The document summarizes a presentation on asthma and hypertension given to nursing students. It defines asthma as a chronic lung disease caused by inflammation and narrowing of the airways. It describes different types of asthma including childhood onset, adult onset, exercise-induced, cough-induced, and nocturnal asthma. It discusses risk factors, pathophysiology, signs and symptoms, classifications, diagnostic tests, management, and common nursing diagnoses related to asthma.

1. SALALE UNIVERSITY COLLEGE OF HEALTH SCIENCE DEPARTMENT
OF ADULT HEALTH NURSING
SEMINAR PRESENTATION ON ASTHMA AND HYPERTENSION
PRESENTED TO MR.BIKILA T.(Bsc,Msc,Asst professor )
November 10,2023
Fitche,oromia,Ethiopia

2. GROUP MEMBERS
1. TOLOSA NEGUSE
2. YADETA KEBEDE
3. DEREJE AYELE
4. GELETO HINIKA

5. Asthma
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Asthma is a chronic lung disease affecting people of all
ages.
It is caused by inflammation and muscle tightening
around the airways, which makes it harder to breathe.

6. Types of Asthma
Child onset asthma:
For some children’s the onset of asthma may begin
during childhood.
Due to genetic reason, the child may become sensitized
to common allergens in the environment.

7. Adult-Onset Asthma:
This term is used when a person develops asthma after
reaching 20 years of age.
Adult-onset asthma affects women more than men, and
it is also much less common than child-onset asthma.

8.  Exercise-Induced Asthma:
 After exercise, if you feel difficulty in breathing or
wheezing, then you could be suffering from
exercise-induced asthma.
 Obviously, your level of fitness is also a factor – a
person who is unfit and runs fast for ten minutes is
going to be out of breath.

9. Cough-Induced Asthma: Cough-induced asthma is
one of the most difficult asthmas to diagnose. The
doctor has to eliminate other possibilities, such as
chronic bronchitis, post nasal drip due to hay
fever, or sinus disease. In this case, the coughing
can occur alone, without other asthma-type
symptoms being present.

10. Nocturnal Asthma: It occurs only during night
time from night to 8 am. It is due to the dust
and pet dander or may be due to a sinus
condition. The patient may have wheezing or
short breath when lying down and may not
notice these symptoms until awoken by them
in the middle of the night – usually between 2
and 4 AM. Nighttime symptoms may also be a
common problem in those with daytime
asthma as well.

11. Risk factors/Triggers for Asthma
• Air Pollutants
– Aerosol sprays
– Cigarette smoke (21% of asthma pts smoke)
– Exhaust fumes
– Perfumes
– Sulfur dioxides
• Allergen Inhalation
– Animal dander (cats..)
– House dust mite
– Pollens
• Genetics (very complex)
• Immune response (early exposure reduces the incidence)
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12. Risk factors/Triggers for Asthma
• Drugs
– Aspirin
– β-Adrenergic blockers (timolol, metoprolol,...causes
bronchospasm)
– NSAIDS
• Food Additives
– Alcohols, dried fruit, processed potatoes
– Monosodium glutamate
– Food preservatives (Sulfites (bisulfites and metabisulfites),
Tartrazine
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13. Pathophysiology of Asthma
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14. Pathophysiology of Asthma
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15. Early warning signs
Itchy, scratchy, or sore throat
Waking up at night
Dark circles under eyes
Runny, stuffy or congested nose
Increased tiredness
Chest tightness, pain, or pressure
Shortness of breath
Coughing, especially at night
Wheezing
Thirst
Itchy, glassy or watery eyes
Rubbing nose a lot
Sneezing
Stomach ache
Headache
Fever
Feeling restless
Change in face color – pale or flushed

16. Clinical Manifestations /Common/
• Wheezing
• Cough
• Dyspnea
• Chest tightness
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17. Status Asthmaticus
• Life-threatening medical emergency, most extreme form of
an asthma attack.
• It is characterized by hypoxia, Hypercapnia, and acute
respiratory failure.
• The patient is unresponsive to treatment with
bronchodilators and corticosteroids.
• The patient may have chest tightness, a severely marked
increase in shortness of breath, or suddenly be unable to
speak.
• Hypotension, bradycardia, and respiratory and/or cardiac
arrest may occur if we do not recognize that the patient’s
condition is getting worse.
• The patient must be immediately intubated, and mechanical
ventilation started.
• Hemodynamic monitoring of the patient is critical.
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18. Complications
• Pneumonia
• Tension pneumothorax
• Status asthmaticus
• Acute respiratory failure
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19. Status Asthmaticus
• Analgesia and sedation are essential.
• Continuous analgesic infusions (e.g., ketamine, morphine)
and sedation with drugs such as propofol help decrease work
of breathing and facilitate patient synchrony with the
ventilator.
• Sometimes neuromuscular blocking agents may be used.
• Inhaled anesthetics, such as isoflurane or halothane, are an
option for those not responding to conventional treatment.
• IV magnesium sulfate, which has a bronchodilator effect,
may be given to patients with a very low FEV1 (forced
expiratory volume in 1 second) or peak flow (less than 40% of
predicted or personal best) or those who do not respond to
initial treatment.
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20. Classification of Asthma
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21. Diagnostic studies
• Under diagnosis of asthma is common.
• A detailed history is important to determine if a
person has had similar attacks, which are often
precipitated by a known trigger.
• Because wheezing and cough occur with a variety of
disorders (e.g., COPD, GERD, vocal cord problems,
heart failure), it is important to determine if asthma
or some other disease process is the cause of these
problems.
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22. Diagnostic studies
• History and physical examination
• Spirometry, including response to bronchodilator
therapy
• Peak expiratory flow rate (PEFR)
• Chest x-ray
• Measurement of oximetry
• Allergy skin testing (if indicated)
• Blood level of eosinophils and IgE (if indicated)
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23. Diagnostic tests
Lung function tests: The function of the
lungs is tested for how much air that you
breathe in and out. It also measures the
rate at which you breathe out by using
equipment called spirometer. Hence this
test is also called a spirometry test.

24. Bronchoprovocation test: It is a test to measure
how much sense the airways of your nose. With
the help of spirometer function of the lungs is
repeatedly measured during the physical
activities or after you received a dose of cold air
or a special drug called bronchodilator to
breathe.
Peak air flow meter: the peak airflow flow meter
is much sensitive device indicates the changes
that occur in your airways. Before you notice
signs and symptoms this device can help to avoid
serious effects of it.

25. Fractional exhaled nitric oxide (FeNO) Test: It
is a test to measure the amount of nitric oxide
present in your breathing air. FeNo is a non-
invasive and quick test. The results of this test
will help to identify the amount of
inflammation in airways.

26. Provocation test: It is a form of a clinical
trial whereby participants are exposed to
either a substance or a molecule that is
claimed to provoke a response.
Methacholine is a known asthma trigger
that, when inhaled, will cause mild
constriction of your airways. If you react to
the methacholine, you likely have asthma.
This test may be used even if your initial
lung function test is normal.

27. Managements of Asthma
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28. Quick Relief vs. Long-term Control of Asthma
Quick Relief
• Bronchodilators
– Short-acting inhaled β2 -adrenergic agonists
(e.g., albuterol)
– Anticholinergic (inhaled) (e.g., ipratropium)
• Anti-inflammatory Drugs
– Corticosteroids (systemic) (e.g., prednisone)
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29. Quick Relief vs. Long-term Control of Asthma
Long-term Control
• Ant inflammatory Drugs
– Corticosteroids
• Inhaled (e.g., fluticasone )
• Oral (e.g., prednisone)
• Bronchodilators
– Long-acting inhaled β2 -adrenergic agonists (e.g., salmeterol)
– Long-acting oral β2 -adrenergic agonists (e.g., albuterol)
– Methylxanthines (e.g., theophylline)
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31. Common Nursing Diagnosis
• Impaired breathing
• Activity intolerance
• Anxiety
• Lack of knowledge
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32. Nursing Interventions
• Health promotion
– Patient education
• Identify and avoid known personal triggers
–Dressing properly during cold weather
–Avoid exposure to pollens, dusts, known
irritants
–Timely treatment for URTI
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