STATUS ASTHMATICUS

DEFINITION:
It is a severe and persistent asthma that doesnt respond to conventional
therapy.
PATHOPHYSIOLOGY:
Due to the repeated exposure to allergens
Inflammation of bronchial mucosa
Constriction of bronchiolar smooth muscle
Severe bronchospasm
Asphyxia
Decreased PaO2 and increased PaCo2
Respiratory acidosis and alkalosis
CLINICAL MANIFESTATIONS:

Same as severe asthma

Labored breathing
Prolonged exhalation
Engorged neck veins
Wheezing may disappear which is impending to respiratory failure.

DIAGNOSTIC FEATURES:

 Arterial Blood Gas (ABG) analysis To find out the PaO2 and PaCo2
Pulmonary Function Tests to evaluate the lung functions.
MANAGEMENT:
Corticosteroids are used to decreased the inflammation and swelling.
Short Acting Beta Agonists (SABAs) provide most relief from the acute
bronchospasm.
A Meter Dose Inhaler (MDI) with or without spaces may be used for
nebulization of the medications.
Oxygen therapy is initiated to treat the dyspnea and IV fluids is used to
treat dehydration.
If there is no responds to repeat the treatments, the patient is required for
hospitalizations.
ABG sample should take if it indicated respiratory acidosis; the patient
should keep in mechanical ventilation.
NURSING MANAGEMENT:
Assess the patient airway patency and responds towards the treatment
pattern.
Monitor the patient for the first 12 to 24 hours or until status asthmaticus
is under control.
Assess the patient skin turgor and administer IV fluids upto 3-4 liters/day.
Vitals should be monitored regularly.
Patient should be free of respiratory allergens.
Non-Allergic pillows should be used to reduce the exposure.