Asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness and reversible airflow obstruction. It is caused by a combination of genetic and environmental factors such as family history, prenatal sensitization, exposure to allergens and pollutants, and infections. Asthma is classified based on severity from mild to severe. Symptoms include wheezing, coughing, chest tightness, and shortness of breath. Diagnosis involves assessing symptoms and lung function tests. Treatment focuses on bronchodilators and inhaled corticosteroids to prevent symptoms and exacerbations.

1. ASTHMA

2. INTRODUCTION
• There are two pathophysiological features of the disease are generally
agreed.
Airway Inflammation
increased airway reactivity

3. DEFINITION
• ASTHMA IS CONSIDERED TO BE A CHRONIC
INFLAMMATORY DISEASE OF THE AIRWAY
ASSOCIATED WITH HYPERRESPONSIVENESS TO
ENVIRONMENTAL STIMULI CAUSING REVERSIBLE
AIRFLOW, OBSTRUCTION AND RESPIRATORY
DISTRESS.

4. ETIOLOGY
✔ GENETICS
✔ EVIDENCE FOR PRENATAL SENSITATION TO AEROALLERGENS
✔ OTHER PRENATAL FACTORS
✔ BREAST FEEDING AND WHEEZING ILLNESS
✔ EXPOSURE TO HOUSE DUST, MITES AND PETS
✔ THE HYGIENE HYPOTHESIS
✔ BRONCHO PULMONARY DYSLASIA
✔ BRONCHIOLITIS

5. CLASSIFICATION
It is classified based on the degree of severity. It is classified into
MILD
MODERATE
SEVERE
MILD :
Occasional attack of wheezing or coughing with no symptoms
between attack.
MORERATE :
More frequent episodes, more persistent symptoms after an
exacerbation and often chronic cough, exercise tolerance may be
reduced.

6. CLASSIFICATION ctnd
SEVERE :
❖ Requiring frequent emergency attention and hospitalization.
❖ Wear med-alert bracelet and to carry a crisis plan
❖ For evaluating scoring system is helpful
❖ Greater than 10 indicates a high probability for hospital admission
❖ Greater than 12 or an arterial oxygen saturation less than 92 % on
room air should be admitted

7. PATHOPHYSIOLOGY
DUE TO ETIOLOGICAL FACTORS
AIRWAY INFLAMMATION
AIRWAY OEDEMAAND ACCUMULATION AND SECRETION OF
MUCUS
SPASM OF SMOOTH MUSCLES OF THE BROCHI AND THE
BROCHIOLES
BRONCHOSPASM AND OBSTRUCTION
NARROWING AND SHORTENING OF THE AIRWAY

8. PATHOPHYSIOLOGY ctnd
INCREASES AIRWAY RESISTANCE TO AIRFLOW
FATIGUE DECREASED RESPIRATORY EFFECTIVENESS AND
INCREASED OXYGEN CONSUMPTION
CHRONIC INFLAMMATION
PERMAMENT DAMAGE TO AIRWAY STRUCTURES

9. CLINICAL
MANIFESTAIONS
• ACUTE ATTACK
✔ Sudden or gradual onset of shortness of breath
✔ Chest tightness
✔ Wheezing
✔ Coughing
✔ Hyperinflation
✔ Sputum production
✔ Nasal discharges
✔ Sinus headaches

10. ✔ Unable to speak
✔ Decreased breath sound
✔ Presence of allergy
✔ Oedema of the nasal turbinates
✔ Middle ear effusions
✔ Conjunctivitis
• CHRONIC ASTHMA
✔ Chest deformities
✔ Weight loss
✔ Chronic illness
✔ Eczema

11. DIAGNOSTIC
EVALUATION
✔ DYSPNOEA
✔ WHEEZING AND COUGHING
✔ ACUTE EXPISODES OF SHORTNESS OF BREATH
✔ HISTORY COLLECTION
✔ PHYSICAL EXAMINATION
✔ PULMONARY FUNCTION TEST
✔ PEAK EXPIRATORY FLOW RATE {PEFR}
✔ BRONCHOPROVOCATION TESTINY
✔ SKIN TESTING
✔ RADIO ALLERGOSORBENT TEST [RAST]
✔ BLOOD COUNT CHEST RADIOGRAPHS

12. TREATMENT
• ACUTE ASTHMA
❑ Bronchodilators And Anti-inflammatory Agents
❑ Beta-adrenergic agonist
❑ Beta-2 agonist inhalation
❑ Inhale steroids
A severe attack may require 3 – 4 inhalation from a nebulizer.
During the first hour or three puffs or a equivalent of albuterol
from a mestored dose inhaler (MDI) and spacer every 5
minutes.

13. TREATMENT ctnd
• INTENSIVE CARE MANAGEMENT
✔ INRAVENOUS TERBUTALINE
✔ INTUBATION AND MECHANICALVENTILATION
• CHRONIC ASTHMA CARE
✔ INHALATION OF STEROIDS
Eg: BECLOMETHASONE
FLUONISOLIDE = 2 – 4 Times/ day
• SEVERE
✔ INHALED STEROIDS
✔ THEOPHYLLINE

14. MANAGEMENT
Mild/Moderate Episode
✔ Sit the child up
✔ Give 100% humidified oxygen to maintain sa o2 > 93%
✔ Give inhaled salbutamol via inhaler and spacer with face mask if
required
1 -5 yrs salbutamol 6 puffs x 3 times > 5 years salbutamol 12 puffs x 3 times
give prednisolone 1 – 2 mg/kg by mouth
Prognosis
yes some improvement no improvement

15. NURSING DIAGNOSIS
✔ Ineffective breathing pattern dyspnoea
related to bronchial constriction as
evidenced by increased respiratory rate.
✔ Ineffective airway clearance related to excessive secretion of sputum
as evidenced by increased respiratory rate
✔ Acute chest pain related to frequent cough as evidenced by facial
grimace.
✔ Imbalanced nutritional status less than body requirement related to
loss of appetite as evidenced by weight loss.
✔ Disturbed sleep pattern related to frequent cough as evidenced by
drowsiness of eye.