Asthma discharge

Question 1

explain & reassure

Answer 1

long term inflammation of airways

in class of 30 aged 5, 10 will wheeze with cold, 2 will develop asthma

Question 2

initial mx then escalating options

Answer 2

salbutamol reliever

if x3 a week or waking up –> ICS

still symptomatic –> remove ICA; use ICS + LABA

Question 3

explain each asthma med

Answer 3

pred –> steroid –> reduce inflammation in acute exacerbation

salbutamol reliever –> opens up airways. up to 10 puffs in acute attacks

beclomethasone preventer –> long term, regular use

Question 4

steroid SEs

Answer 4

minimise thrush by proper washing & oral hygiene

effect on growth - 3 schools of thought
- nope because it has local effect on lungs

• tiny theoretical risk that is outweighed by the advantages, especially if we consider the risk of asthma if we let it go unchecked
• risks growth, general health, development, education etc

Question 5

inhaler + spacer technique

Answer 5

expiry date, cannister full, no dust or dirt

take cap off, shake well, attach to spacer, tight seal with spacer,

one puff into chamber, 5-6 normal breaths, spacer clicks if correctly, whistles if wrongly

Question 6

spacer maintenance

Answer 6

wash regularly with soap and water

do NOT towel dry it, leave it to air dry (static - powder stuck)