Asthma Flashcards
A chronic lung disease that causes narrowing and inflammation of the airways, specifically the smaller airways like the bronchi and bronchioles
Asthma
Is there a cure for asthma ?
No, but it can be managed
What surrounds the bronchi and bronchioles ?
Smooth muscles that can constrict or dilate.
What happens during an allergy attack?
The smooth muscles are triggered by something and constrict the bronchi and bronchioles causing chest tightness and dyspnea
what is inside the structures of bronchioles and bronchi and what happens during asthma attack?
The mucosa lining contains mucus producing goblet cells. The lining becomes more inflamed and the goblet cells produce excessive mucus that further decreases airflow.
This leads to cough, wheezing. There will be air trapping and they cannot fully exhale. If we have air trapping, gas exchange is not going on
We will have decreased oxygen levels and increased carbon dioxide levels
What kind of things can trigger asthma attacks ?
Smoke, pollen, pollution, perfumes,
dander, dust, mites, pests
cold and dry air, mold
Respiratory infection, GERD, hormonal shifts, exercise
intake of certain substances (beta adrenergic blockers that are nonselective) NSAIDS, aspirin, preservatives (sulfites)
Early S/S of Asthma attack
starting to become short of breath easily
easily fatigued with physical activity
frequent coughing (mainly at night) and trouble sleeping at night
symptoms similar to a cold: sneezing, scratchy throat, tired, headache
irritable
wheezing with activity
reduced peak flow meter reading
S/S of Asthma Attack
Chest Tightness
Wheezing (auscultate…expiratory wheezing and can progress to inspiration in severe cases)
Coughing
Difficulty Breathing (***especially exhaling)
Increased respiratory rate
Can progress to: where rescue inhaler won’t work, can’t talk easily, chest retractions (stomach sucked in, chest sticking out along with collarbone with each breath…this means the patient is not getting enough air into the lungs), cyanosis of the lips and skin, sweaty…need medical intervention fast!!
What can a peak flow meter do?
it shows how controlled a patient’s asthma is and if it is getting worse (lets a patient know if an attack is pending…several hours to days before one)
Patient presenting with an asthma attack - what are you going to do ?
Baseline Vital signs
Keep patient calm and comfort the patient
Position in High Fowlers to help with ease of breathing
Administer Bronchodilators as ordered by MD (short acting)
Administer Oxygen (O2 sat 95-99%)
Assess peak flow meter reading (watch for numbers less than 50% of the patient’s personal best reading)
Auscultate lung sounds throughout: (decrease in wheezing?….patient breathing easier? respiratory rate normal?)
Monitor skin color and for any retractions of the chest, can they talk to you with ease now or is it still difficult for them to talk?)
Current peak flow meter reading numbers (if the patient uses this device…ask patient (if they know) their personal best reading and current readings, and medications they’ve take
This device shows how controlled asthma is and if it is getting worse
Peak Flow meter
How to use a peak flow meter ?
the patient will exhale as hard as they can onto the device. The device will then measure how much air was exhaled out of the lungs.
Many times a peak flow meter is used with an asthma action plan created with MD. As stated above, the device measures the airflow out of the lungs (large airways) not small (so the patient needs to know early warning signs too). It helps the patient know when they need to take a short-acting bronchodilators and when they should go to the hospital for treatment.
When a patient starts using a peak flow meter, they need to FIRST figure out their personal best peak flow meter reading. This will be the highest number reached over a period of time. It will be the number used to compare against other reading numbers, which will allow the patient to know if their asthma is under good control.
How is the personal best peak flow meter reading figured out? The patient will use the peak flow meter to figure out their best peak flow reading when their asthma is under good control, and measure it once in the morning and once at night for 3 weeks usually and record the numbers BEFORE TAKING MEDICATION. The highest number they obtain over this period of time will be their personal best reading.
Then they will need to continue to use the peak flow meter at the same time every day, either in the morning or at night BEFORE TAKING MEDICATION, and compare it with the personal best reading. If the reading is 80% or less than their personal best, they need to follow the action plan created with their doctor.
Education for asthma patient
You will be providing them with education on how to follow their prescribed asthma action plan (quiz the patient to ensure they understand how to follow the plan).
Help the patient identify triggers (educate them on the triggers), how to avoid (except exercise-induced) and those early warning signs.
What if an asthma trigger is exercised-induced?
The patient doesn’t need to quit exercising (important for overall health). To help decrease the chances of an attack they can:
warm up before exercising for 10-15 minutes
administer short acting beta agonists before exercising
breathe through nose instead of mouth during cold windy days to warm the air before it enters the lungs (cold air can make the smooth muscles around the airway constrict)
avoid exercising when sick with a respiratory illness
Medications used to treat asthma- 2 categories
Bronchodilators
Anti Inflammatories
Bronchodilators types used for Asthma:
Beta-agonists* and Anticholingerics*, Theophylline
*commonly given as inhaled routes for asthma…theophylline is oral
