ASTHMA

Reported by: Rochelle L. Ricafrente Of BSN3-2 September 25, 2010

Definition
Reversible inflammation lung condition due to hypersensitivity leading to narrowing of smaller airway.

EPIDEMiOLOGY
- 2009 300 million with asthma worldwide 250 000 died - <18 y/o - More men gets asthma than women

TYPES OF ASTHMA
Extrinsinc Asthma Intrinsinc Asthma Mixed asthma

Atropic/Allergi c Asthma Causes: dust, gases, smoke, dander, lints

-It cause by anything except allergen Causes: Hereditary, drugs, foods, physical and emotional stress

- It is a combination of extrinsinc asthma and intrinsinc asthma

CLINICAL MANIFESTATION
1. Cough- non productive to productive 2. dyspnea 3. Wheezes 4. Restlessness 5. Hypoxemia 6. Cyanosis 7. Tachycardia 8. Diaphoresis

INVASIVE AND NON-INVASIVE DIAGNOSTIC TEST

SPIROMETRY To measure the airflow obstruction by getting the ratio of FEV1/FVC.

ATRIAL BLOOD GAS

To measure the PH and the level of O2 and CO2 and also to check how long the O2 are able to move going to the blood and removing CO2 from the blood.

PEAK EXPIROMETRY FLOW RATE

To measure how past a person can breath out the air

Zone Green

Reading 71 to 100% of the usual or normal peak flow readings are clear. 50 to 70 %of the usual or normal peak flow readings

Description Indicates asthma is under control

Yellow

respiratory airways are narrowing and additional medication may be required.

Red

Less than 50 %of the usual or normal peak flow readings

ndicates a medical emergency. Severe airway narrowing may be occurring and immediate action needs to be taken. This would usually involve contacting a doctor or hospital.

DRUGS

BETA- ADRENERGIC AGONIST (BRONCHODILAT0r)

QUICK RELIEF a. Albuterol (Proventil) b. Levalbuterol (Xopenex) c. Pibuterol (Maxair) d. Metaprolerol Sulphate (Alupent) LONG TERM RELIEF a. Theophyline ( theo-dur)

LONG relief MEDICATION

CORTECOSTEROIDS a. Cromolyn Na (Intal) b. Nedocromol (Tilade) LEUCOTRIENE RECEPTOR ANTAGONIST
a. Zafirlucast (Accolate)

energy. b. Semi fowler for the lung expantion. c. Inc. OFI to liquify the mucus and easy to expelled by coughing. d. Nebulizer to liquify the mucus and easy to loosen the mucus. e. suction if needed.

a. Complete bed rest to preserve

NURSING MANAGEMENT

NURSING DIAGNOSIS
1. Ineffective airway clearance related to increase mucus production as manifested by wheezing, difficulty of breathing 2. Impaired gas exchange r/t altered delivery of oxygen as evidenced by restlessness 3. Ineffective breathing pattern related to obstruction of airway as manifested by tachycardia, difficulty of breathing

CHRONIC BRONCHITIS

DEFINITION
BRONCHITIS called BLUE BLOATERS inflammation of bronchus due to hypertrophy or hyperplasia of goblet mucus producing cells leading to narrowing of smaller airways.

EPIDEMEOLOGY
2005
12 million

National Heart, Lungs, Blood, Institution -125 000 died every year - Most common in adult women

CLINICAL MANIFESTATION
1. Productive cough 2. Dyspnea 3. Rhonchi 4. Hypoxemia 5. Cyanosis 6. Prolonged expiration grunt 7. Pulmonary HPN

DIAGNOSTIC TEST
SPIROMETRY To measure the airflow obstruction by getting the ratio of FEV1/FVC.

PEAK EXPIROMETRY FLOW RATE

To measure how past a person can breath out the air

ATRIAL BLOOD GAS

To measure the PH and the level of O2 and CO2 and also to check how long the O2 are able to move going to the blood and removing CO2 from the blood.

DRUGS
Meter Dose Inhaler a. Beta2 agonist b. Corticosteroids c. Anticholinergic

Breath Actuated MDI

a. Beta Agonist
Dry Powder Inhaler

a. Beta2 agonist b. Corticosteroids c. Anticholinergic

Nebulizer
a. Beta2 agonist b. Corticosteroids c. Anticholinergic

energy. b. Semi fowler for the lung expantion. c. Inc. OFI to liquify the mucus and easy to expelled by coughing. d. Nebulizer to liquify the mucus and easy to loosen the mucus. e. suction if needed.

a. Complete bed rest to preserve

NSG. MGT

NURSING MANAGEMENT
1. Ineffective airway clearance related to bronchial inflammation as manifested by rhonchi, difficulty of breathing 2. Impaired gas exchange r/t altered delivery of oxygen as evidenced by inability to move secretion 3. Ineffective breathing pattern related to obstruction of airway as manifested by tachycardia, difficulty of breathing 4. Nutritional Imbalance r/t fatigue as manifested by weight loss.