-Intermittent, irreversible airway obstruction -It·s onset is sudden as opposed to the slow insidious progression of symptoms seen in bronchitis and emphysema -Increase responsiveness if trachea and bronchi to various stimuli

. and bronchospasm.-is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms. airflow obstruction.

 Dyspnea  Cough Sputum Chest Pain History on cigarette smoking  wheezing .

Environmental Factors (change in temperature) Atmospheric Pollutants (industrial and cigarette smoke) Stress and Emotional Upset Allergens (animal dander. is associated with high risk of asthma prevalence . dust mites) Viral respiratory infections may increase one's risk of developing asthma maternal cigarette smoking.

Increased capillary permeability that results in mucosal edema and further narrows the airways 3. Constriction of smooth muscles of both the large and small airways. Altered Immunologic Response Basis of Asthma : May be genetic or immunologic Immunologic asthma ² result of an antigen antibody reaction in which chemical mediators are released Reactions: 1. Increase mucus gland secretion and increase mucus production . resulting in bronchospasms 2.

mucosal inflammation and hyper secretion of mucus Altered Oxygen and Carbon Dioxide Exchange Increased airway resistance and hyperinflation that cause respiratory muscles to work harder resulting in muscle fatigue and ultimately exhaustion. .Increased airway resistance Results from muscle spasm.

prevent severe attacks and prevent side effects from medications . prevent recurrent symptoms.Primary goal of treatment: To promote normal functioning of the individual.

Pharmacological: Inhaled B-agonist (albuterol sulfate. ephedrine) . ventalin) it stimulates b2 receptors in bronchial smooth muscle resulting in relaxation Methylprendnisolone reduces inflammation and edema of airway and decreases hyperactivity of airway Bronchodilators(ephinephrine.

Complications: ‡Spasms of the extremities ‡Tachycardia ‡Headache .

face powder. feathers. animal hair. .uA clear history of hypersensitivity to some known substance that may be inhaled or ingested-particular type of food. uClose association of the attacks with allergic rhinitis. or such a history suggesting the probability of such sensitivity. mark pallor. uFinding of an abnormally high count of eosinophilic cells in the blood or the sputum tends to confirm this diagnostic impression. uBloood gas evaluatiom and simple spirometry ² useful in evaluating gas exchange and providing baseline data that assist in identifying dangerous hypoxemia and respiratory acidosis. and swelling of the nasal mucous membrane aids in establishing the case as one of the extrinsic allergic asthma.

uPhysical exertion. uTesting in Pulmonary function laboratory can usually provide objective evidence of airway obstruction. uOften a diagnosis is confirmed by instructing the patient to inhale a trial aerosol bronchodilator (during a coughing episode) .may induce acute bronchospasms in most patients with asthma. The key factors appears to be heat loss from the respiratory tract induced by hyperventilation.

Improving Airway Clearance: 1. Teach effective cough maneuver . Medicate with bronchodilators 5. Provide extra humidity 4. Provide adequate nutritional levels 3. Ensure adequate systemic fluid intake 2.

Providing Emotional Support and Preventing Anxiety 1. Encourage relaxation techniques 3. Give/Assist the patient with respiratory maneuvers 4. Never leave patient alone during an asthmatic attack 2. Assess for possible medication overuse .

intubations and ventilatory assistance may be required Facilitating Learning .Improving Breathing Patterns Improving gas exchange 1. If respiratory alkalosis is present. encourage slower breathing 2. If respiratory acidosis and hypoxemia are present: -administer oxygen as prescribed -if oxygen is not relieve the attack.

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continue medication on regular basis for 24-28 hours .Symptoms: Mild wheeze. If improved. as determined by clinician) Actions: Take inhaled bronchodilator. cough. shortness of breath occurring with activity but not at rest Peak Flow: 70-90% of baseline (personal best or predicted. chest tightness.

begin or increased prednisone.Symptoms: wheeze cough. If improved. symptoms may interfere with daily activity Peak Flow: 50-70% of baseline Actions: Repeat inhaled bronchodilator every 20 mins. shortness of breath while at rest. chest tightness. For 1 hour. continue medication every 3-4 hours for 24-28 hours. If not improved in 2-6 hours after initial treatment. Contact your physician .

cough . Be prepared: Have plan for receiving emergency care quickly in the event of a sudden episode. difficulty walking and talking. Begin or increased prednisone. . every 10mins up to 3 times. wheeze(may disappear with very severe episode). seek emergency care immediately. and chest tightness at rest. Always carry an inhaler if bronchodilator with you. perhaps retraction of muscles in chest or neck Peak flow: less than 50% of baseline and little response to bronchodilator Actions: Repeat inhaled bronchodilator. Keep emergency phone numbers handy. If there is no significant improvement after 20-30 minutes.Symptoms: Severe shortness of breath. 4-6 puffs.

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