Asthma

By : Kristine
Charisse V . Tanedo
BSN III MSU - IIT
 What is Asthma?

• -Chronic inflammatory disease of

airways that causes airway hyper
responsiveness, mucosal edema
and mucus production.
•
• -reversible either spontaneously or
with treatment
•
• -most common chronic disease of
childhood and can occur at any age
 Cause:

• Seasonal allergens – grass, tree,

weed, pollens
•
• Perennial allergens – mold, dust,
animal dander
•
 Risk Factors (exacerbations):

• Allergens
• Respiratory infections
• Exercise
• Weather changes
• Exposure to sulfur dioxide
• Exposure to food additives and
medications
•
 Medications:

• Acetylsalicylic acid (aspirin)

•
• B-Adrenergic blockers
•
• Non-steroidal anti-inflammatory
drugs
• -causes: bronchospasm
•
 Food additives:

• Sulfites (bisulfites and metabisulfites)

•
• Beer, wine, dried fruit, shrimp
•
• Processed potatoes
•
• Monosodium glutamate
•
 Pathophysiology:
Triggers: infection, allergens, exercise, irritants

IgE= mast cells mediated response

Release of mediators from mast cells eosinophils, macrophages, lymphocytes

Early phase response Late phase response

-Bronchial smoothe muscle constriction

Infiltration with eosinophils and neutrophils
-mucus secretion -inflammation
-vascular leakage -bronchial hyperreactivity
-mucosal edema

Infiltration with monocytes and lymphocytes

-Obstruction of large and small airways
-air trapping
-respiratory acidosis
hypoxemia
 3 most common symptoms:

• 1.) Cough – with or without mucus

production
• 2. ) Dyspnea
• 3.) Wheezing
•
– Other symptoms:
• Chest tightness
• Diaphoresis
• Tachycardia
• Central cyanosis – late sign

 Diagnostic findings:
• Eosinophilia (secondary to allergic reaction)


• Elevated IgG


• ABG – respiratory alkalosis



• Respiratory acidosis


• FEVI and FVC =markedly decrease



– Allens test – check collateral circulation in ulnar

artery; done before ABG
 Complications:
• Status asthmaticus
•
• Respiratory failure
•
• Pneumonia
•
 Medications:
– Ventolin
– Salbutamol


• Long acting control medications

• Quick –relief medications – short acting beta
2 adrenergic agonists –medications of
choice in acute symptoms and prevent
exercise to induced asthma


• Inhaled bronchodilators –first line of defense

(dilates)
• 2nd : steroid IVTT (anti-inflammatory effect)
 Management of exacerbations

• Quick-acting beta 2 adrenergic

agonist
 = first used for prompt relief of airflow
obstruction

 Nursing interventions:

• (Acute Asthma Episode)

•
• Position in high fowlers or sitting to aid in breathing
•
• Administration of oxygen as prescribed (nasal)
•
• Stay with the patient to decrease anxiety
•
• Administration of bronchodilators as prescribed
•
• Record color, amount and consistency of sputum, if
there is any.