asthama is the chronic inflammatory disease of the respiratiory tract in which airways is narrowing and swell it up and production of the mucus this is a chronic condition which need proper treatment and as early as possible so knowledge of this condition can be useful for making differential diagnosis and proper treatment of the patient for the nursing students bsc and gnm and also can be used for their learning understanding and for their exam too

1. ASTHMA
Department of Medical
Surgical Nursing
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2. LEARNING OBJECTIVES
At the end of this lecture the students should be able to:-
Define asthma.
Enumerate the causes of asthma.
Explain about the pathophysiology of asthma.
List out the clinical manifestations of asthma.
Enumerate the diagnostic evaluation of asthma.
Explain the management of asthma. 2

3. Introduction
• Asthma is a condition in which airways narrow
and swell and may produce extra mucus. This
can make breathing difficult and trigger
coughing, a whistling sound (wheezing) when
breathe out and shortness of breath.
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4. DEFINITION
Asthma:---It is a chronic inflammatory disease of
airway in which inflammation causes varying
degree of obstruction in the airway.
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6. INCIDENCE
• Asthma affect an estimated 20 million
Americans.
• Among adults, women have 30 % greater
prevalence of asthma than men.
• 39% higher in African Americans than in whites.
• 4000 deaths per year.
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7. CLASSIFICATION OF ASTHMA
ASTHMA
Step 1
Mild intermittent
Step 2
Mild persistent
Step 3
Moderate persistent.
Step 4
Severe persistent.
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9. 1. Exact cause unknown.
2. Triggers:-
Allergens- IgE receptors mast cells.
Exercise induced asthma.
Respiratory infections.
CAUSES OF ASTHMA
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10. Nose & sinus problems.
 Allergic Rhinitis.
 Nasal polyps.
 Sinusitis.
 Smoking
Ct--CAUSES OF ASTHAMA
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11. • Drugs & food additives.
• Gastro esophageal reflux disease
(GERD).
• Emotional stress.
• Genetic factors.
• Bugs in house , pollen
Ct--CAUSES OF ASTHMA
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12. Release of mediators from the mast cells like eosinophils,
basophils, macrophages, lymphocytes.
Early phase response
(with in 30 – 60 min)
Late phase response
(with in 5 – 6 hours).
IgE mast cells mediated response
Triggers
PATHOPHYSIOLOGY
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13. •Bronchial smooth muscle
constriction.
•Excessive mucus secretion.
•Vascular leakage.
•Mucosal edema.
•Infiltration by eosinophils, basophils,
neutrophils.
•Inflammation.
•Bronchial hyperactivity.
•Infiltration with monocytes,
lymphocytes.
•Obstruction of large & small airways.
• Air trapping
•Respiratory acidosis
•hypoxemia 13

14. 1. Wheezing, fever.
2. Dyspneoa, chest pain.
3. Cough with sputum.
4. Prolonged expiration.
5. Signs & symptoms of hypoxemia.
CLINICAL MANIFESTATIONS
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15. 7. Restlessness & increased anxiety.
8. Increased pulse & B.P.
9. Pulsus paradoxus.
10.Tachypnea.
11.Absence of normal breath sounds.
Ct---CLINICAL MANIFESTATIONS
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16. 1. History taking.
2. Physical examination.
3. Pulmonary function test.
4. Chest x- ray.
5. Peak flow monitoring.
6. Blood studies.
7. Sputum culture sensitive
examination.
DIAGNOSTIC EVALUATION
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17. Medical management:
1. Anti inflammatory drugs:--
i. Corticosteroids
ii. Chronolyn sodium, nedochronil (for
children).
iii. Lucoterine modifiers, e.g. zafirlucast,
zeileuton, montelucast.
2. Bronchodilators:--
e.g. β- adrenergic agents, methylxanthine
preparations, anticholinergic agents.
TREATMENT
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18. Ct---TREATMENT
3. Mast cell stabilizers.
4. Anti IgE antibody.
5. Β2 sympathomimetics.
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19. • Pneumothorax.
• Rib fracture.
• Atelectasis.
• Pneumonia.
• Pneumomediastinum.
• Status asthmaticus.
COMPLICATIONS
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20. NURSING MANAGEMENT
Nursing diagnosis.
i. Ineffective breathing pattern related to disease
condition.
ii. Impaired gas exchange related to excessive
production of sputum.
iii. Imbalanced nutrition less than body
requirement related to anorexia. 20

21. Ct--Nursing diagnosis:--
iv. Activity intolerance related to difficult
breathing.
v. Anxiety related to disease condition.
vi. Deficient knowledge related to lack of
information and education
Ct-----NURSING MANAGEMENT
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22. Definition of asthma.
Causes of asthma.
Pathophysiology of asthma.
Clinical manifestations of asthma.
Diagnostic evaluation of asthma.
Management of asthma.
 Medical
 Nursing
SUMMARY
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23. BIBLIOGRAPHY
• Smeltzer, S.C., Bare, B.G., Hinkle, J.L., & Cheever,
K.H. (2010). Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing (12th ed.). Philadelphia:
Lippincott Williams & Wilkins.
• Black, J.M. & Hawks, J.H. (2009). Medical-Surgical
Nursing: Clinical Management for Positive
Outcomes (8th ed.). Philadelphia:
Elsevier/Saunders.
• Lewis, S.M., Dirkse, S.R., Heitkemper, M.M., &
Bucher, L. (2010). Medical-Surgical Nursing:
Assessment and Management of Clinical
Problems (7th ed.). St. Louis: Mosby.
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