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- Asthma -
Transcript of - Asthma -
SIGNS & SYMPTOMS
Use of accessory muscles during expiration
Wheezing on inspiration and expiration
Barrel chest - hyperinflation
Often runs in families
More than 100 genes have been identified that increase susceptibility
24.6 million people in the United States
Occurs at all ages
1/2 of all cases occur in childhood,
and another 1/3 before age 40
Death rate highest for adult females,
black people, and adults over age 65.
Supported by history of allergies and recurrent episodes of wheezing, dyspnea, cough,
or exercise intolerance.
Severe hyperinflation during attack can cause cardiac output.
As a Nurse Practitioner:
Avoid allergens and irritants
Use peak flowmeter
Don't underestimate severity
Chronic inflammatory disorder of the bronchial mucosa.
LATE RESPONSE (4-8 hours later, can be even more severe than early response)
Latent release of inflammatory mediators again induces bronchospasm, edema, and mucous secretion.
Allergy or irritant
IgE produced and
binds to mast cell
Degranulation of mast cell
Increased capillary permeability
Increased mucous secretion
Narrowed airway & obstruction of airflow (especially expiratory flow)
Air trapping & hyperinflation
distal to obstruction
Decreased alveoli perfusion
Hypoxemia without CO2 retention
(decreased CO2 & increased PH)
Severe air trapping causes CO2 retention
Silent chest (no audible air movement)
& PaCO2 greater than 70 mmHg
Ominous signs of
BEGINNING OF ATTACK:
Spirometry - shows a decrease
in FEV1 during induced attack.
Untreated inflammation can cause irreversible airway damage called
Inadequate treatment can lead to death.
EDUCATION (for patients with asthma)
Monitor for risk
Assess for symptoms
Refer to pulmonologist
Assess arterial blood gas & expiratory flow rates
Search for underlying trigger (ex: infection)
Hypercapnia - CO2
Expected early in attack
Need mechanical ventilation
#2: Inhaled bronchodilators
#3: Oral Corticosteroids
Increased allergen & irritant
exposures in childhood
Recurrent respiratory viral infections
(Lack of exposure to
common pathogens causes an imbalanced immune system)
Boys affected more than girls
McCance, K., & Huether, S. (2006). Pathophysiology (5th Ed). St. Louis, MO: Elesevier Mosby.
Gudnadottir, M., & Svavarsdottir, E. (2014). Advanced Nursing Intervention for Families of Children and Adolescents with Asthma: The Father's Perspective. Nursing Science, 34, 49-52.
Nkoy, F., Stone, B., Fassl, B., Koopmeiners, K., Halbern, S., Kim, E., Poll, J., ... Maloney, C. (2012, Nov.). Development of a Novel Tool for Engaging Children and Parents in Asthma Self-
Management. AMIA Annual Symposium Proceedings, American Medical Informatics Association.
Advanced Nursing Intervention for Families of Children and Adolescents
with Asthma: The Father's Perspective.
Development of a Novel Tool for Engaging Children and Parents in Asthma