles around the airways tense up. This condition limits
the flow of air through the lungs and leads to abnormal breathing.
Asthma is mostly genetic but can be triggered by a lot of factors—
genes, stress, strong emotions, change of temperature,
environment, dust, pollen, molds, chemicals in the air or in food,
tobacco smoke, exercise, animals and viral infections.

B. Demographics

 Patient Name: XYZ

 Age/Sex: 3 years old/Male
 Weight: 23
 Height: 102
 Date Admitted: March 10, 2024
 Address: Calamba, Laguna

C. History of Present Illness

 Chief Concern: Cough, DOB, Vomit

 PTA (+) Cough; (+) DOB
 Pertinent s/sx to cough and dyspnea
 HR: 169; RR: 61; T: 37.5 O2 Sat: 91%
 HEENT: Dry Mucus membrane
 Chest/Lungs: Wheezes, Rales/Crackles/Rhonchi

D. Past Medical History

  Dengue Fever, Pneumonia (2023)
 Father is smoking

E. Anatomy and Physiology

 F. Pathophysiology

Trigger Factor

Airways become
Contracted and Narrowed

Secrete more Mucus Muscle Tightens Swelling of Mucosal Lining

DOB, Decreased O2

G. Management

 You can take asthma medicines in several different ways. You may breathe in the
medicines using a metered-dose inhaler, nebulizer or another type of asthma inhaler.
Your healthcare provider may prescribe oral medications that you swallow.
 Bronchodilators: These medicines relax the muscles around your airways. The
relaxed muscles let the airways move air. They also let mucus move more easily
through the airways. These medicines relieve your symptoms when they happen
and are used for intermittent and chronic asthma.
 Anti-inflammatory medicines: These medicines reduce swelling and mucus
production in your airways. They make it easier for air to enter and exit your
lungs. Your healthcare provider may prescribe them to take every day to control
or prevent your symptoms of chronic asthma.
 Biologic therapies for asthma: These are used for severe asthma when symptoms
persist despite proper inhaler therapy.

H. Medications

Drug Name Drug Class Uses Side Effects Nursing

Consideration
Generic Bronchodilators Used to - Increase - Teaching the
Name: prevent and heart rate patient the
Albuterol treat - Palpitations proper
wheezing and - Insomia technique
Brand shortness of - Dizziness ensures that
Name: breath caused - Allergic they receive
Ventolin, by breathing Reaction the full dose of
Proventil, problems - Chest Pain albuterol,
ProAir and maximizing its
AccuNeb effectiveness
in relieving
bronchospasm.

Generic Adrenergic Used to - Chest Pain - Monitor

Name: Bronchodilators prevent or - Headache respiratory
Levalbuterol relieve the - Vomiting rate, oxygen
wheezing, - Muscle saturation, and
Brand shortness of Pain lungs sounds
Name: breath, - Dizziness before and
Xoponex coughing, and - Drowsiness after
chest administration.
tightness If more than
caused by one inhalation
lung disease is ordered,
such as wait at least 2
asthma and minutes
chronic between
obstructive inhalations.
pulmonary Use a spacer
disease device to
improve drug
delivery, if
appropriate.

Generic Corticosteroid Help to - Blurred - Take this

Name: suppress the Vision medicine with
Orapred, immune - Irritability food or milk to
Pediapred, system - Abdominal avoid stomach
and Prelone Pain irritation.
- Swelling
Brand - Appetite
Name: Changes
Deltasone - Dizziness

I. Surgery
-
 J. Nursing Care Plan

ASSESSTMENT NSG DX PLANNING INTERVENTIONS EVALUATION

SUBJECTIVE: - Position the client After 1hour of

Impaired
After 1hour of with the head of the nursing
Gas
 (+) Cough Exchange
nursing intervention bed elevated, in a intervention the
 (+) Dyspnea the client will able semi-Fowler’s patient was able to
related to
to demonstrate position (head of the demonstrate proper
airway
OBJECTIVE: proper coughing. bed at 45 degrees coughing.
obstruction
when supine) as
tolerated.
 Restlessness
 Chest/Lungs: - Encourage frequent
Wheezes, position changes
Rales/Crackle and deep-breathing
s/Rhonchi and coughing
exercises. This
 SOB/DOB promotes optimal
 Hypoxemia chest expansion,
- O2: 91% mobilization of
secretions and
oxygen diffusion.

- Maintain adequate
fluid intake at least
2-4cups a day for
mobilization of
secretions.

- Encourage adequate
rest, and limit
activities. This helps
limit oxygen needs
and consumption.

- Keep environment
allergen and
pollutant free to
reduce irritation
effect of dust and
chemicals on
airways.
 ASSESSTMENT NSG DX PLANNING INTERVENTIONS EVALUATION

SUBJECTIVE: - Elevate the head of After 1hour of

Ineffective
After 1hour of bed and/or have the nursing
Breathing
 (+) Cough Pattern
nursing intervention client sit up in a intervention the
 (+) Vomit the client will able chair. To promote patient was able to
related to
 (+) Dyspnea to maintain an physiological and maintained an
Hyperventil
effective breathing psychological ease effective breathing
ation
OBJECTIVE: pattern, as of maximal pattern, as
evidenced by inspiration. evidenced by
 Weak looking relaxed breathing at relaxed breathing at
a normal rate and - Demonstrate slower a normal rate and
 Tired looking
depth and the and deeper depth and the
 (+) Cough absence of dyspnea. respirations and use absence of
 (+) DOB of the pursed-lip dyspnea.
 Temp: 37.5 technique to assist
 HR: 169 client in taking
control of the
beats/min.
situation.
 RR: 61
breaths/min - Educate patient in
 O2: 91% effective coughing
 Hgb: 134 techniques. Place in
 RBC: 5 appropriate position
for clearing airways.
It promotes more
effective breathing
 and airway
management.

- Encourage
ambulation/exercise
to prevent onset or
reduce severity of
respiratory
complications and
to improve muscle
strength.

- Avoid overfeeding,
such as might occur
with young infant or
client on tube
feedings.
Abdominal
distention can
interfere with
breathing as well as
increase the risk of
aspiration.