- Reactive Airway
- Affects AIRWAY not alveoli
- Sensitivity to allergens/irritants
- Viscous Secretions
It is an intermittent and reversible airflow obstruction affecting only the airway. It can occur due to Inflammation and Bronchospasm.
Assessment: Auscultate for wheezing.
History: When do you have SOB, What triggers? What Helps? How long does it last?
✔May or May Not have Symptoms between attacks
- Audible Wheezes,
- Increased Respiratory rate,
- Use of accessory muscles,
- Barrel chest due to air trapping.
- Arterial O2 may decrease in acute asthma.
- Arterial CO2 is going to be low initially in the beginning, because the patient is hyperventilating, but it will eventually increase later due to the edema and swelling of the airway and the trapped CO2.. indicating poor gas exchange
- ✔ Elevated serum eosinophils and IgE globulins
- Sputum with eosinophils and mucous plugs shed epithelial cells
- ✔ Most accurate test to diagnose asthma are pulmonary function tests.
- Patient Education on triggers
- Peak flow meter BID, (this is what tells them how to adjust their inhaler use and give them a range)
- Exercise plan, make sure to make time for rest breaks, but keep moving to prevent pneumonia!
- O2 Therapy
- Drug Therapy Plan:
- Step I Mild Intermittent - less than one attack per week, at night no more than 2 times a month - treat with short acting beta agonist
- Step II Mild Persistent - more than once a week, but NOT daily, more than 2x a month at night - treat with daily anti-inflammatory inhaled corticosteroid + rescue
- Step III Moderate Persistent - Daily attacks, and effects sleep at night more than once a week - treat with long gating beta agonist, and daily, and rescue
- Step IV Severe Persistent - Daily, Nightly, Activities limited - give them a medium dose and long
✔Bronchodilators will cause tachycardia and shakiness (Albuterol).
& sometimes I get so upset,