Asthma

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by Princess120981
Last updated 5 years ago

Discipline:
Health & Fitness
Subject:
Health

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Asthma

Asthma is an airway disease that can be classified physiologically as a variable and partially reversible obstruction to air flow, and pathologically with overdeveloped mucus glands, airway thickening due to scarring and inflammation, and bronchoconstriction, the narrowing of the airways in the lungs due to the tightening of surrounding smooth muscle. Bronchial inflammation also causes narrowing due to edema and swelling caused by an immune response to allergens.

PATHOPHYSIOLOGY

ASTHMA

Tests used in the diagnosis of asthma include the following:•Pulmonary function tests•Exercise challenge: Involves baseline spirometry followed by exercise on a treadmill or bicycle to a heart rate greater than 60% of the predicted maximum, with monitoring of the electrocardiogram and oxyhemoglobin saturation •Fraction of exhaled nitric oxide (FeNO) testing: Noninvasive marker of airway inflammation•Radiography: Reveals hyperinflation and increased bronchial markings •Allergy testing: Can identify allergic factors that may significantly contribute to asthma

Diagnosis

• Wheezing: A musical, high-pitched whistling sound produced by airflow turbulence is one of the most common symptoms of asthma. The wheezing is usually during exhalation. • Cough: Usually, the cough is nonproductive; coughing may be present with wheezing• Cough at night or with exercise: Coughing may be the only symptom of asthma, especially in cases of exercise-induced or nocturnal asthma; children with nocturnal asthma tend to cough after midnight, during the early hours of morning • Shortness of breath• Chest tightness: A history of tightness or pain in the chest may be present with or without other symptoms of asthma, especially in exercise-induced or nocturnal asthma In an acute episode of asthma, symptoms vary according to the episode’s severity. Infants and young children suffering a severe episode display the following characteristics: • Breathless during rest• Not interested in feeding• Sit upright• Talk in words (not sentences)• Usually agitatedWith imminent respiratory arrest, the child displays the symptoms mentioned and is also drowsy and confused. However, adolescents may not have these symptoms until they are in frank respiratory failure. Findings during a severe episode include the following:•Respiratory rate is often greater than 30 breaths per minute•Accessory muscles of respiration are usually used•The heart rate is greater than 120 beats per minute•Loud expiratory and inspiratory wheezing can be heard•Oxyhemoglobin saturation with room air is less than 91%

Assessment

Interventions

- Impaired gas exchange R/T bronchoconstriction AEB patient grasping for air - Ineffective breathing pattern R/T spasm of the airway AEB muscle fatigue.-Ineffective airway clearance R/T airway spasm, secretion retention and amount of mucus.

1. Airway management:-Position the patient in a position semifowler-Auscultation of breath sounds of patients-Patient's fluid balance-Monitor respiration rate-Clear the airway of secretions (Suction)-Teach the client to use an inhaler2. Acid-base management:-Monitor blood gas analysis-Monitor electrolyte levels-Monitor oxygen saturation-Collaboration of medication to maintain the acid-base balance (sodium bicarbonate)-Monitor hemodynamic status3. Airway management:-Monitor respiratory patients-Monitor the use of additional respiratory muscles -Monitor Vitas signs; respiration, pulse, blood pressure, temperature4. Oxygen therapy

Nursing Diagnosis

Gentic Risk

Your inherited genetic makeup predisposes one to having asthma. It's thought that three-fifths of all asthma cases are hereditary. According to a CDC report, if a person has a parent with asthma, he or she is three to six times more likely to develop asthma than someone who does not have a parent with asthma.-6.5% of families in which NEITHER parent has asthma have a child with asthma. -28% of families in which ONE parent has asthma have a child with asthma. -63% of families in which BOTH parents have asthma have at least one child with asthma.

Childhood Asthma:What Can I Do...

Treatment•O2 3L qd•Albuterol•Salmeterol•Montelukast•Ipratropium•Prednisone

PATIENT TEACHING•Teach patient how to recognize asthma•How to perform coughing and deep breathing exercise •Avoid foods or environment that may trigger asthmas


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