School Age: Asthma Flashcards
T or F: asthma is most common chronic illnes in children
True
What time of the year is peak time for asthma?
Fall - September
What are some triggers of asthma?
Exercise, viral or bacterial agents, allergens, fragrances, food additives, pollutants, weather changes, emotions or stress
What is the impact of asthma on a child?
- Lifestyle
- Activity level
- Increase absences
- Medications on regular basis
- Hospital visits
Define asthma
chronic inflammatory disorder of the airways causing varying degrees of obstruction and narrowing in the airways
What are some protective factors that reduce risk for asthma?
large family size, later birth order, child care attendance, dog in the family, and living on a farm
What are common risk factors for asthma?
- Familial disposition
- Exposure to smoke
- House dust and mites
- Preterm birth
- Child who had RSV
- Pets
How does an acute asthma episode occur?
exaggerated inflammatory response = vasodilation, increased capillary permeability, mucosal edema, contraction of smooth bronchial muscle, and secretion of thick mucus = narrow and obstruct the air-ways (acute asthma episode)
What are characteristics of an acute asthma episode?
sudden onset of breathing difficulty, cough, wheeze, breathlessness, airway obstruction
What do triggers of asthma do?
Triggers increase frequency and severity of smooth muscle contractions (bronchospasms)
impaired expiration leads to: 3 things
air trapping, hyperinflation, and dyspnea
What are the 1st signs of asthma
- Can’t - Cough
- Wait – wheeze on expiration or prolonged expiration
- Till – tightness (chest)
- Spring – Shortness of breath (dyspnea)
What are the signs of increasing distress in asthma? (9)
Wheezing on inspiration and expiration
diminished breath sounds
tachypnea
use of accessory muscles (scalene)
retractions
anxiety
restlessness
agitation
positioning
What are the ominous signs of asthma? (5)
quiet chest
head bobbing
use of accessory muscles (increased work of breathing)
disorientation
lethargy
What are the ways to manage asthma? (7)
- Investigations (Chest X-ray, blood gases, pulmonary function tests)
-Humidified O2, pulse oximetry
- Hydration & IV access
- Positioning
- Quick –Relief Medications: Bronchodilators & anti-inflammatory agents
- Monitor airway response to treatment: frequent assessments pre/post meds
- Asthma pathway
What is the asthma pathway?
Objective tool used to assess patient with asthma and decide on frequency of assessment and medications
- uses PRAM score
T or F: Patient does not need salbutamol q4h if PRAM is less than 3
F, pt will always receive salbutamol q4h no matter the score
What PRAM score would lead to giving salbutamol? and when would you contact MD?
more than or equal to 3
- at 6 or more = contact MD
What are the assessments for PRAM?
- suprasternal indrawing (0 or 2)
- scalene retractions (0 or 2)
- wheezing (0-3)
- air entry (0-3)
What are the preventer or controller medications for asthma?
- inhaled corticosteroids (budesonide-Pulmicort)
- oral corticosteriods (predisone)
- long-acting bronchodilators aka beta agonists (salmeterol)
- combination meds (symbicort, advair)
What are the reliever medications?
- short acting beta agonist (salbutamol-ventolin)
What are nursing considerations for reliever medications?
- take before inhaled steroid
- dont use daily
- may use before exercise or activity
What does corticosteroid do for asthma?
Anti-inflammatory, reduces mucosal edema, controls seasonal allergies
What does beta agonist do for asthma?
Relaxes smooth muscle, increased bronchodilation & mucous clearing
