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.

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.