asthma BSc nursing 2nd year.pptx
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Asthma is a chronic inflammatory airway disease characterized by recurrent wheezing, breathlessness, chest tightness and coughing. It affects over 25 lakh Indians annually, with higher prevalence in women. The chronic inflammation causes airway hyperresponsiveness and obstruction. Symptoms are caused by early phase bronchoconstriction and late phase infiltration of inflammatory cells. Treatment involves inhaled corticosteroids, bronchodilators, and management of triggers through lifestyle changes and patient education.
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Empyema
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Asthma- Easy PPT for Nursing Students
Asthma- Easy PPT for Nursing Students
Definition & picture
Risk factors
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Pathophysiology
Assessment & diagnostic methods
Medical management
Lung abscess
Lung abscess is a localized infection and necrosis of lung tissue that forms a cavity containing pus. It is usually caused by aspiration or infection traveling via the bloodstream. Common symptoms include fever, cough, sputum production, and weight loss. Diagnosis involves chest x-ray or CT scan to identify lung cavities. Treatment consists of antibiotics chosen based on suspected bacteria and may require hospitalization. Complications can include spread of infection to the pleural space or amyloidosis.
Emphyisema
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Bronchitis
Bronchitis is an inflammation of the bronchial tubes caused by viral or bacterial infection or irritants like smoke. It is classified as acute (lasting days to weeks) or chronic (lasting months). Acute bronchitis is usually caused by cold/flu viruses while chronic bronchitis is often caused by long-term smoke inhalation. Symptoms include cough, wheezing, chest tightness and mucus production. Treatment focuses on reducing inflammation, opening airways, treating infection if present, and addressing underlying causes like smoking.
Atelectasis
Atelectasis is defined as the collapse or closure of the lung resulting in reduced or absent gas exchange. It develops when alveoli become airless from absorption of air without replacement through breathing. Common causes include obstruction of the airway by secretions, diminished distention of alveoli due to chest wall issues or neuromuscular disorders, and anesthesia effects. Signs include cough, dyspnea, and hypoxemia. Treatment focuses on clearing secretions through positioning, deep breathing, and chest physical therapy. Bronchodilators and mucolytics may also be used, along with mechanical ventilation for severe cases.
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A lung abscess is a localized cavity filled with pus in the lung, usually caused by a bacterial infection. Common causes include infections by anaerobic bacteria, aspiration of foreign materials, and complications from conditions like pneumonia or tumors. Symptoms include cough with foul smelling sputum, chest pain, fever, and dyspnea. Diagnosis involves chest x-ray, CT scan, and sputum culture. Treatment consists of antibiotics based on culture results, drainage procedures, and surgery if complications develop.
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Asthma- Easy PPT for Nursing Students
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Definition & picture
Risk factors
Clinical manifestations
Pathophysiology
Assessment & diagnostic methods
Medical management
Lung abscess
Lung abscess is a localized infection and necrosis of lung tissue that forms a cavity containing pus. It is usually caused by aspiration or infection traveling via the bloodstream. Common symptoms include fever, cough, sputum production, and weight loss. Diagnosis involves chest x-ray or CT scan to identify lung cavities. Treatment consists of antibiotics chosen based on suspected bacteria and may require hospitalization. Complications can include spread of infection to the pleural space or amyloidosis.
Emphyisema
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Bronchitis
Bronchitis is an inflammation of the bronchial tubes caused by viral or bacterial infection or irritants like smoke. It is classified as acute (lasting days to weeks) or chronic (lasting months). Acute bronchitis is usually caused by cold/flu viruses while chronic bronchitis is often caused by long-term smoke inhalation. Symptoms include cough, wheezing, chest tightness and mucus production. Treatment focuses on reducing inflammation, opening airways, treating infection if present, and addressing underlying causes like smoking.
Atelectasis
Atelectasis is defined as the collapse or closure of the lung resulting in reduced or absent gas exchange. It develops when alveoli become airless from absorption of air without replacement through breathing. Common causes include obstruction of the airway by secretions, diminished distention of alveoli due to chest wall issues or neuromuscular disorders, and anesthesia effects. Signs include cough, dyspnea, and hypoxemia. Treatment focuses on clearing secretions through positioning, deep breathing, and chest physical therapy. Bronchodilators and mucolytics may also be used, along with mechanical ventilation for severe cases.
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Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic
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Asthma and nursing managements
TOPIC: Nursing Management of Br.Asthma
المحاضر: فريدة محمد مصطفى (مشرفه التعليم الطبي بالتمريض)
SPEAKER: Sr.Fareedah M. Mustafa
( Nursing Education Coordinator , MGH)
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BRONCHIAL ASTHMA
ntroduction
Definition
Etiological factors
Pathophysiology
Types of asthma
Clinical manifestation Restlessness Wheezing or crackles Absent or diminished lung sounds Hyper resonance Use of accessory muscles for breathing Tachypnea with hyperventilation
Clinical manifestation
Diagnostic evaluation
Bronchoprovocation Testing: Testing that is done to identify inhaled allergens; mucous membranes are directly exposed to suspected allergen in increasing amounts. Skin Testing: Done to identify specific allergens. Exercise Challenges: Exercise is used to identify the occurrence of exercise-induced bronchospasm. Radio allergosorbent Test: Blood test used to identify a specific allergen. Chest Radiograph: May show hyper expansion of the airways.
Managemnet
Goal- Promote bronchodilationn Reduce inflammation Remove secretions Prevent ongoing symptoms Prevent asthma attack Maintain normal lung function Avoid triggers
Pharmacological therapy 1. Long term control medication- Inhaled corticosteroid Leukotriene modifiers Long acting beta agonist Methylxanthines Combine inhaler
2 Quick relief medication Short acting beta agonist Anticholinergic Oral or I/V corticosteroid
3 Bronchial thermoplasty- Form severe asthma that does not respond to medication
Non- pharmacological
Oxygen therapy Postural drainage & chest physiotherapy Coughing & deep breathing exercise Avoidance of allergen relaxation technique acupuncture
Prevention
Patients with recurrent asthma should undergo tests to identify the substances that precipitate the symptoms. Possible causes are dust, dust mites, roaches, certain types of cloth, pets, horses, detergents, soaps, certain foods, molds, and pol- lens. If the attacks are seasonal, pollens can be strongly sus- pected. Patients are instructed to avoid the causative agents whenever possible.
Complications Complications of asthma may include status asthmaticus, respiratory failure, pneumonia, and atelectasis. Airway obstruction, particularly during acute asthmatic episodes, often results in hypoxemia, requiring the administration of oxygen and the monitoring of pulse oximetry and arterial blood gases. Fluids are administered, because people with asthma are frequently dehydrated from diaphoresis and in- sensible fluid loss with hyperventilation.
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This document discusses asthma, including its definition, causes, risk factors, symptoms, diagnosis, management, and prevention. Asthma is a chronic inflammatory disease of the airways characterized by variable and recurring symptoms of wheezing, chest tightness, coughing, and shortness of breath due to bronchospasm and airway obstruction. It is caused by exposure to allergens and irritants and has strong familial links. Diagnosis involves assessing symptoms and lung function tests. Management focuses on relieving symptoms via bronchodilators and preventing exacerbations with anti-inflammatory drugs and avoidance of triggers. Nursing care monitors symptoms and ensures proper use of medications.
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COPD
COPD is a chronic lung disease characterized by obstructed airflow caused by conditions like emphysema and chronic bronchitis. Risk factors include cigarette smoking, genetics, and air pollution. Symptoms include excessive cough, shortness of breath, wheezing, and fatigue. Diagnosis involves assessing symptoms, examining lungs, and tests like chest X-rays, pulmonary function tests, and blood gas analysis. Treatment focuses on preventing further lung damage by quitting smoking, using bronchodilators and steroids, antibiotics for infections, and exercises to clear airways and strengthen breathing. Complications can be respiratory failure, pneumonia, and depression if not properly managed.
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Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic
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This document provides information about atelectasis, including:
- Atelectasis is a condition where one or more areas of the lungs collapse or do not inflate properly, resulting in inadequate gas exchange.
- It can be caused by obstructive factors like mucus plugs or non-obstructive factors like pleural effusions.
- Treatment aims to re-expand the lungs and includes techniques like bronchodilators, chest physiotherapy, bronchoscopy, and sometimes surgery.
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TOPIC: Nursing Management of Br.Asthma
المحاضر: فريدة محمد مصطفى (مشرفه التعليم الطبي بالتمريض)
SPEAKER: Sr.Fareedah M. Mustafa
( Nursing Education Coordinator , MGH)
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BRONCHIAL ASTHMA
ntroduction
Definition
Etiological factors
Pathophysiology
Types of asthma
Clinical manifestation Restlessness Wheezing or crackles Absent or diminished lung sounds Hyper resonance Use of accessory muscles for breathing Tachypnea with hyperventilation
Clinical manifestation
Diagnostic evaluation
Bronchoprovocation Testing: Testing that is done to identify inhaled allergens; mucous membranes are directly exposed to suspected allergen in increasing amounts. Skin Testing: Done to identify specific allergens. Exercise Challenges: Exercise is used to identify the occurrence of exercise-induced bronchospasm. Radio allergosorbent Test: Blood test used to identify a specific allergen. Chest Radiograph: May show hyper expansion of the airways.
Managemnet
Goal- Promote bronchodilationn Reduce inflammation Remove secretions Prevent ongoing symptoms Prevent asthma attack Maintain normal lung function Avoid triggers
Pharmacological therapy 1. Long term control medication- Inhaled corticosteroid Leukotriene modifiers Long acting beta agonist Methylxanthines Combine inhaler
2 Quick relief medication Short acting beta agonist Anticholinergic Oral or I/V corticosteroid
3 Bronchial thermoplasty- Form severe asthma that does not respond to medication
Non- pharmacological
Oxygen therapy Postural drainage & chest physiotherapy Coughing & deep breathing exercise Avoidance of allergen relaxation technique acupuncture
Prevention
Patients with recurrent asthma should undergo tests to identify the substances that precipitate the symptoms. Possible causes are dust, dust mites, roaches, certain types of cloth, pets, horses, detergents, soaps, certain foods, molds, and pol- lens. If the attacks are seasonal, pollens can be strongly sus- pected. Patients are instructed to avoid the causative agents whenever possible.
Complications Complications of asthma may include status asthmaticus, respiratory failure, pneumonia, and atelectasis. Airway obstruction, particularly during acute asthmatic episodes, often results in hypoxemia, requiring the administration of oxygen and the monitoring of pulse oximetry and arterial blood gases. Fluids are administered, because people with asthma are frequently dehydrated from diaphoresis and in- sensible fluid loss with hyperventilation.
Nursing diagnosis
Impaired gas exchange r/t altered oxygen supply Ineffective airway clearance r/t bronchospasm & obstruction from narrow lumen Ineffective breathing pattern r/t bronchospasm Risk for increasing attack of r
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This document discusses asthma, including its definition, causes, risk factors, symptoms, diagnosis, management, and prevention. Asthma is a chronic inflammatory disease of the airways characterized by variable and recurring symptoms of wheezing, chest tightness, coughing, and shortness of breath due to bronchospasm and airway obstruction. It is caused by exposure to allergens and irritants and has strong familial links. Diagnosis involves assessing symptoms and lung function tests. Management focuses on relieving symptoms via bronchodilators and preventing exacerbations with anti-inflammatory drugs and avoidance of triggers. Nursing care monitors symptoms and ensures proper use of medications.
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COPD
COPD is a chronic lung disease characterized by obstructed airflow caused by conditions like emphysema and chronic bronchitis. Risk factors include cigarette smoking, genetics, and air pollution. Symptoms include excessive cough, shortness of breath, wheezing, and fatigue. Diagnosis involves assessing symptoms, examining lungs, and tests like chest X-rays, pulmonary function tests, and blood gas analysis. Treatment focuses on preventing further lung damage by quitting smoking, using bronchodilators and steroids, antibiotics for infections, and exercises to clear airways and strengthen breathing. Complications can be respiratory failure, pneumonia, and depression if not properly managed.
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Gsatritis
Gastritis is an inflammation of the stomach lining that can be acute or chronic. Acute gastritis develops suddenly while chronic gastritis persists over a long period of time. Common causes include bacterial infections, NSAIDs, autoimmune disorders, and bile reflux. Symptoms may include abdominal pain, bloating, weight loss, and nausea or vomiting. Diagnosis involves medical history, physical exam, and tests like blood tests, stool tests, or endoscopy. Treatment focuses on antacids, H2 blockers, PPIs, antibiotics, and managing pain or nutrition imbalances. Prevention emphasizes diet, avoiding alcohol/smoking, exercise, and stress management.
Care of an unconcious patient
Consciousness refers to awareness of oneself and one's surroundings, while unconsciousness is an abnormal state where the client is unresponsive. Unconsciousness can have varying degrees of severity from brief fainting to deep comas. It can be caused by trauma, medical conditions, drugs/alcohol, and more. Signs include lack of response, unawareness, no purposeful movement, incontinence, and abnormal breathing. Assessment involves Glasgow Coma Scale and vital signs. Diagnostic tests include imaging, lumbar puncture, and blood tests. Medical management focuses on preserving brain function, treating complications, and preventing further damage. Nursing care for unconscious patients involves airway maintenance, positioning, skin care, nutrition, and working with
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This document provides information about colostomies, including:
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- Indications for a colostomy include birth defects, infections, inflammatory bowel disease, injuries, blockages, and cancers of the colon or rectum.
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Introduction, meaning,definition,causes,pathophysiology, sign and symptoms,diagnostic evaluation, management
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Cystic fibrosis is a genetic disease that causes thick, sticky mucus to build up in the lungs and digestive tract. It is caused by mutations in the CFTR gene and most commonly affects people of northern European ancestry. Symptoms include persistent lung infections, breathing issues, and poor growth/weight gain. Treatments focus on airway clearance, antibiotics, nutrition support, and managing complications. Nursing care involves managing respiratory symptoms, maintaining nutrition, and reducing anxiety related to dyspnea. While there is no cure, treatments have improved life expectancy in recent decades.
Respiratory system
The document discusses several respiratory disorders:
- Asthma is a chronic inflammatory disease of the airways causing hyperresponsiveness and mucus production. Common triggers include allergies, irritants, exercise and stress. Symptoms are coughing, wheezing and shortness of breath. Treatment includes preventative inhaled corticosteroids and bronchodilators for relief.
- Pneumonia is an infection of the lungs that causes inflammation in the air sacs. Symptoms are cough, fever, chest pain and shortness of breath. It can be caused by bacteria, viruses or fungi. Treatment involves antibiotics, fever relief medications and oxygen therapy.
- COPD is a lung disease characterized by obstruction of
asthma.pptx
Asthma is a chronic lung disease characterized by episodic airway obstruction due to bronchospasms, increased mucus secretion, and mucosal edema. It is triggered by both extrinsic allergens like pollen, animal dander, and foods as well as intrinsic factors like respiratory infections, stress, and pollution. Symptoms range from mild wheezing to difficulty breathing and low oxygen levels. Diagnosis involves pulmonary function tests, allergy testing, and monitoring lung function and oxygen levels. Treatment focuses on avoiding triggers, using bronchodilators and corticosteroids to reduce inflammation and open airways, and humidified oxygen for severe attacks to prevent complications like respiratory failure.
Respiratory diseases
The document discusses various respiratory diseases including obstructive and restrictive diseases, chronic obstructive pulmonary disease (COPD), asthma, pneumonia, bronchiectasis, and ventilator-associated pneumonia (VAP). It describes the characteristics, causes, clinical features, investigations, and management of these conditions. Key points include that COPD involves chronic bronchitis and emphysema, asthma is characterized by reversible airflow obstruction, and pneumonia can be community-acquired or hospital-acquired such as VAP in ventilated patients.
BRONCHIAL ASTHMA.pptx
Bronchial asthma is a chronic inflammatory disease of the airways characterized by airflow obstruction, bronchial hyperactivity, and mucus production. It affects 334 million people worldwide and causes 250,000 deaths per year. The disease has genetic and environmental causes and can be triggered by factors like dust, pollen, smoke, and exercise. It is diagnosed based on symptoms, medical history, and pulmonary function tests. Treatment involves bronchodilators, corticosteroids, and other drugs to relieve symptoms and reduce inflammation. Lifestyle changes and avoidance of triggers can also help manage the condition.
Copd
Chronic obstructive pulmonary disease (COPD) refers to chronic lung diseases characterized by airflow limitation. The two main conditions that make up COPD are chronic bronchitis and emphysema. Chronic bronchitis involves inflammation of the airways and excessive mucus production, while emphysema involves breakdown of lung tissue and enlargement of the airspaces. The primary cause of COPD is cigarette smoking. Symptoms include cough, sputum production, and shortness of breath. Management focuses on smoking cessation, bronchodilators, pulmonary rehabilitation, oxygen therapy, and preventing and treating exacerbations. Nursing care involves positioning, breathing exercises, suctioning and airway clearance techniques.
cough approach by aMit!!! GMCH
TUBERCULOSIS HAS BEEN EXCLUDED BECAUSE IN INDIA TUBERCULOSIS IS THE MOST COMMON CAUSE OF CHRONIC COUGH AND REST OTHER CAUSES OF CHRONIC COUGHS ARE IGNORED
ASTHMA IN PRG.pptx
Asthma is a chronic inflammatory disease of the airways that causes recurrent attacks of wheezing, breathlessness, chest tightness, and coughing. During pregnancy, over 50% of asthmatics experience exacerbations, especially between 17-34 weeks gestation. Changes in respiratory physiology during pregnancy like increased tidal volume can worsen asthma symptoms. Risk factors include allergens, irritants, infections, cessation of medications, and stress. Treatment focuses on controlling symptoms, preventing exacerbations, and minimizing medication use while protecting mother and fetus. Pharmacological treatments are the same as non-pregnant women and include bronchodilators and inhaled corticosteroids. Acute exacerbations require oxygen, hydration
Asthma
Asthma is a chronic lung disease characterized by inflamed airways that constrict in response to triggers. It can be extrinsic, caused by allergies to things like pollen, or intrinsic, brought on by non-allergic factors like infections or stress. Symptoms include wheezing, coughing, and shortness of breath. Diagnosis involves pulmonary function tests and ruling out other conditions. Treatment focuses on avoiding triggers, using medications to open airways like bronchodilators and preventers like corticosteroids, and humidified oxygen during severe attacks to prevent complications like respiratory failure.
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The human eye is located in bony sockets called orbits. It has three layers - the outer sclera, middle choroid layer with blood vessels, and inner retina layer with photoreceptor cells. The retina contains rod and cone cells that contain light-sensitive proteins to detect light and color. Signals from these cells are transmitted through the optic nerve to the brain for vision. The lens focuses light rays onto the retina, especially the dense fovea region for highest visual acuity. Fluids in the eye's chambers, such as the aqueous humor and vitreous humor, help maintain its shape and transfer signals.
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The document discusses pneumonia, defining it as an inflammation of the lung tissue caused by various microorganisms. It classifies pneumonia into types such as community-acquired, hospital-acquired, ventilator-associated, and pneumonia in immunocompromised patients. Risk factors, pathophysiology, clinical manifestations, diagnostic assessments, and management approaches are explained. The document also outlines a nursing care plan for patients with pneumonia focusing on ineffective airway clearance, fluid deficits, nutritional imbalances, and patient education needs.
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This document defines allergies as conditions caused by an immune system reaction to typically harmless substances. It discusses allergens like pollen, mold and foods that can cause allergic reactions. The document also describes the different types of hypersensitivity reactions, clinical manifestations of allergies, diagnostic tests, and medical and nursing management of allergic conditions.
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This document discusses deep vein thrombosis (DVT), including its definition, risk factors, causes, symptoms, diagnosis, treatment, nursing management, complications, and prevention. DVT occurs when a blood clot forms in a deep vein, usually in the legs. It is a common complication after surgery, with risks including prolonged immobility, older age, cancer, and orthopedic procedures. Treatment involves anticoagulants, compression stockings, elevation of the legs, and early mobilization to prevent further clots.
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asthma BSc nursing 2nd year.pptx
- 1. Asthma
- 2. Definition "Asthma is a chronic inflammatory disorder of the airways. The chronic inflammation causes an increase in the airway hyper-responsiveness that leads to recurrent episodes of wheezing,breathlessness, chest tightness and cough, particularly at night or early in morning.
- 3. Incidence • Asthma affect an estimate 25,00,000 indians every year. • Among adults ,women have 30 % greater prevalence of asthma than man.
- 4. Comparison of normal airway to asthmatic airway
- 6. Pathophysiology Release IgE Activate mast cell meditate response Release of Inflammatory mediators from mast cells, eosinophills, Macrophages, lymphocyte Triggeres ( infection, irritation,allergens)
- 7. Early phase response Late phase response • Bronchospasma • Mucus secretion • Vascular leakage • Mucosal edema Peak in 30-60 min Peak in 5-6 hrs • Infiltration with eosinophils & neutrophils • Inflammation • Bronchial hyperactivity • Infiltration with monocyte and lymphocytes In 1 to 2 days • Obstruction of airways • Wheezing • Air trapping • Coughing • Dyspnea
- 8. Types of asthma Intrinsic Extrinsic Mixed asthma Cough variant asthma Exercise induced asthma Nocturnal asthma Occupational asthma
- 9. Sign & symptoms of asthma • On auscultation- heard wheezing sound • Dyspnoea • Cough • Chest tight ness • Secretion may be thick, white , gelatinous mucus. • Expiration may be prolong
- 10. Diagnostic evaluation • History collection • Physical examination • Chest X- ray • Pulmonary function test • Peak exploratory flow rate • ABG ( artery blood gas) • Allergy skin test • Eosinophil count & IgE • Spirometry
- 11. Management of asthma Pharmacological management Anti- Inflammatory agent. ( corticosteroids) • Metered dose inhaler (MDI) - fluticasone, beclomethasone • Oral- prednisone, methyl prednisone • IV- hydrocortisone • DPI (dry powdered inhaler)- budesonide ,mometasone
- 12. Beta 2 adrenergic agonist Long acting (LABA) • Salmetrol (DPI) • Fotmoterol (nebulizer, DPI) Short acting (SABA) • Albuterol ( MDI, oral tablet, nebulizer) • Levalbuterol ( nubulizer , MDI) Anti IgE • Subcutaneous injection - omalizumab
- 13. Non-pharmacological management • Breathing exercises (breathing through the nose, slow breathing, controlled holding of breath.) • Reduced stress ,anxiety through meditation • Avoid smoking • Steam inhalation
- 14. Nursing management Nursing Assessment • History collection • Physical examination • Check all lab reports Nursing diagnosis • 1. Ineffective Breathing pattern related to bronchospasm as evidenced by prolonged expiration.
- 15. • Maintain the head of the bed elevated (fowler's position) and position the client depending on respiratory effort. • Plan for periods of rest between activities. • Encourage the client to use breathing exercises. • Encourage a proper diet that benefits both weight and allergen avoidance. • Avoid smoking • Administrator medication as order Intervention
- 16. 2. Ineffective airways clearance related to increased pulmonary secretions as evidenced by wheezing sound . Intervention • Encourage deep breathing and coughing exercises. • Encourage increase fluid intake. • Limit alcohol and caffienated drinks. • Assist with respiratory treatment such as spirometery and chest physiotherapy. • Steam inhalation
- 17. 3. Impaired gases exchange related to obstruction of airways by secretions as evidenced by dyspnea. Intervention • Provide Fowler's position and comfortable position. • Encourage expectoration of sputum, or suction if needed. • Administer supplemental oxygen as indicated. • Provide chest therapy as ordered.
- 18. 4. Fatigue related to increase work on breathing as evidenced by restlessness. Intervention • Place the client in comfortable position. • Enforce the need to stop exercise or activity before fatigue is exacerbated. • Schedule and integrate nursing care to allow periods of uninterrupted rest. • Encourage for balance diet. •
- 19. Health education • Teach patient to identify and avoid asthma triggers. • Take medication as prescribed. • Teach proper technique of using medication and equipment like inhaler ,nebulizer, peak flow rate meter. • Identify allergens and avoid allergens. • Control of pest in home.