Asthma

Question 1

Sign’s and Symptom’s

Answer 1

• Dyspnoea
• Chest pain
• Increased RR
• Cough
• SOB
• Anxiety
• Increased HR
• Decreased SpO2

Question 2

Pathophysiology

Answer 2

1. Inflammatory response triggered by allergen’s = mucous secretion occludes small airways and bronchial hyperactivity
2. Airway inflammation = swelling of the membranes that line the bronchi and bronchioles
3. Mast cells, when activated, release several chemicals “mediators” which cause an inflammatory response, increase’s blood flow and movement of WBC to the area and bronchoconstriction
4. Alveoli in areas distal to airway obstruction become hyper-inflated
5. Air trapping within the alveoli causes increased pressure that decreased alveolar perfusion causing a ventialation/perfusion mismatch. This will initially cause hypoxaemia and eventually cause hypercapnia leading to asthma symptom’s

Question 3

Aetiology (cause’s)

Answer 3

Combination of genetic and environmental factor’s:

Allergy induced asthma, triggered by airborne substance’s ie. pollen, smoke, pet’s, etc

Occupational asthma triggered by workplace irritant’s ie. fume’s, dust, gases, chemical’s

Exercise induced asthma can worsen when air is cold or dry

Question 4

Nursing Diagnose’s

Answer 4

Ineffective airway clearance r/t increased production of mucus, bronchospasm and ineffective cough

Impossible aired gas exchange r/t altered delivery of inspired O2

Anxiety r/t perceived threat of death and respiratory distress

Question 5

Assessment’s

Answer 5

• Peak Flow - force of expiration
• Posterior chest - inspection, auscultation, percussion, lung expansion
• Peripheral vascular - colour, oedema, warmth, sensation, capillary refill

Question 6

Nursing Intervention’s, Evaluation and Rationale for choice

Answer 6

Administer bronchodilators through nebular or spacer’s, to expand the airway and increase O2 - Medication’s were administered as prescribed with good effect - Decreased RR & WOB, Increased PF

Administer oxygen as prescribed, to maintain oxygen levels in the blood (hypoxemia) - Oxygen titrated as required to maintain O2 saturations as charted

Educate patient on use of spacer, to prevent future exacerbation to ensure medication is being fully breathed into lungs not expelled back out

Reassure/educate patient and family members to lower anxiety and reduce SNS stimulation decrease RR & WOB - reassurance and education provided to patient and family as appropriate