Week 12- Asthma Flashcards by Kendra Lichty

What is the most common chronic illness in children?

asthma 155 deaths per year

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What is the cause of asthma?

unknown

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What is the asthma triad?

3 Common components in asthma that 12-15% of ppl with asthma have

nasal polyps
asthma
sensitivity to aspirin&NSAIDs

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What do 30% of asthmatics have?

chronic sinus problems

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What are predisposing factors to asthma?

genetics
atony (greater tendency to have allergic reaction to environmental allergens)\
Exposure to tobacco smoke

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Define atony.

Allergic

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What factors cause airway obstruction in asthma?

mucus
swollen mucosa
muscle spasm

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What are common triggers of asthma?

Irritants: tobacco smoke, exercise, weather changes, outdoor pollutants, exposure to indoor chemicals
Allergens: dustmites, pet dander, pollen, moulds, cockroaches, food additives

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What are common triggers of asthma?

Irritants: tobacco smoke, exercise, weather changes, outdoor pollutants, exposure to indoor chemicals
Allergens: dustmites, pet dander, pollen, moulds, cockroaches, food additives
Other factors: URT infection (90% of attacks in children triggered by a cold or flu), rhinitis/sinusitis, gastroesophageal reflux, sensitivity to aspirin and other NSAIDs, topical and systemic beta-blockers

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What triggers asthma attacks in 90% of children?

URT infection

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What are the characteristics of asthma?

sudden onset or persistent symptoms of:

dyspnea
chest tightness
wheezing
Sputum production
Cough

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What are the classifications of asthma

Mild- O2 sats >90%
Cough @ night, SOBOE

Moderate- O2 sats >90%
SOB @rest, talking, normal mental status

Severe- O2 sats >90%
Laboured resp, tachycardia
Can’t talk, altered mental status

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What is mild asthma?

O2 sats >90%

Cough at night, SOBOE

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What is moderate asthma?

O2 sats >90%

SOB at rest, talking, normal mental status

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What is severe asthma?

O2 sats >90%
Labouted resp, tachycardia,
Can’t talk, altered mental status

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What is the asthma severity scale?

4 classifications of severity of asthma

1: mild, intermittent
2: mild persistent
3: moderate persistant
4: severe, persistent

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What are the components of asthma management?

education
environmental control measures
- appropriate meds
- action plan, regular follow-up care
adherence to treatment plan

What are the components of asthma management?

education
environmental control measures
appropriate meds
action plan
regular follow-up care
adherence to treatment plan

how do you gain optimal asthma control?

education
environmental control measures
appropriate meds
action plan
regular follow-up care
adherence to treatment plan

What is the most common cause or trigger for the increasing rates of asthma in children?

dust mites

What are environmental conrols for dust mite triggered?

Get rid of the carpets; non laminent has to be hard wood

Laundry more than once a week in hot water

How do we promote asthma control?

Collaborative goals

relief & prophylaxis of attacks
prevention of exacerbation
provide quick relief of symptoms

How do we promote asthma control?

Collaborative goals

relief & prophylaxis of attacks
prevention of exacerbation
provide quick relief of symptoms
symtom control (cough, wheeze, chest tightness and breathlessness
use of least amount of medication with the least side effects

How do we assess for asthma control?

5 Q asthma test to assess for asthma control; if you answer yes to any one of these questions asthma is not under good control

What are the 5 Qs to assess for asthma control?

1. Do you use your blue inhaler 4x/wk? 2. Do you cough, wheeze or have a tight chest 4x/wk? 3. Do you cough, wheeze or have chest tightness wake you at night? 4. Did you stop exercising because of asthma in the last 3 months? 5. Do you miss school, work, social activities in the past 3 months?

What are 3 types of reliever medications

B2 agonists (salbumtamol-ventolin)- quick relief Anticholinergics (ipatropium bromide- atrovent)- not first line, can be in conjunction with ventolin Theophyllin, aminophyline (older, not routinely given)

Name a B2 agonist (reliever)?

salbumtamol (Ventolin)

Name an anticholinergic (reliever)

ipatropium bromide (atrovent)

Name 4 types of controller medications.

- corticosteroids (bdesonide, beclomethason, futicasone) Inhaled !st line - Leukiotriene antagonist (singulair, acccolate) - Prednisone 2nd line (status asthmatics only) - Long acting beta2 agonist- 2nd line (salmeterol)

What is classified as the green zone?

Peak flow 80-100% - no cough, wheeze, chest tightness, or shortness of breathing during the day or night TAKE LABA EACH DAY

What is classified as the yellow zone?

``` Peak flow 50-80% Cough, wheeze, chest tightness or SOB - Waking due to asthma - can do some but not all usual activities TAKE LABA AND ADD SABA ```

What is classified as the red zone?

Peak flow less that 50% - very SOB - SABA not helping - cannot do usual activities - symptoms are same or worsen after 24 hours in the yellow zone TAKE SABA & LABA AND GO TO EMERGENCY ROOM

What should be done in follow up?

PEFR (peak expiratory flow rate) L/min Measure amount of air that can be forcefully exhaled in 1 second ESTABLISH PERSONAL BEST

What should be done in follow up?

PEFR (peak expiratory flow rate) L/min Measure amount of air that can be forcefully exhaled in 1 second ESTABLISH PERSONAL BEST (PEFR symptom diary)

What is status asthmatics?

Ongoing severe respiratory distress despite vigorous treatment

How do you manage status asthmatics?

Assess: accessory muscle use, dyspnea, neuro, O2 sats Management by correction of dehydration, acid-base balance, electrolyte imbalance via IV, reduce hypoxia (O2 therapy, and sat monitoring, arterial blood gases, inhalation therapy, possible IV corticosteroids and high fowlers)

What is needed when developing a teaching plan?

``` Assessment Identify learning needs Plan Implement plan Evaluate ```

What is needed when developing a teaching plan?

Assessment (needs, development, readiness to lean, self-efficacy) Identify learning needs (cognitive affective psychomotor) Plan (objective, prioritize, collaborate, developmentally appropriate) Implement plan Evaluate

What are school based asthma programs?

developed to teach both children with or without the disease how to control it

Why school-based asthma programs?

- Asthma interfere with learning and limits physical activity at school - Convenient location to access student for health teaching - Provides knowledge about asthma to the school staff and students - Raises awareness about asthma and increases the chances of getting help quicker - Reduces bullying of children with asthma

What are 2 ontario based programs for asthma education?

Public Health School Asthma Project (Government of Ontario’s Ministry of Health and Long Term Care) Roaring Adventures of Puff (The Ontario lung Association)