Asthma

It is an inflammation disease of the airway causing mucosal edema and increased mucous production, ultimately leading to recurrent episodes of asthma attacks causing symptoms like a cough, wheezing, and dyspnea.

Causes of Asthma 

• Airborne allergens
• Airway irritant
• Physical activities
• Stress, emotional upset
• Viral respiratory tract infection
• Medications like aspirin
• Cold air
• Gastroesophageal Reflux Disease (GERD)
• Menstrual cycle in some women

Risk factors of Asthma 

• Having a blood relative with asthma
• Allergic conditions such as dermatitis or allergic rhinitis
• Overweight/ Obesity
• Being a smoker
• Exposure to second-hand smoke
• Women smoke during their pregnancy 
• Exposure to occupational triggers.

Types of Asthma 

• Acute
• Latent
• Irritable
• Status asthmatics

Pathophysiology of Asthma 

• Allergen/contributing factors/ irritants (stress, cod , air)
• IgE stimulates (IgE alwrespondsonse to allergens)
• Mast cell activated
• Mast cell secrete histamine, prostagbradykininbradykin, and leukotriene
• Bronchoconstriction (bronchospasm) and increased production.
• SOB/ absinthe traction of airway (wheezing)
• Decreased expiratory volume
• Decreased forced vital capacity
• Increased eosinophils in the blood
• Increased IgE in the blood
• AGB shows hypoxemia

Clinical manifestations

• The asthma attack usually occurs at night and early morning.
• Nasal flaring
• Dyspnea
• Non-productive cough
• Wheezing
• Diaphoresis
• Tachycardia
• Cyanosis in later stage
• Emotional upset

Diagnostic investigations of Asthma 

• Family and occupational history
• Eosinophils counts
• IGE
• ABG
• Sputum for culture
• Physical examination
• Spirometry
• Peak flow
• Methacholine challenge
• Nitric oxide test
• Imaging test
• Allergy testing

Complication

• Status asthmatics
• Respiratory failure
• Pneumonia
• Atelectasis

Medical management

Pharmacological – long-acting medications

• Corticosteroids
• bronchodilators
• leukotriene modifiers
• long-acting beta-agonists
• theophylline

Quick-relief (rescue) medication

• Short-acting beta agonists
• Ipratropium
• Oral and intravenous corticosteroids

Allergy medication

• Alergy shots (immunotherapy)
• Omalizumab (Xolair)
• Allergy medication:- oral and nasal spray antihistamines and decongestants
• Bronchial thermoplasty
• Oxygen therapy
• Nebulization

Nursing management

• Assess respiratory rate and depth.
• Breathing pattern for shortness of breath.
• Monitor ABG
• Fowler’s position provides
• Administer corticosteroid and bronchodilators
• Suctioning frequently.
• Monitor color and consistency of sputum
• Encourage fluid intake
• Chest physiotherapy frequently
• Change position frequently