Nsg: Asthma Flashcards
Childhood Asthma
Chronic inflammatory disorder of the airways.
Asthma episode/attacks are associated with airflow limitation or obstruction that reversable either spontaneously or with Tx.
S/s of asthma
Wheezing, breathlessness, chest tightness, cough (Especially @ night/early morning)
Etiology of Asthma
- Allergens: outdoor, indoor.
- Irritants: smoke, paint.
- Exposure to occupational chemicals
- Exercise
- Cold air or changes in weather or temp.
- Envro change: moving, new school
- Colds and infections
- Animals
- Meds: ASA, NSAIDS
- Strong emotions: anger, fear
- Foods: milk, peanuts
- Endocrine factors: thyroid diseae.
Patho of Asthma
-Bronchospasm and obstruction
Mechanisms responsible:
- inflammation and edema of the mucus membranes
- Accumulation of thick secretions from mucus glands
- Spasm of the smooth muscle of the bronchi and bronchioles.
What is Pulmonary Function Tests?
Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body’s circulation.
Spirometry measures airflow. By measuring how much air you exhale, and how quickly, spirometry can evaluate a broad range of lung diseases. In a spirometry test, while you are sitting, you breathe into a mouthpiece that is connected to an instrument called a spirometer. The spirometer records the amount and the rate of air that you breathe in and out over a period of time.
What is Peak Expiratory Flow Rate?
This test measures the amount of air that can be forcefully exhaled in one second. It is measured in L/min using a “Peak Expiratory Flow Meter”
Assessment of Asthma
-S/s
-History of attacks
-Last time reliever meds were used and lvl of relief.
-Ask questions about the asthma
what has helped in the past?
-Physical examiniation (Note)
-lab tests (PEFR, ABG’s)
-Pulmonary function tests (PFT)
-Peak expiratory flow rate (PEFR)
-skin and provocative testing.
What is a Metered dose-inhaler (MDI) ?
The holder of a spray.
Usually attached to an inhaled corticosteroid to prevent yeat infections in the mouth.
Asthma Interventions
1) Allergen Control
- Assist parent in modifying the enviro to reduce contact with offending allergen
2) Provide acute asthma care (for when having attack) to relieve bronchospasm
- Teach parent and older siblings to recognize early s/s of an upcoming attack
3)Support child and family (emotiona and with info)
4) Drug therapy:
- prevent/controls asthma
- reduces the severity and frequency of asthma exacerbations
- Reverses airflow obstruction.
- Teach correst use of prescribed meds
- Long term control meds: preventor meds. To maintain/control of inflammation Ex: corticosteroids (Flovent).
- Quick relief: Rescue meds. To tx s/s and exacerbations Ex: beta adrenergic agonists (Ventolin) (Bronchodilator)
(Note: Use Bronchodilator first to open airways, then use corticosteroid to control inflammation.)
5) Chest Physiotherapy:
- Instruct or supervise breathing exerises and controlled breathing to promote proper diaphragmatic breathing, side expansion, and improved chest wall mobility.
- use play techniques for breathing exercises with young children to extend expiratory time and increase expiratory pressure.
- teach family to perform percussion and postual drainage and to encourage coughing if indicated.
6) Encourage physical exercise
- Recommend activityes with short burst of energy and swimming
- Restrict activity only when child’s condition makes it necessary
- Encourage good posture for maximun lung expansion.
- Assist child and family in selecting activities appropriate to childs capabilities and preferences.
What is Croup?
Swelling or obstruction in the region of the larynx.
Can affect the larynx, trachea, and bronchi.
Describes according to the primary area affected. Ex: Epiglottis, larngitis, tracheitis.
S/s of Croup
- Hoarsness
- Resonant cough described as “barking” (croupy)
- varying degrees of inspiratory stridor
- Varying degrees of respiratory distress
What are Allergies?
Sensetivities to a specific substance called an allergen.
How can Allergens enter the body?
- Ingestion: Foods, meds.
- Inhalation: pollens
- Injection: Insect venom
- Skin absorptoin: poisonous plants.
Tx of Allergies
-Identifying the allergen
-Eliminating or limiting exposure to the allergen
-Use of Antihisamines (vasoconstrictors)
Ex: Benadyl, Caladryl.
What is Anaphylaxis?
Acute clinical syndome resulting from an interaction of an allergen and a pt who is HYPERSENSITIVE.
When the allergen entes the circulatory system, vasoactive amines are released and cause vasodilation, bronchoconstriction, and increased capillary permeability (break in capillaries) = edema.
Severe reactions are immediate in onset, are often life threatening, and frequently involve muliple systems.
