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Asthma Concept Map

Pediatric Respiratory Map

Rebecca Weldon

on 27 September 2012

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Transcript of Asthma Concept Map

Asthma Concept Map By: Heather Leary
and Rebecca Weldon Parent Specific Teaching Concept Map Nursing Process Nursing Process #1 Nursing Process #2 Nursing Process #3 •HR is 97 within 20 minutes of initiating oxygen therapy. •Patient correctly demonstrates breathing techniques before discharge. •The patient will take in 8 oz of fluid Medical Interventions Nursing Interventions Risk factors Causes Signs & Symptoms Medical Diagnosis Pathophysiology Anxiety
Chest tightness
Edema of bronchial mucosa
Hypercapnia Encourage family members to participate in the learning process Parent Resources
http://www.cdc.gov/asthma/children.htm Parent Interventions Stress the importance of follow-up care Nursing Process #4 •Monitored exposure to allergens •Anti-inflammatory agents for the long-term asthma Hyperinflation of lungs
Non-productive cough
Prolonged expiration
Retraction of intercostal spaces
Shortness of breath
Use of accessory neck muscles
Wheezing Asthma is a hypersensitivity reaction to a stimulus that is more serious than other reactions. During this inflammatory process, TH2 cells stimulate B cells to differentiate into IgE producing plasma cells. These cells produce growth factors for mast cells and cause eosinophils to activate.
IL-4 and IL-5 and TNF alpha cells activate which causes inflammatory cells to activate, migrate, and eventually proliferate.
Then fibroblast to activate and they change the appearance of the airway. This happens because lymphocytes, eosinophils and mast cells are present. These cells also cause damage the epithelium line of the bronchials. The reaction is exaggerated and includes inflammation of the airway. Types: Atopic asthma is also known as extrinsic asthma. This type of reaction There are two types of asthma which are atopic and nonatopic. Nontropic asthma which is also known as intrinsic is caused by an extrinsic antigen or allergen. This disease usually occurs in childhood or adolescents especially in patients with a family history of allergies. asthma is considered an autoimmune disease •Spirometry test •Detailed history of family and person •Physical Examination •Pulmonary function testing •Allergy testing •Inhalation challenge test •Bronchodilators •Corticosteroids •Leukotriene modifiers •Beta-2 adrenergic agonists (long and •Rescue inhalers •Air humidifiers •Using a nebulizer to administer medication and breathing treatments •Removing allergens and irritants •Corticosteroids Stress Exercise Food allergies Upper respiratory tract infections Indoor allergies: pollens paints molds Irritants such as smoke, perfumes and paints Outdoor allergies: dander, molds, and insects Emotions: laughing and depression Overuse of aspirin Cold airs Hormonal changes Congestive heart failure Allergies: pollen, dander, mites, molds, Having a blood relative with asthma Low birth weight GERD Obesity Pulmonary embolism Between ages of 2-17 dust, air pollution Airway management Respiratory management (rebreathing techniques and Vital sign monitoring (making sure pulse oxygenation is in Reduce exposure to allergens, or irritants, and any Teaching the client how to use inhalers or other Help the patient understand how to avoid Assess and document the rate and depth of breaths Administer oxygen as ordered Place client in Fowler’s Force fluids to liquefy secretions and prevent dehydration other stimulants positioning) the 90’s and heart rate is in the normal range) medications correctly every 2-4 hours allergens position Barelmo, J.M., & Eckman, M (Eds.). (2011). Professional Guide to Pathophysiology (3rd ed.) Ambler, PA: Lippincott Williams & Wilkins.

Matfin, G., Porth, C. M. (2009). Disorders of Ventilation and Gas Exchange. In H. Kogut, E.

Kors, D. Schiff, H. Surrena, (Eds.), Pathophysiology: Concepts of Altered Health States (pp. 709-714). Philadelohia, PA: Lippincott Williams & Wilkins

London, M.L., Ladewig, P.W., Ball, J.W., Bindler, R.C., Cowen, K.J. (2011). Maternal and child nursing care
(3rd ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Ralph, S. S., & Taylor, C. M. (2011). Nursing Diagnosis Reference Manual (8th ed.) China: Lippincott Williams & Wilkins Nursing Diagnosis: •vital sign monitoring (making sure pulse oxygenation is in the 90’s and heart rate is in the normal range) Nursing Interventions: •airway management- make sure airway is open and clear •respiratory management- re-breathing techniques and positioning •oxygen therapy Impaired gas exchange related to airway constiction as evidence by decreased pulse ox and wheezing. •HR is within the normal range for the patient’s age group within 30 minutes of
initiating oxygen therapy. Goals: •Patient states they are having an easier time breathing upon changes made in position and airway within 20 minutes. •Pulse Oxygenation is within the 90’s within 15 minutes of initiating therapy. Evaluation: •Patient states they are having an easier time breathing within 10
minutes of position changes. •Pulse ox is was 94% within 8 minutes. Activity intolerance related to impaired breathing as evidence by wheezing, panting and exhaustion. Nursing Diagnosis: •Reduce exposure to allergens or irritants and any other stimulants that would cause an asthma attack Nursing Interventions: •Monitor and record respiration rate, pulse oxygenation, heart rate and rhythm, and blood pressure •Teach patient how to conserve energy while breathing by focusing on deep breathing or using re-breathing techniques •Patient is able to demonstrate correct deep breathing and re-breathing techniques before discharge. Goals: •Patient is able to participate in PE at school after taking allergy medication or prescribed asthma medication within the first month treatment is initiated. Evaluation: •Patient is active and able to participate in physical activity without discomfort within 3 weeks of treatment. Nursing Diagnosis: Ineffective breathing pattern •force fluids to liquefy secretions and prevent dehydration. •Encourage 8 oz of fluid every 2 hours. Interventions: •assess and document the rate and depth of breaths every 2-4 hours •place client in Fowler’s position and adminster oxygen as ordered Goals: •Patient’s respiratory rate and effort will return to normal limits within •Patient’s respiratory rate will remain stable for the next 24 hours. •Encourage deep breathing, coughing, and incentive spirometer 3 hours of asthma attack. Evaluation: every hour. •Patient’s respiratory rate and effort are within normal limits •Respiratory rate is stable for the next 24 hours. •The patient will perform deep breathing, coughing and within 3 hours. incentive spirometer every hour. every 2 hours. •The family has accommodated the patient’s needs Deficient knowledge related to the control and treatment Nursing Diagnosis: of asthma as evidence by uncontrolled symptoms and patient report. •Encourage family members to participate in the clients learning process. Interventions: •Provide information about asthma and how to treat it (what asthma is and what •Teach the client how to use inhalers, spacers or other medications correctly •Help the patient understand how to avoid allergens (such as removal of pet dander, air filters,
plastic covers over down bedding) medications are prescribed)
•The patient includes and encourages family participation within the first month of diagnosis. Goals: •Patient will state what the definition of asthma is, what happens when they are having an asthma
attack and what they can do to alleviate their pain before discharge. •Patient will demonstrate the correct technique to use inhalers, spacers or other medications before
discharge. •Have the patient explore and identify 3 allergens and 3 tools and ways to avoid them within the first month of diagnosis. Evaluation: •Before discharge, the patient has explained their correct understanding of asthma and •The patient demonstrates the correct technique when self-administering medications •The patient can report they have identified allergens and tools to avoid how to treat it. before discharge. them during first 3 weeks of diagnosis. within the first two weeks of diagnosis. Provide information about what asthma is Inform the patient and parenthow you treat this disease Teach the client and parent how to use inhalers and other medications correctly Help the parent and patient understand how to avoid allergens Interventions Anticholingergics short acting) Learn how to prevent attacks How to measure peak expiratory flow readings and what it means Help them understand and cope with the diagnosis Help them understand the need for daily management to asthma in order to promote normal respiratory function Teach how to give rescue medications and how to give daily management medications as well These are some websites that can aid parents and even nurses in some situations. This site gives parents and nurses words to use that the child can understand such as breathing tubes instead of lungs, etc http://kidshealth.org/kid/asthma_basics/what/asthma.html This site gives tools and links to support groups as well as more information. This website some approaches for teaching their children about the illness if they don not understand after discharge. http://www.in.gov/isdh/reports/breatheasyville/parents/teachyourchildasthma.html related to constriction of airway as evidence by wheezing and decreased pulse ox.
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