Disease Information
Name(s) of Disease:
Asthma (p. 1105-1113)
General description:
Chronic inflammatory disorder of the airways characterized by recurrent episodes of
wheezing, breathlessness, chest tightness, & coughing
RISK FACTORS: allergies, genetic predisposition, environmental factors, respiratory
viruses
Pathology/ Causes:
Onset: Trigger occurs and mast cells in bronchial mucosa to release histamine,
prostaglandins, leukotrienes which causes
1. Bronchoconstriction
2. Increased capillary permeability
3. Mucosal edema & ↑ mucous production
Late phase response (4-12 hours after onset): inflammatory cells damage airway
epithelium cause
1. ↑ mucus production
2. Limited mucus clearance
3. Prolonged bronchoconstriction → ↓ gas exchange
Signs and Symptoms:
• Dyspnea, wheezing, coughing
• Tachycardia, tachypnea, prolonged expiration
• Severe attaches: fatigue, anxiety, apprehension
• Onset of respiratory failure: inaudible breath sounds with ↓ wheezing, ineffective
cough
DX:
• Pulmonary fx test: determines degree of airway involvement during & between
attacks
• Challenge or bronchial provocation testing: confirm dx
• ABG: monitor O2 & CO2 & acid-base status
• Skin testing: identify allergic triggers
TX:
Medications
see p. 1110 for
Nursing
implications
Antiinflammatory
• Corticosteriods
• NSAIDS
Bronchodilators
• Adrenergic stimulants (albuterol – metered dose inhaler)
Diet
Nonsurgical Tx
Surgical Tx
Nursing Dx
• Methylxanthines (theophylline, aminophylline)
• Anticholinergic agents (ipratropium bromide – metered dose inhaler)
• Leukotriene modifiers (zafirlukast, zileuton)
NA
Complimentary therapy
• Herbal
• Biofeedback
• Yoga
• Breathing techniques
• Acupuncture
• Homeopathy
• Massage
NA
Ineffective airway clearance
Ineffective breathing pattern
Anxiety
Ineffective therapeutic regimen management
Major Complications
Status asthmaticus: prolonged asthmas not responding to tx. Leads to respiratory failure with
hypoxemia, hypercapnia, & acidosis = MEDICAL EMERGENCY
Other:
Teach about prevention of future attacks - home management must be postponed until
adequate ventilation is restored