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A Rini Meilani
ATSHMA
CASE
Miss M, 16 years old, a student, complained of fatigue and shortness of breath continuously since last night. There is a wheezing and cough with thick secretions that hard to get out. The result of the physical examination are RR 30x / minute , pulse 112x / minute, blood pressure 90/50 mmHg, and rapid shallow breathing, cold acral. Clients said that she worry about her condition.
DEFINITION
Asthma is a disease of the respiratory system including airway inflammation and reversible bronchospasm symptoms (Crackett, Antony. 1997).
ETIOLOGY
1. Allergens 2. Weather change 3. Stress 4. Environment 5. Sport / weight physical activity
CLASSIFICATION
Based on the cause, bronchial asthma can be classified into 3 types:
1. Extrinsic (allergic)
2. Intrinsic (non-allergic)
3. Combined asthma
SYMPTOMS
Shortness of breath Wheezing Cough Feel pain in the chest (some patients) Cyanosis Impaired consciousness Rapid and shallow breathing Tachicardi
DIAGNOSTIC EXAMINATIONS
1. Blood Tests
Blood gas analysis (generally normal): hypoxemia, hypercapnia, or acidosis SGOT and LDH Hyponatremia and leukocyte Ig E
COMPLICATIONS
Status asthmaticus Atelectasis Hypoxaemia Pneumothorax Emphysema Thoracic deformity
TREATMENTS
A. Non-Pharmacologic
Provide counseling Avoid trigger factors Keep hidration Fisiotherapy Give O2 if necessary.
B. Pharmacologic
Bronchodilators Kromalin Ketolifen
E. Physical examination
Inspection Auscultation Palpation Percussion : nostril movement : wheezing sound ::-
Intervention : o Explain the importance of rest and balance of activity and rest o Assist patients in fulfill their needs o Assist patients in selecting a comfortable position to rest
Goal
Intervention : o Tell the patient about the disease o Tell the patient about respiratory medicine, side effects, and unwanted reactions o Explain the technique of inhaler using
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