. Asthma and NURSING MANAGEMENTS Fareeda Mohd. Mustafa CNE,MGH, MADINA 2.

DEFINITIONAsthma :-*Is the common chronic inflammatory disease of theairways characterized by variable and recurring symptoms,reversible airflow obstruction, and bronchospasm . 3. Anatomy 4. Causes:- The cause of asthma is not known, but there is evidencethat many factors play a part1-)Genetic factors2-)Environmental factors:3-)Dietary changes4-)Lack of exercise5-)Occupational exposure 5. Pathophysiology :-Airway inflammation is the primary problem in asthma.An initial event in asthma appears to be the release ofinflammatory mediators triggered. The mediators arereleased from bronchial mast cells, alveolarmacrophages, and epithelial cells. Some mediatorsdirectly cause acute bronchoconstriction. The inflammatory mediators alsodirect the activation of eosinophils and neutrophils, andtheir migration to the airways, where they cause injury.called late-phase asthmatic response results inepithelial damage, airway edema, mucus hypersecretion and hyper responsiveness of bronchialsmooth muscle Varying airflow obstruction leads torecurrent episodes of wheezing, breathlessness, chesttightness and cough 6. Asthma triggers:-A trigger is any thing or condition that causesinflammation in the airways, which then leads toasthma symptoms*Infections such as colds, flu, or pneumonia*Allergens such as food, pollen, mold, dust and petdander*Exercise 7. Asthma triggers:-*Air pollution and toxins*Weather, especially extreme changes in temperature*Drugs (such as aspirin,)*Emotional stress and anxiety*Singing, laughing, or crying*Smoking, perfumes, or sprays 8. Risk factors for asthma :-1-)Genetics2-)Allergies3-)Medical ConditionsRespiratory infections in childhood-Low birth weight-Obesity-Congestive heart failure-Pulmonary embolism4-)Gender5-) Ethnic Background6-) Medications 9. Types of Asthma :-1.) Child-Onset Asthma2.) Adult-Onset Asthma3.) Exercise-Induced Asthma4.) Cough-Induced Asthma5.) Occupational Asthma6.) Nocturnal Asthma7.) Steroid-Resistant Asthma (Severe Asthma) 10. Diagnosis :-1-)Peak flow measurements2-) spirometer3-)Lung function tests4-)Blood tests to measure eosinophil count (a type of whiteblood cell) and IgE (a type of immune system proteincalled an immunoglobulin)5-)Arterial blood gas6-)Chest x-ray 11. SpirometerA spirometer is a diagnostic device that measures the amount of airyoure able to breathe in and out and the time it takes you to exhalecompletely after you take a deep breath 12. Clinical manifestations :-1-)Coughing, especially at night2-)Wheezing3)Shortness of breath4-)Chest tightness, pain, or pressure 13. Early warning signs:-* Frequent cough, especially at night*Losing your breath easily or shortness of breath*Feeling very tired or weak when exercising*Wheezing or coughing after exercise*Feeling tired, easily upset*Decreases or changes in a peak expiratory flow*Signs of a cold,*upper respiratory infection, or allergies(sneezing, runny nose, cough, congestion, sore throat, andheadache)*Trouble sleeping

14. Symptoms of worsening asthma:-*Cough that wont go away (day and night)*Wheezing*Tightness in the chest*Shortness of breath*Poor response to medicines (bronchodilators) 15. Late, severe symptoms:-* Severe wheezing (both when breathing in and out)*Coughing that wont stop*Very rapid breathing*Inability to catch your breath*Chest pain or pressure*Tightened neck and chest muscles*Difficulty talking*Inability to fully exhale*Feelings of anxiety or panic*Pale, sweaty face*Blue lips or fingernails 16. Managements:- cannot be cured, but appropriate management can control thedisorder and enable people to enjoy a good quality of life1.) The first step in asthma management is environmentalcontrol by* Clean the house at least once a week and wear a mask whiledoing it*Avoid pets with fur or feathers*Wash the bedding (sheets, pillow cases, mattress pads) weeklyin hot water*Encase the mattress, pillows and in dust-proof covers*Replace bedding made of down, foam rubber*Consider replacing carpeting with hardwood floors *Use theair conditioner*Keep the humidity in the house low 17. Managements:-2.) The second step is to monitor lung function. *Asthmatics use apeak flow meter to gauge their lung function* listen to breath sounds*pulse oxymetry ,and vital signs3.) The third step in managing asthma involves the use ofmedications. There are two major groups of medications used incontrolling asthma* Anti inflammatory (corticosteroids) and bronchodilators.*immunotherapy may help those there are not control symptomsor used medications. 18. Nursing managements:-*The goal of nursing care in a patients having an asthma attack is to makesure there is adequate oxygen intake.1-) Evaluate respiratory rate/depth and breath sounds2-). Assist client to maintain a comfortable position 3-)Encourage/instruct in deep-breathing and directed coughingexercises4-)Obtain history of recent medication use, particularly theophyllinepreparations, steroids and inhalers.5-)Obtain baseline data on respiratory function, using a peak flow meter,listen to breath sounds 19. *Nursing managements:-6-) the nurse must following physician order to:-Administer inhaled rapid acting bronchodilators to open up theairways.Administer corticosteroids such as prednisone to reduceinflammation in the airways.-Administer low flow humidified oxygen to prevent hypoxemia.Administer intravenous fluids to prevent dehydration and oral intakelooses secretions in the airways.7-)-the nurse has to ensure that long term asthma medications likeinhaled corticosteroids long acting bronchodilators are administeredas prescribed by the physician. 20. *Nursing management:-8-)Check results of diagnostic procedures .9)Assess vital signs every 15 to 30 minutes in initial treatmentperiod; retake temperature at least once;10-)observe for changes in level of consciousness (e.g., depression due tohypoxemia or excitation due to aminophylline and/ or epinephrine11-)Removing any potential allergen or trigger from environment likeflowers or perfumes12-)Maintaining a quite calm environment to reduce anxiety and promotenormal respiratory rate13-)Monitoring the side effects of administered medications14-)Monitoring the arterial blood gases as an indication of improvementor deterioration-15-)Prepare for mechanical ventilation if patient cannot breathe on hisown 21. complications of asthma:-: 1-)Decreased ability to exercise and take part in other activities 2-)Lack of sleep due to nighttime symptoms 3-)Permanent

changes in the function of the lungs 4-)Persistent cough5-)Trouble breathing that requires breathing assistance (ventilator6-) Pneumothorax7-) Respiratory failure8-)Death 22. Preventions :-*You can reduce asthma symptoms by avoiding known triggers andsubstances that irritate the airways.*Eliminate tobacco smoke from the home. (Smoking outside thehouse is not enough. Family members and visitors who smoke outsidecarry smoke residue inside on their clothes and hair 23. *Patient Teaching :-*Providing information that will help prevent asthmatic episodes and teachingpatients skills required to administer asthmatic medications properly. Theseskills and information are as follows1-)The need to identify and eliminate any actual or potential allergen, substanceor condition that could precipitate an asthma attack.2-)The need to permit no smoking around3-)The need to report frequent use of rapid acting bronchodilators.The need to take long term medication as prescribed even when there are noasthma attacks.4-)How to use an inhaler and a spacer.5)How to use a peak flow meter and the significance of the readings.6(Assisting the patient to create an asthma management and emergency plan.7)When to contact a healthcare provider or seek emergency services