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INTRODUCTION:
Asthma is a lower respiratory tract
disease;it is an pulmonary obstructive
disease.It is also called as “REACTIVE
AIRWAY DISEASE
DEFINITION:
 Asthma is a common chronic
inflammatory disease of the airways
characterized by variable and recurring
symptoms, reversible airflow obstruction
and bronchospasm. Common symptoms
include wheezing, coughing, chest
tightness, and shortness of breath
INCIDENCE:
It can occur in any age and in any sex
26 million are diagnosed with asthma
every year
10.6 million people are affected
Womens are increased risk of death
compare to men
In India 4000-6000 are dying every year
with asthma
TYPES:
ETIOLOGY:
Idiopathic
CAUSES:
RISK FACTORS:
Hereditary
Allergens
Airpollutants
Upper respiratory tract infections
Drug over dosage
Occupational exposures
Environmental factors
Psychological factors
PATHOPHYSIOLOGY:
CLINICAL MANIFESTATIONS:
Wheezing
Cough
Chest tightness
Dyspone
Hypoxia
Nasal flaring
Sputum is thick and tenacious
Decreased or absence of breath sounds
called “SILENT CHEST”
SYMPTOMS:
ASSESSMENT AND DIAGNOSTIC
STUDIES:
History collection
Physical examination
Pulse oximetry
Pulmonary function test
Arterial blood gas
Complete blood count
Chest x-ray
MANAGEMENT:
 Medications:
 Bronchodilators:
-long acting beta adrenagic blockers:
eg:salmeterol,formeterol,theophylline
 Anti-inflammatory drugs:
-corticosteriods:
eg:flunisolides,beclamethasone,cromolyn
-Mast cell stabilizers:
eg:montelukast,zileuton
 DRY POWDER INHALERS
CORTICOSTEROIDS ARE
MOST EFFECTIVE
DELIVERY METHODS:
Medications are typically provided as
metered-dose inhalers (MDIs) in
combination with an asthma spacer or as
a dry powder inhaler. The spacer is a
plastic cylinder that mixes the medication
with air, making it easier to receive a full
dose of the drug. A nebulizer may also be
used.
ADVERSE EFFECTS:
Long-term use of inhaled corticosteroids at
conventional doses carries a minor risk of
adverse effects.Risks include the
development of cataracts and a mild
regression in stature.
OTHER METHODS:
When asthma is unresponsive to usual
medications, other options are available for
both emergency management and prevention
of flareups. For emergency management
other options include:
Oxygen to alleviate hypoxia if saturations fall
below 92%.
Oral corticosteroid are recommended with
five days of prednisone being the same 2
days of dexamethasone.
Magnesium sulfate intravenous
treatment has been shown to provide
a bronchodilating effect when used in
addition to other treatment in severe
acute asthma attacks.
Heliox, a mixture of helium and
oxygen, may also be considered in
severe unresponsive cases
COMORBIDITES:
NURSING MANAGEMENT:
 Check vitalsigns at regular intervals.
 Monitor allergic symptoms.
 Administer medication, note action of
medications.
 Avoid exposure to pollution environment.
 Deep breathing exercises.
 Health education.
NURSING DIAGNOSIS:
Ineffective airway cleareance related
to bronchospasm.
Impaired breathing pattern related to
excessive mucus secretion.
Sleep pattern disturbance related to
cough and dysponea.
Anxiety related to difficulty in
breathing.
Knowledge deficit related to treatment
regimen.
yamini

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