Chapter 11: Respiratory Complications: Asthma

Question 1

Asthma

Answer 1

most common form of lung disease that affects pregnancy
-characterized by a limitation of airflow that is generally more marked during expiration than during inspiration
-the obstruction associated with asthma is a reversible process caused by airway inflammation and an increased responsiveness of the airways to a variety of stimuli (e.g. dust, pollen, grass, and cold temperatures)
>the airway response to the stimuli involves contraction of the bronchial smooth muscle, hypersecretion of mucus, and edema of the mucosal surfaces

Question 2

Effects of Pregnancy

Answer 2

complications reported among asthmatics include hyperemesis, vaginal bleeding, hypertensive disorders, a predisposition to infections, gestational diabetes, preterm rupture of membranes and PTL, and delivery of a low-birth-weight infant
-there is little risk to the fetus with well-controlled maternal asthma; safer for pregnant asthmatics to be treated with appropriate medications than to have asthma symptoms and exacerbations
>exacerbations that cause hypoxia and decrease uterine blood flow increase incidence of intrauterine growth restrictions, preterm birth, and neonatal mortality

Question 3

S/S

Answer 3

dyspnea, coughing, wheezing, voice changes, chest tightening, and the presence of scant or copious clear sputum
-lung auscultation usually reveals bilateral expiratory wheezing

Question 4

Management

Answer 4

careful monitoring and appropriate adjustments in therapy may be required to maintain maternal lung function and ensure adequate oxygen supply to the fetus

• failure to control asthma during pregnancy can lead to hypoxia in both patient and fetus; PO2 less than 60 mm Hg places fetus in jeopardy
• medications currently used for asthma are generally well tolerated during pregnancy and appear to be safe for the fetus

Question 5

Importance of patient adherence with asthma medications

Answer 5

• noncompliance with asthma medications is the primary cause of worsening asthma symptoms during pregnancy
• nurses should reinforce the importance of taking asthma medications as prescribed to promote maternal-fetal well-being