ASMA

MK : BHS. INGGRIS 1
Disususn oleh kelompok 2:

 Andrian Alfa Heru

 Cupriyanti
 Irmawati Yusuf
 Juwita Sari
 Lutfi Umaimah
 Rina Ayuni

PRODI S1 KEPERAWATAN
FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH TANGERANG
 BACKGROUND
Asthma is disease that very close with community and
have population that continue increased (The Global
Initiative for Asthma, 2004). Case asthma throughout world
according to survey GINA (2004) reach 300 million soul and
predicted on year 2025 sufferers asthma increases to 400
million. Moments this disease asthma occupy order ten big
cause pain and Dead in Indonesia (Department of health RI,
2007). P this caused by management asthma that no
controlled that in added with attitude patient and doctor that
often time disparaging level severity disease asthma so
causing pain sustainable and worse can cause instantaneous
death to the sufferer (Dahlan, 1998).
HOW THE LUNGS WORK
1. The Understanding of Human Lung
Lungs is organ body human that there in in chest. This
lung has the function of entering oxygen and remove carbon
dioxide.
Lungs is internal organ system breathing and including in sistem
kitaran verteBrata that breathes. This works for swapping
oxygen from air with carbon dioxide from blood with
hemoglobin aid. This process is known as respiration or
respiration.
The lungs are located in the cavity of the chest (thoracic cavity),
protected by structure bone seldom and covered two Wall that
known as pleura. Second layer this separated by layer air known
as pleural cavities containing pleural fluid.
UNDERSTANDING ASTHMA
Asthma own originated from words asthma.
Word this originated from language Greece which
has a meaning difficult to breathe. The disease of
asthma is known as The presence of symptoms of
shortness of breath, cough, and wheezing are caused
by narrowing of the airways. A know in other words
asthma is inflammation atau swelling channels
breath are reversible so that causing the production
of excessive viscous fluid (Prasetyo, 2010)
 ETIOLOGI
a. Extrinsic Asthma
Asthma extrinsic is a form of asthma are the most
common, and caused because allergic reactions
sufferers against things certain (allergens), that no bring
influence anything to they that healthy. system immunity
work free control and cause reaction allergy. Reaction
this caused by allergens. Allergens can appear in form:
start from powder flower, plant, tree, dust inside out
home, mushrooms, to substance / food ingredients .
When an allergen enters the body of people with
allergies,
 The effect of histamine release on the lungs
is a reaction stretching / contraction channel
breathing and increase production mucus
discharged inner layer tissue in the channel.
b. Asthma Intrinsic
Asthma intrinsic no responsive to triggers that
originated from allergens. This type of asthma is
caused by stress, infection, and condition
environment as weather, humidity and temperature
air, pollution air, and also by excessive sports
activity
 HISTORY OF ASTHMA

Asthma recognized in Egypt Ancient and

treated with drink potion incense that known as kifi.
Disease this secara official called as problem
breathing by [Hippocrates] around year 450 Before
Masehi, with name Greece that means "panting"
forming basic from name modern. In the year 200
BC disease this trusted at least some related to
emotions.
 EPIDEMIOLOGY
To year 2011, 235-300 million person in whole
world suffer asthma, and sekitar 250,000 person died per
year because disease this Level vary between Country
with prevalence between 1 and 18%. More often found in
country advanced compared country developing. So level
visible more low in Asia, Europe East and Africa. In
country advanced disease this more many suffered by they
that less lucky in the economic sementa ra in countries
developing grama h ordinary found on kalangan atas.
Reason for this difference is not is known. over of 80% of
mortality occurred in the producing countries an low and
medium.
CAUSES OF ASTHMA OCCURRENCE

a. Triggers (trigger) that result tighten or narrowed it

Respiratory tract (bronchoconstriction). Trigger
does not cause inflammation. Many circles medical
that assume triggers and bronchoconstriction is
interference breathing I, that not yet means asthma, but
can lead to a sma intrinsic type . Symptoms
bronchoconstriction are caused by triggers tend to arise
instantaneous, takes place in a short time and is
relatively easy to overcome in short time
b. Cause (inducer) that welcometkan
inflammation (inflammation) on respiratory tract .
The cause of asthma (inducer) can cause
inflammation (inflammation) and at once
hyperresponsiveness (response that excessive) of
the respiratory tract. The cause of asthma (inducer)
with such cause symptoms yes ng generally be
rlangsung more lam a (chronic), and more difficult
to overcome, than that respiratory disorder caused
by triggers (trigger).
ASTHMA CLASSIFICATION

1. Intermittent
2. Light Persisten
3. Persistent Medium
4. Persistent Weight
 PATHOPHYSIOLOGY OF ASTHMA
Individual with asthma experience response immune
that bad to environment. Antibody that resultedn (IgE) then
attack cells mast in lungs. Exposure repeated to antigen
result bond antigen with antibody, cause perelease of mast
cell products (called mediator) as histamine, bradykinin
and prostaglandin and anaphylaxis from substance that
react slow. Release mediator this in network lungs affects
the muscles smooth and glandular road of breath,
bronchospasm, swelling membrane mucosa and formation
mucus that very many.
 After patient exposed allergens cause or factor
originator, soon will arise dyspnea. Patient feel
seperti choked and must stand up or sit and
attempted full deploy power for breathe. Difficulty
main located on moment expiration. Branching
tracheobronkial widened and elongated divea
inspiration, but difficult for impose air Exit from
bronchioles that narrow, experience edema and
filled mucus, that in state normal will contract to
the level an certain at the time expiration
 ASTHMA CONTROL

1. Knowledge
2. Monitor
3. Avoiding Risk Factors
4. Long Term Medical Treatment
1. Knowledge
Provide knowledge to people with asthma
about the circumstances his illness and mechanism
treatment that will lived forward (GINA, 2005).
2. Monitor
Monitor asma s ecara regularly to the team
medical that handle disease asthma. Monitor
development symptoms, things What only that may
happen to people with asthma with condition
symptoms are experienced and monitor the
development of lung function (GINA, 2005).
3. Avoiding Risk Factors
that most maybe do sufferers asthma in reduce
symptoms asthma is avoid factor originator that could
improve symptoms asthma. Factor resiko this could form
food, drugs, pollution, and so on (GINA, 2005).
4. Long Term Medical Treatment
Long - term treatment of people with asthma, done
based on the severity of asthma symptoms . On sufferers
asthma intermitten, no there is treatment period long. On
mild intermittent asthma sufferers , using drug options
glucocorticosteroids inhalation and supported by
Theophylline, chromones, or leukotriene. And for asthma
moderate persistent, using choice of medicine
 PREVENTION
The effectiveness of preventive measures of
the onset of asthma was not have evidence strong.
There is some that enough strong between
other:restrictions exposure to cigarette good on
moment in content and after born,breastfeeding,
move animal pets from home patients who have
symptoms allergy to pet the. Restrictions intake for
time pregnancy or on moment breastfeeding too no
ever proven effective so no recommended.
Reduction or disappearance compound certain of
which are known to originate from the workplace
on those who are sensitive can be effective
 TREATMENT FOR ASTHMA
SUFFERERS
How the treatment of asthma are most effective
, namely finding triggers, eg smoke, animal pets, or
aspirin, and eliminating exposure to the triggers . If
stay away from triggers still not yet enough, new
recommended for use drug. Drug pharmacy selected
based, between other, severity disease and frequency
symptoms. Treatment special for asthma on large
categorized as in drug fast reaction and slow reaction
On attack asthma medium or weight,
corticosteroids oral respectively added to in
design this treatment :
a. Lifestyle Modification

b. Drugs

c. Rapid reactions

d. Long-term control

e. Drug consumption method

f. Adverse impact
g. Alternative Medicine
THEORY OF NURSING CARE
 A. Assessment.
1. Identity
Includes name, age, address, gender, no MR, occupation,
payer, etc.
2. Historical health
a. Past medical history
Assess whether the client has experienced an asthma before, whether
the client has experienced previous lung disease, assess whether the
client has taken the drug and review the patient's allergy history.
b. Health history now
Usually the client has dyspnea with elongated expiration, a thick
cough and difficulty out, cyanosis, tachycardia, anxiety, diaporesis etc.
c. Family health history
Assess whether there are families of clients who have the same
disease, whether there is a hereditary disease
3. Physical examination
Vital sign :
Blood pressure, pulse, breathing, temperature.
Head to too check:
1) Head
Usually there is no abnormalities in the head, head
clean and not dandruff.
2) Eye
Conjunctival anemis, sclera usually not jaundice,
no edema.
3) Nose
Usually there will be a lot of secretions if the
client is exposed to influenza virus that can cause
disruption of the pernapsan channel.
4) Ear
Usually there is no abnormality in the ear, not swelling
5) Mouth
Usually there is no abnormality in the mouth.
6) Neck
There is no swelling of the lymph nodes, no
abnormalities in the tyroid gland.
7) Thorak
Typically breathing sounds wheezing
8) Lungs
Usually the lungs are heard
9) Abdomen
Usually there will be an increase in intestinal peristaltic.
10) Up / down extremity
There is usually no abnormality in the upper and lower
extremities.
11) Sleep patterns and rest
• Lack of sleep due to shortness
• Insomnia.
12) The pattern of cognitive perception
Clients are able to disclose strategies to
combat acute attacks but are unable to use effectively
during an attack (panic).
13) Patterns of perception and self-concept
Feeling as a weak or sickly person, change body
image.
14) Pattern of relationship with others
Complaining because of attacks triggered by people
around, such as: smoke, cigarettes.
15) Coping pattern and tolerance to stress.
Anxious, angry, desperate
B. NURSING DIAGNOSES

1. Ineffective airway clearance is associated with

oxygen supply disruption (bronchospasm), secretive
buildup, thick secretions.
2. Ineffective breathing patterns are associated
with oxygen supply disruption (bronchospasm).
3. Gas exchange disorders are associated with
oxygen supply disruption (bronchuspasm).
 C. NURSING INTERVENTIONS
No Nursing diagnosa Destination/resul Intervention ratiomal
t criteria
1. Ineffective airway Achievement of Independent • Some
clearance is associated with airway clearance • Auscultation degree of
oxygen supply disruption with the of breath bronchial
(bronchospasm), secretion following sounds, note spasm
buildup, viscous secretions outcome criteria: the sound of occurs with
a. Maintain a breath airway
patent airway • Assess / obstruction
with a clear or monitor the and can /
clear breath frequency of does not
sound. breathing, note manifest the
b. Show behavior the ratio of existence of
to improve airway inspiration / advertitious
clearance eg expiration breath.
effective cough
and secrete
• Note the Tachypnea
degree of usually exists at
dyspnea, some degree
anxiety, and may be
respiratory found at
distress, use reception or
of auxiliary during stress /
drugs. acute infection.
• Place a • Respiratory
comfortable dysfunction
position on is a variable
thepatient, that depends
for example: on the stage
raising the of the acute
head of the process
bed, sitting leading to
on the hospitalizatio
bedside. n
• Keep the • The elevation
minimum of the head of
environmental the bed
pollution, for facilitates the
example: dust, function of
smoke etc. breathing by
• Increase fluid using gravity.
intake up to • The trigger
3000 ml / day type of
as per heart respiratory
tolerance allergy can
gives warm episode acute
water. episodes.
• Collaboration • Hydration
Give medication as helps decrease
indicated by the viscosity of
bronchodilator secretions, the
use of warm
fluids can
decrease the
viscosity of the
secretions, the
use of warm
fluid may
decrease
bronchial
spasmo
• Relax smooth
muscles and
lower airway
spasms,
wheezing, and
mucosal
production
2. Ineffective breathing Improvement Independent • Helping
patterns are associated of breath • Teach deep patients
with oxygen supply pattern with breathing extend the
oxygen supply the following patients. expiratory
disruption result criteria: • Elevate the time so that
(broncohospasm) Maintain head and patients will
adequate help change breathe
ventilation by position. more
showing RR: Give the effectively
16-20 x / min semi fowler and
and regular position. efficiently.
breathing • Sitting high
rhythms. Collaboration allows lung
Not • Give extra expansion
experiencing oxygen. and eases
cyanosis or breathing.
other signs of • Maximize
hypoxia. breathing
Patient can and lower
perform deep breathing
breathing work.
3. Disturbance of gas Repair gas Independent • Cyanosis may
exchange associated exchange with the Routinely be peripheral
with oxygen supply following result examine skin and or greyish-
distrubances criteria: mucous central and
(bronkuspasme) Improved membranes. central
ventilation. • Palpate cyanosis
Repairs adequate fremitus. indicates the
tissue oxygen Keep an eye on severity of
vital signs and hypoxemia.
heart rhythms. • Decreased
Collaboration vibration
Provide vibration
additional oxygen suspected
as indicated by fluid / air
AGDA results and accumulation
patient tolerance .
 Tachicar
di, dysrhythmias,
and changes in
blood pressure
may indicate the
effect of systemic
hypoxemia on
cardiac function.
• Can improve or
prevent the
worsening of
hypoxia
FINISH …