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Dea Arista Egi Nugraha F.

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

2. Skin Test Examination


To find the allergic factors by various of allergen

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

NURSING CARE PLAN


(ASSESSMENT)
A. Identification of Patients
Name Age Occupation Medical Diagnosis : Ms. M : 16 years : Student : Asthma Bronchiale

B. The main complain


Clients complained of continously of shortness breath and weakness.

C. History of present illness


Clients complained of shortness of breath since last night. Cough with thick secretions that hard to get out.

NURSING CARE PLAN


(ASSESSMENT)
D. History of past illness
Client has a history of shortness of breath since childhood. Lately attacks often relapse and her families just know that the client suffer from asthma.

E. Physical examination
Inspection Auscultation Palpation Percussion : nostril movement : wheezing sound ::-

NURSING CARE PLAN


(DIAGNOSIS AND INTERVESTIONS)
Diagnosis 1 : Not effective airway clearance related to bronchospasm. Goal : To maintain a patent airway with the clean and clear sound
Intervention: o Auscultation of breath sounds, note the presence of breath sounds o Place the patient in comfortable position o Maintain a minimum environmental pollution o Increase fluid intake to 3000 ml / day o Give bronchodilator drugs

NURSING CARE PLAN


(DIAGNOSIS AND INTERVESTIONS)
Diagnosis 2 : Damage to gas exchange related to oxygen supply disruption (bronchospasm)
Goal : improved ventilation and adequate of oxygen

Intervention : o Provide oxygen addition

NURSING CARE PLAN


(DIAGNOSIS AND INTERVESTIONS)
Diagnosis 3 : Activity intolerance related to general weakness, imbalance between O2 supply and needs Goal : Activity can be enhanced

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

NURSING CARE PLAN


(DIAGNOSIS AND INTERVESTIONS)
Diagnosis 4 : Lack of knowledge related to less information

Goal

: To express of understanding of the condition / disease processes and actions.

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

THANK YOU

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