Management of Patients withLower Respiratory Disorders ASTHMA At the end of the lecture, the student will be able to Describe the patho-physiology of the disease. Discuss the major risk factors and clinical manifestations of the disease. Use the nursing process as a framework for patient care. Discuss medical , surgical and nursing management of the disease.

1. MANAGEMENTOF
PATIENTSWITH
LOWERRESPIRATORY
DISORDERS
ASTHMA
Jamilah Saad Alqahtani
Nurse Lecturer, MSN, TOT, OR Nurse
Specialist, RGN, BSN

2. Objectives
• At the end of the lecture, the student will be
able to
◦ Describe the patho-physiology of the disease.
◦ Discuss the major risk factors and clinical
manifestations of the disease.
◦ Use the nursing process as a framework for
patient care.
◦ Discuss medical , surgical and nursing
management of the disease.

3. ASTHMA
◦ A chronic inflammatory disease of the airways that is largely reversible.
◦ Results in (1) airway hyper-responsiveness,(2) mucosal edema, and (3) mucus production.
◦ Most common chronic disease of childhood
◦ Allergy is the strongest predisposing factor.

4. Pathophysiology of Asthma

5. Clinical Manifestations
◦3 most common symptoms: dyspnea, wheezing, cough
◦Chest tightness
◦Tachycardia
◦Diaphoresis
◦Late signs: hypoxemia and central cyanosis

6. Assessment and Diagnostic Tests
◦ A positive family history
◦ Sputum tests - show eosinophilia (increased level of eosinophils)
◦ Serum Immunoglobulin E (IgE) – shows increased levels due to allergy
◦ Arterial blood gas (ABG) test – shows hypoxemia and respiratory acidosis
◦ Pulse oximetry - shows hypoxemia
◦ Spirometry – evaluate lung function

7. Prevention & Complications
PREVENTION
• Identify the substance that causes the asthma attack.
• Avoid the causative agents
COMPLICATIONS
• Status asthmaticus
• Respiratory failure
• Pneumonia
• Atelectasis

8. Pharmacologic Management
◦ Quick-relief medications
◦ for immediate treatment of asthma symptoms
◦ Most useful when an attack begins
◦ Beta 2-adrenergic agonists (ventolin)
◦ Anticholinergics (Atrovent)
◦ Long-term control medications (Prevention)
◦ to maintain control of persistent asthma
◦ has “NO VALUE” during an attack
◦ Corticosteroids (Fluticasone)
◦ Leukotriene modifiers (Montelukast)
◦ Mast cell stabilizers (Cromolyn Sodium)

9. Nursing Management
◦Obtain a history of allergic reactions to medications before
giving medications
◦Identify medications the patient is currently taking
◦Give medications as prescribed and monitor patient response
◦Give fluids if patient is dehydrated