Asthma

Question 1

Causes of Asthma

Answer 1

Allergens or irritants cause inflammation of airways causing limitations such as bronchoconstrictions, bronchial hyperactivity, and edema of the airway

Question 2

Triggers

Answer 2

Genetics, pollutants, allergen inhalation, infections, exercise, drugs (NSAIDs or salicylates), stress, etc

Question 3

S&S

Answer 3

• Nocturnal awakening d/t cough, wheezing, SOB, chest tightness
• Prolonged expiration
• inhalation-expiration ratio 1:3 or 1:4 because air takes longer to move out of bronchioles

Question 4

silent chest

Answer 4

severely decreased breath sounds which may signal severe airway obstruction and impending respiratory failure

Question 5

Severe manifestations

Answer 5

• use of accessory muscles
• RR > 30/min
• Restlessness, drowsy, confused, anxious
• status asthmaticus
• ALOC

Question 6

Diagnostics

Answer 6

• Pulmonary function tests
• Peak flow monitoring (PEFR)
• Chest X-ray
• ABGs
• Allergen testing

Question 7

Pulmonary Function Test

Answer 7

withold bronchodilators 6-12 hours before spirometry

Question 8

Peak Flow (PEFR)

Answer 8

Used to determine drug dosage and predict effectiveness of therapy

Question 9

PEFR Zones

Answer 9

• Green: airflow is normal
• Yellow: Airflow decreased, routine meds should be adjusted
• Red: Pt needs to use rescue medications and call healthcare provider

Question 10

Care for asthma

Answer 10

• ABG
• O2 Sats
• PEFR monitoring
• Oxygen by NC or Face Mask
• SABA first Corticosteroids after
• IV Fluids
• Teach patient to identify and avoid triggers
• Decrease patient’s sense of panic
• Encourage slow, pursed-lip breathing

Question 11

Asthma Meds

Answer 11

• Quick Relief: SABA (limited to < 2 times/week)
• Long-term:
• LABAs effective for 12 hours (i.e. salmeterol, formoterol)
• LAMAs (i.e. Ipratropium bromide aka Atrovent HFA)
• Corticosteroids: IV hydrocortisone; Methylprednisolone (Solu-Medrol)
• Leukotriene modifiers (motelukast/singulair)
• Monoclonal antibody (omalizumab/xolair)
• Combo Drugs: (budesonide/formoterol (symbicort) and fluticasone/salmeterol (Advair Diskus))

Question 12

Asthma Med Teaching

Answer 12

• Brush teeth after using corticosteroid to prevent candidiasis
• SABA first then corticosteroid
• Inhalers: shake, inhale, hold, exhale