definition , causes, clinical features. diagnostic evaluation, management

2. A chronic lung disorder that is marked by recurring
episodes of airway obstruction (as from bronchospasm)
and that is triggered by hyper reactivity to various
stimuli.
http://www.merriam-webster.com/dictionary/asthma

3. Narrowed bronchioles
(muscles spasms)

4. 1. Allergic asthma (extrinsic)
2. Non-allergic asthma (intrinsic)
3. Cough variant asthma
4. Occupational asthma
5. Exercise induced asthma
6. Nocturnal asthma

5.  It is triggered by allergens
 Triggers:
 Irritants- Tobacco smoke, wood smoke, room deodorizers,
fresh paint, household cleaning products, cooking odours,
workplace chemicals, perfumes, and outdoor air pollution,
changes in temperature.

6.  It is triggered by non allergens

7.  When cough is the only asthma symptom, this is known as
cough variant asthma (CVA)

8.  A common respiratory condition that results from exposures in the
workplace
 Examples of the occupations and the potential irritants include:
a) Dental hygienists: latex
b) Bakers: flour
c) Welders and metal workers: metals: metals (nickel, platinum and
chromic acid)
d) Plastic manufacturer.
e) Farmers and veterinarians: animal proteins
f) Carpenters: wood dust

9.  A type of asthma triggered by exercise or physical exertion.

10.  Use drugs for other disease control

11.  The chances of having asthma symptoms are much higher
during sleep because asthma is powerfully influenced by the
sleep pattern.
 Causes : Exposure to allergens, cooling of the airways, heart
burn at night .

12. Genetic factors
Environmental factors
a) House dust mites
b) Exposure to tobacco smoke.
c) Predisposed to animals, pollens and dust.
Dietary changes – junk food and fast food .

13.  Lack of exercise - Less stretching of the airways
 Occupational exposure
- Irritants in the workplace : chemicals, dusts, gases and pollens.
- These can be found in industries , spray painting of cars, wood
working, chemical production.

14. Due to etiological factors
Increased inflammatory changes in
lungs
Constriction of bronchioles
Breathing impairment
dyspnea

15. Common symptoms of asthma
1. Coughing, especially at night
2. Wheezing
3. Shortness of breath
4. Chest tightness, pain, or pressure

16. Mild asthma attack
1. Cough
2. Wheezing
3. Mild difficulty breathing during normal activities
4. Difficulty sleeping

17. Moderate asthma attack
1. Severe cough
2. Moderate wheezing
3. Shortness of breath
4. Chest tightness
Usually worsens with exercise
5. Inability to sleep
6. Nasal congestion

18. Severe asthma attack
1. Severe wheezing
2. Severe difficulty breathing
3. Inability to speak in complete sentences
Sentences are interrupted by breathing
4. Inability to lie down
5. Signs of severe difficulty breathing

19. Rib retractions: ribs are visible during each breath
Nasal flaring: nostrils open wide during each breath
Use of accessory muscles: neck muscles are prominent during each
breath
1. Chest pain
Sharp, chest pain when taking a breath, coughing
2. Rapid pulse
3. Fatigue
4. Rapid breathing rate

20. Initial exam
History collection
Physical examination
Knowing Asthma symptoms, known asthma
and allergy triggers, activity level and diet,
home and work environment, and family
history.

21. Peak Flow Meter
PEFR is used to assess the severity of wheezing in those who have
asthma. PEFR measures how quickly a person can exhale air from the
lungs
Peak expiratory flow rate (PEFR)

22.  It measures how much air you can exhale.
 FEV1(force expiratory volume) > 80% = normal
 Confirms the presence of airway obstruction and measure the
degree of lung function impairment.
 Monitor your response to asthma medications

24. Pulse Oximetry
Blood levels of eosinophils
Sputum culture and sensitivity

27.  Bronchodilators
◦ -adrenergic agonists
(e.g., albuterol, salbutamol[Ventolin])
 Acts in minutes, lasts 4 to 8 hours
 Short-term relief of bronchoconstriction
 Treatment of choice in acute exacerbations

28. Antiinflammatory drugs
◦ Corticosteroids (e.g., beclomethasone, budesonide)
 Suppress inflammatory response
 Inhaled form is used in long-term control
 Systemic form to control exacerbations and
manage persistent asthma

29. Asthma nebulizer
Changes asthma medications from a liquid
to a mist, so that they can be more easily
inhaled into the lungs.

30.  Impaired breathing pattern
 Ineffective airway clearence
 Risk for infection
 Activity intolerence
 Imbalanced nutrition
 Fear and anxiety
 Sleep pattern disturbance
 Knowledge deficit

31. 1. Exercise: short, intermittent periods of
exertion.
2. Stop smoking.
3. Avoid environmental exposure .
4. Avoid dust allergens.
5. Perform breathing exercise.