Bronchial Asthma

Prepared by: Rashmi Goswami

Nursing lecturer
JSM Nursing Academy Surat
 Definition
• Asthama is a chronic inflammatory disease of the airways, characterized
by airflow obstruction, bronchial hyperactivity, & a mucous production.
 Causes & Risk Factors

Airborne
Family history Stress
allergens

Respiratory Chronic exposures Drugs & Food

infections to allergens additives

Physical activities GERD

 Clinical manifestations

Shortness of
Coughing
breath

Chest
tightness

Wheezing Mucus production

 Diagnostic Evaluation
• History collection
• Spirometer
• Pulse oximetry
• Chest X-ray
• Laboratory test: (Allergy, ABG, CBC, Sputum culture)
• PFT (Pulmonary function test)
• PEF (Peak expiratory flow) portable, easy to use
- How well the lungs to use are able to expel air.
 Management
• Goal:

Promote bronchodilation Remove secretions

Reduce inflammation Prevent asthma attacks

 Pharmacologic therapy
1. Quick relievers: Used for acute attacks to relieve bronchospasm.
• Salbutamol
• Terbutaline
• Adrenaline
• Aminophylline
 Cont…
2. Long term control medicines: used for long term to control inflammation & to
prevent further attacks.
1. Inhaled corticosteroids: They are the most effective long-term control medicines to
relieve airway inflammation and swelling. Eg. – Budesonide
2. Leukotriene inhibitors: Reduce inflammation Eg.- Zileuton (Zyflo)
3. Long acting beta agonists (LABAs): Inhaled long-acting beta agonists work to
keep breathing passages open for 12 hours or longer. Eg.- Salmetrol
4. Methylxanthines: Long acting bronchodilators Eg.- Aminophylline &
Theophylline
 Non-Pharmacologic interventions
• Oxygen therapy
• Postural drainage & chest physiotherapy
• Coughing & deep breathing exercise
• Avoidance of known allergens
• Relaxation techniques
• Acupuncture
 Nursing management
• History collection:
- History of allergies
- Onset of symptoms
- Exposure to irritants
• Physical examination:
• Assess respirations (rate, pattern, depth, & breathing effort)
• Assess for lung sounds
• Assess for signs or symptoms
 Cont…
• Assess changes in vital signs & temperature
• Monitor ABG – increasing PaCO2 & decreasing PaO2 are signs
respiratory failure.
• Monitor for oxygen saturation