Asthma

Question 1

Patho

Answer 1

• chronic inflammatory disorder of airway

* edema, inflammation, tenacious secretions, smooth muscle spasms (wheezing, bronchospasm), ↓ expiratory airflow

Question 2

Causes/Triggers

Answer 2

• allergy
• environmental allergens (dust mites, roaches)/ Dust
• smoke (any form)
• meds
• pets
• exercise
• change in weather (cold air)
• strong emotions

Question 3

S/SX

Answer 3

• recurrent episodes of wheezing
• can’t catch their breath, dyspnea
• cough
• fatigue
• chest tightness/pain
• retraction in infants
• hyperresonance of chest w/ percussion
• coarse and loud breath sounds
• repeated episodes = barrel chest
• sx usually worse at night

sx of acute asthma attack:
report itching in fron of neck or upper back → restless, have headache → tired, irritable w/ hacking non-productive cough →chest begins to tighten as secretions ↑ and cough becomes rattling and productive (clear frothy sputum)

as attack becomes severe:
child breathe deeply → prolonged expiration w/ audible wheezing → pale/cyanotic → restlessness ↑ w/ anxious expression → sweating → (young child) tripod sitting position → (older child) sit up w/ shoulders hunched over w/ hands on legs/bed to facilitate use of accessory muscles

Question 4

Diagnosis

Answer 4

• chronic cough w/ no signs of infection and/or diffuse wheezing during expiration
• Pulmonary Function Test (determine presence and degree of lung disease and repsonse to resp therapy)
• Spirometry function test (for >5 o 6 yo)
• Peak expiratory flow rate (PEFR) - max airflow that can be forcefully exhaled in one second

Question 5

Treatment

Answer 5

• Chest physiotherapy
• percussion, vibration, squeezing chest and breathing exercises (blowing bubbles)
• monitor O2 sat
• allergy shots (in case of anaphylactic shock)
• small frequent meals to prevent abd distention and help prevent diaphragm expansion
• encourage fluids = thin secretions (no extremely cold fluids)
• evaluate participation in exercise activities on an individual basis
• humidified O2
• Albuterol – EMERGENCY ACUTE ASTHMA ATTACK
• corticosteroids for long-term – beclomethasone, fluticasone