ASTHMA (Sue)

What is it?
• chronic
• inflammatory disorder of the airway

Characteristics:
• wheezing
• Breathlessness
• chest tightness
• coughing
• inflammation causes increased responsiveness to various stimuli
• acute episodes usually reverse spontaneously or with treatment
• most brief “attacks”
• some longer with degree of airway impairment daily
• rare cases: (acute episode - severe enough to cause respiratory failure and death)

How is it Diagnosed?
• (PFTs) pulmonary function tests
• bronchial provocation test (which uses inhaled substances such as
methacholine or histamine) confirms the diagnosis
• (ABGs) arterial blood gases
** (during an acute attack)
** used to determine if mechanical ventilation is needed
• skin testing ( if allergic trigger)

How is it treated?

(bronchoconstriction and airflow obstruction)

• short-acting adrenergic stimulants

• (rapid acting bronchodialators)
• anticholinergic drugs
• methylxanthines
• primary taken daily (anti-inflammatory agents, bronchodialators, and leukotriene
modifiers)
• a short-acting inhaled B2-agonist for quick relief of acute symptoms

Administration

• MDI ( metered dose inhaler)

• DPI ( dry powder inhaler) or nebulizer
Alternatives:

• Dietary therapies
• environmental medicine
• nutritional supplements
• biofeedback, yoga, acupuncture, homeopathy and massage

Nursing Interventions

Acute:

• can cause a cyclical pattern of anxiety ( spurs with breathing difficulty)

• nursing care: ABCs ( airway clearance first and reducing anxiety)
• prevention
Other:

• skin color
• temperature
• Consciousness level
• ABG results
• pulse oximetry reading
• cough effort
• sputum for color, consistency, and amount
• Fowler’s, high Fowler’s, or orthopneic position to facilitate breathing
• Oxygen
• nebulizer treatments
• humidification
• chest physiotherapy (percussion & postural drainage) to facilitate secretions
• Increasing fluid intake
• provide suctioning as needed
• controlled breathing pattern techniques (i.e. pursed lip breathing, abdominal
breathing, relaxation techniques)

Lemone, Priscilla, & Burke, Karen. ( 2008). Medical-Surgical Nursing: Critical Thinking
in Client Care.Upper Saddle River, New Jersey: Pearson Education Inc.