The document discusses asthma, its symptoms, pathophysiology, and treatment. It then presents a case study of a 37-year-old female patient presenting to the emergency room with an asthma exacerbation characterized by shortness of breath, wheezing, coughing, and low oxygen saturation. Nursing assessments for the patient identify ineffective breathing patterns and impaired gas exchange. Interventions like positioning, breathing exercises, rest, hydration, and oxygen therapy are recommended to address these issues and improve the patient's condition.

1. Teacher: Laisa Camille D.Lubid
Presented by Group: 4

3. Asthma is a long term lung disease, that inflames and
narrows the airways. Asthma causes chest
tightness, shortness of breath, coughing, and
wheezing.

5. As your asthma worsens, three primary asthma
pathophysiology changes take place in your lungs:
• Increased Mucus
• Inflammation and Swelling
• Muscle Tightening

6. • Sudden dyspnea
• Wheezing
• Tightness in the chest
• Diminished breath sounds
• Coughing
• Thick, clear, or yellow sputum
• Rapid pulse
• Tachypnea
• Use of accessory muscles for breathing

7. Asthma is incurable but there is medications that can slow it
down. Inhalers having air inside them that give you air when
you’re having an attack.

8. Case study
Ms. Jane, a 37 years old female with a history of
asthma, presents to the ER with tachypnea, and acute
shortness of breath with audible wheezing. She
complained that “I cannot breath’’. Ms. Jane has taken her
prescribed medications of Cromolyn Sodium and
Ventolin at home with no relief of symptoms prior to
coming to the ER. A physical exam revealed the
following: HR= 110 bpm, RR= 40 bpm with signs of
accessory muscle use and the patient state is restlessness
and cyanosis. Auscultation revealed decreased breath
sounds with inspiratory and expiratory wheezing and she
was coughing up small amounts of white sputum. SaO2
was 85% on room air. An arterial blood gas (ABG) was
ordered with the following results: pH= 7.5, PaCO2=
27mmHg, PaO2= 75mmHg.

9. 1. Ineffective breathing pattern r/t presence of secretions
AEB productive cough and dyspnea.
2. Impaired gas exchange r/t ventilation perfusion
imbalance AEB dyspnea, RR= 40 bpm, and HR= 110
bpm.
3. Ineffective airway clearance r/t increased mucus
production AEB wheezing, dyspnea, cough, and
sputum
4. Fatigue r/t physical exertion to maintain adequate
ventilation AEB use of accessory muscles to breath.
5. Risk for activity intolerance r/t decreased oxygenation.

10. 1. Ineffective breathing pattern r/t presence of
secretions AEB productive cough and dyspnea.
2. Impaired gas exchange r/t ventilation perfusion
imbalance AEB dyspnea, RR= 40 bpm, and HR=
110 bpm.

11. Assessment Nursing
Diagnosis
Planning Interventions Rationale Evaluatio
n
Subjective
data:
“I cannot
breath.” as
verbalized by
the patient.
Objective
data:
>wheezing
upon
inspiration
and
expiration
>Acute
shortness of
breath
>dyspnea
Ineffective
breathing
pattern r/t
presence of
secretions.
Patient will
manifest
signs of
decreased
respiratory
effort AEB:
>Absence of
dyspnea,
cough, and
sputum.
Pattern of
breathing
effective be
mark on
normal
breath sound
and O2
saturation
normal AEB:
1. V/S
monitor
and record
2. Auscultate
breath
sounds and
assess
airway
pattern
3. Place the
patient in
semi-
fowler
position or
three-point
position.
1. To follow
up the
important
changes
2. to check
for the
abnormal
breath
sounds
3. To
minimize
difficulty
in
breathing

12. Assessment Nursing
Diagnosis
Planning Interventions Rationale Evaluat
ion
>coughing,
sputum is
white
>cyanosis
>SaO2= 85%
>V/S
RR: 40 bpm
HR: 110 bpm
BP: 130/90
mmHg
To: 36.8oc
>Breathing
remained within
normal limits
>Breathing, not
difficult
>Does not use
aids breathing
muscle.
Patient will
verbalize
understanding
of causative
factors and
demonstrate
behaviors that
would improve
breathing
pattern
4. Demonstrate
diaphragmat
ic, pursed-lip
breathing,
and
coughing
exercises.
5. Encourage
opportunitie
s for rest and
limit
physical
activities.
4. To
maximize
effort for
expectorati
on.
5. To prevent
situations
that will
aggravate
the
condition

13. Assessment Nursing
Diagnosis
Planning Interventions Rationale Evalua
tion
6. Keep
environmental
pollution to a
minimum
according to
individual
situation.
7. Increase fluid
intake to
3000ml/ day.
6. Precipitators of
allergic type of
respiratory
reactions that
can trigger or
exacerbate
onset of acute
episode.
7. Hydration
helps thin
secretions,
facilitating
expectoration
and using
warm liquids
may decrease
bronchospasm.

14. Assessment Nursing
Diagnosis
Planning Interventions Rationale Evalua
tion
8. Provide O2 as
ordered.
8. To maintain
normal O2 in
the body.

15. Assessment Nursing
Diagnosis
Planning Interventions Rationale Evaluation
Subjective data:
“I cannot breath”
said the patient
Objective data:
>dyspnea
>restlessness
>cyanosis
>SaO2= 85%
>ABGs result
PH= 7.5
PaCO2=27mmHg
PaO2=75mmHg
>V/S:
RR: 40 bpm
HR: 110 bpm
BP: 130/90
mmHg
To: 36.8 oc
Impaired
gas
exchange
r/t
ventilation
perfusion
imbalance.
Patient will
improve
gas
exchange
AEB :
>Absence
of cyanosis
>V/S is in
normal
limit
Patient will
demonstrat
e improved
ventilation
and
adequate
oxygenatio
n of tissues
AEB:
1. V/S
monitor
and record
2. Auscultate
breath
sounds and
assess
airway
pattern
1. Changes
in the
vital sign
will show
the
disease’s
progress
or client’s
progress
2. to check
for the
presence
of
adventitio
us breath
sounds

16. Assess
ment
Nursing
Diagnosis
Planning Interventions Rationale Evaluati
on
>ABG’s within
client’s normal
limits
Maintain client
comfort AEB:
>Assessing ease of
breathing every 4
hours.
3. Elevate head
of the bed
and change
position of
the pt. every 2
hours.
4. Encourage
deep
breathing and
coughing
exercises.
5. Encourage
opportunities
for rest and
limit physical
activities.
6. Provide O2
ventilation
3. To minimize
difficulty in
breathing.
4. To maximize
effort for
expectoration.
5. To prevent
situations that
will aggravate
the condition
6. To increase O2
perfusion in
the body.