Asthma Flashcards
Describe Asthma.
- A chronic inflammatory disorder of the Bronchi & Bronchioles that obstructs airways
- Asthma comes & goes with flare-ups in the form of asthma attacks
- Attacks ARE REVERSIBLE!
What are the s/s of Asthma?
- A – accessory muscle use
- S – SOB/dyspnea
- T – Tight chest/tachypnea
- H – High pitched wheezing
- M – Minimal/diminished breath sounds
- A – 3 A’s
- Absent breath sounds (silent chest) PRIORITY
- Acidosis (CO2 retention)
- Air trapping (prolonged exhalation)
How does air trapping during an asthmatic attack manifest?
Barrel chest
True or False
Asthma can lead to hypercapnic respiratory failure.
True
What is hypercapnia?
High CO2
A pH of < 7.35 and a PaCO2 > 45 indicates…
Acidosis
A PaO2 < 80 indicates…
Hypoxia
What are the s/s of Hypoxia?
- Mental status change (FIRST SIGN OF HYPOXIA!)
- Agitation
- Restlessness
- Drowsiness
What is Status Asthmaticus?
- EMERGENT!
- Severe, life-threatening, acute episode of airway obstruction
- Intensifies once it begins, often does not respond to common therapy
What can Status Asthmaticus lead to?
Patient can develop pneumothorax and cardiac/respiratory arrest
What is the treatment of Status Asthmaticus?
- IV fluids – to promote sputum
- Potent systemic bronchodilator, steroids, epinephrine – to open airways
- Oxygen – to promote gas exchange/perfusion
- May need intubation to keep the airway open
What is the purpose of the peak flow meter?
Allows us to evaluate lung performance to anticipate a severe asthma attack before it happens
What is the procedure to use a Peak Flow Meter?
- Stand or sit in upright position
- Put the flow meter scale to 0 or lowest value
- Inhale deeply
- Put the mouthpiece in mouth & create a seal with the lips
- Exhale as quickly & forcibly as possible & record reading
- Repeat 2 more times, with a break of 5 -10 seconds between
- Record 1 score = the HIGHEST of the 3 attempts
What are some triggers for asthma attacks?
- Allergens (indicated by elevated eosinophils)
- Smoking
- Stress (emotional/physical)
True or False
Strenuous activity must be avoided to prevent an asthma attack.
False – take meds before exercise to avoid attack
True or False
Iced water can produce bronchospasms
True
What diagnostic procedures are used for Asthma?
Pulmonary Function Test (PFT)
What does a PFT measure?
- Forced vital capacity (FVC)
- Forced expiratory volume (FEV)
- Peak expiratory flow rate (PEFR)
What do “controller” drugs do for Asthma?
- Change airway responsiveness to prevent asthma attacks
- Used every day, regardless of symptoms
What do “rescue” drugs do for Asthma?
Actually stop attack once it has started
What are the two TYPES of drugs used for both controller and rescue therapy for Asthma and why?
- Bronchodilators – to open the airways
- Anti-inflammatories – to reduce inflammation of the airways
What type of bronchodilators may be used to treat Asthma, what does each do and name the drug used for each?
- B – Beta 2 agonist
- Relaxes smooth muscles of the airways
- albuterol
- A – anticholinergic
- dries out the body, decreasing secretions & dilating the airways
- Ipratropium
- M – Methylxanthines
- Prevents histamine/allergic reactions – opens airways
- Theophylline
What do we need to keep in mind regarding Theophylline use?
- Toxic and will cause tachycardia
- Therapeutic range is 10-20 mg/dL
