Asthma Flashcards
Asthma Patho
chronic inflammation from exposure to allergen or irritants
- early phase: within 30-60 minutes
- late: 4-10 hrs
During an asthma attack
- respiratory alkalosis
2. respiratory acidosis (sign of respiratory failure)
The nurse caring for a client with asthma understands the pulmonary system most affected by asthma is the:
airways
Meds that can trigger asthma
- aspirin
- ACE inhibitors
- beta blockers
What should you teach the client who has asthma that is triggered by exercise?
“Use a short-acting beta2 agonist before engaging in exercise.”
Asthma Manifestations
- prolonged expiration
- wheezing
- cough
- hypoxemia
Hypoxemia signs
- restlessness and anxiety
- wheezing
- hyperresonance
- silent chest= failure
- confusion: most worried
Severe Acute Attack
- dyspenic at rest
- talk in words
- RR> 30
- P>120
- PEFR: 40%
- in ED or hospitalized
Life-threatening Asthma
- too dyspenic to speak
- sweating
- drowsy/confused
- PEFR < 20%
Status asthmaticus
Life-Treatening Asthma Exacerbation
- hypercapnia and hypoxemia
- can lead to pnemothorax
Asthma Diagnostics
- detailed history and physical exam
- pulmonary finction tests
Asthma Management
Adrenergics (beta-agonists) Steroids Theophylline Hydration Mask O2 Anticholinergics
Acute treatment of Asthma Attacks
Short acting bronchodilators
Epinephrine
Oxygen
Prophylactic (preventative) therapy to reduce number of asthma flares
Inhaled corticosteroids
Long acting bronchodilators
Inhaled Anticholinergic
Management of triggers (treatment of seasonal allergies)
3 Types of Bronchodilators
β2-adrenergic agonists (long and short acting)
Methylxanthines
Anticholinergics
Short-acting β2-adrenergic agonists
- albuteril and pirbuterol
- for acute bronchospasm
- onset in minutes
Quick-relief bronchodilators (rescue inhalers)
Treat symptoms of acute exacerbations
Short-acting inhaled β2-adrenergic agonists (e.g., albuterol [Proventil HFA])
Anticholinergics
Inhaled Corticosteriods
- Pulmicort
- don’t use with corticosteroids
- for persistent asthma
- 1-2 wks before effective
- women: take calcium & vit D
Leukotriene modifiers
- bronchodilator and anti-inflammatory
- prophylactic and maintenance
- allergy & exercised induced
Monoclonal Antibodies
- prevents IgE from attaching to mast cells
- high risk of anaphylaxis
Bronchodilators (long-acting/long-term control)
- beta agonists
- effective for 12 hrs
- added to ICS
- not monotherapy
Methylxanthines
- theophylline (therapeutic: 10-20 mcg)
- step 2 care in mild persistent asthma
- bronchodilator with mild antiinflammatory
- high interaction
Anticholinergic drugs
- Short-acting (e.g., ipratropium [Atrovent])
- Long-acting (e.g., tiotropium [Spiriva])
- in combo with SABA
- SE: dry mouth
Peak Flow results
Green zone -80-100% -remain on meds Yellow -50-80% -trigger Red ->50% -definitive action taken
