Asthma

By : Kristine Charisse V . Tanedo BSN III MSU - IIT

What is Asthma?
• -Chronic inflammatory disease of airways that causes airway hyper responsiveness, mucosal edema and mucus production. • • -reversible either spontaneously or with treatment • • -most common chronic disease of childhood and can occur at any age

Cause:
• Seasonal allergens – grass, tree, weed, pollens • • Perennial allergens – mold, dust, animal dander •

Risk Factors (exacerbations):
• • • • • • • Allergens Respiratory infections Exercise Weather changes Exposure to sulfur dioxide Exposure to food additives and medications

Medications:
• Acetylsalicylic acid (aspirin) • • B-Adrenergic blockers • • Non-steroidal anti-inflammatory drugs • -causes: bronchospasm •

Food additives:
• • • • • • • • Sulfites (bisulfites and metabisulfites) Beer, wine, dried fruit, shrimp Processed potatoes Monosodium glutamate

Pathophysiology:
Triggers: infection, allergens, exercise, irritants IgE= mast cells mediated response Release of mediators from mast cells eosinophils, macrophages, lymphocytes Early phase response Late phase response

-Bronchial smoothe muscle constriction Infiltration with eosinophils and neutrophils -mucus secretion -inflammation -vascular leakage -bronchial hyperreactivity -mucosal edema Infiltration with monocytes and lymphocytes -Obstruction of large and small airways -air trapping -respiratory acidosis hypoxemia

3 most common symptoms:
• 1.) Cough – with or without mucus production • 2. ) Dyspnea • 3.) Wheezing •
– Other symptoms:
• • • •

Chest tightness Diaphoresis Tachycardia Central cyanosis – late sign

Diagnostic findings:
• Eosinophilia (secondary to allergic reaction)

• Elevated IgG

• ABG – respiratory alkalosis

• Respiratory acidosis

• FEVI and FVC =markedly decrease

– Allens test – check collateral circulation in ulnar artery; done before ABG

Complications:
• Status asthmaticus • • Respiratory failure • • Pneumonia •

Medications:
– Ventolin – Salbutamol

• Long acting control medications • Quick –relief medications – short acting beta 2 adrenergic agonists –medications of choice in acute symptoms and prevent exercise to induced asthma

• Inhaled bronchodilators –first line of defense (dilates) • 2nd : steroid IVTT (anti-inflammatory effect)

Management of exacerbations
• Quick-acting beta 2 adrenergic agonist

= first used for prompt relief of airflow obstruction

Nursing interventions:
• (Acute Asthma Episode)


• Position in high fowlers or sitting to aid in breathing


• Administration of oxygen as prescribed (nasal)


• Stay with the patient to decrease anxiety


• Administration of bronchodilators as prescribed


• Record color, amount and consistency of sputum, if there is any.