Explanation of Disease

Etiology: Asthma is caused by the inhalation of an allergen that an individual in hypersensitive to. The most common inhaled allergens that cause asthma attacks are: animal dander, mites in house dust, molds that grow indoors, cockroach allergens, pollen, chemicals, fumes, airborne industrial pollutants, and smoke (Cramer & Davidson). Incidence: Asthma is estimated to affect 10% - 15% of the population in the United States. It is estimated to cause 3,500-5,000 deaths annually in the United States (Cramer & Davidson). Risk Factors: Asthma is closely linked to allergies. It is estimated that 75% of people with asthma also have allergies. Viral respiratory infections can also aggravate asthma attacks (Cramer & Davidson). Pathophysiology: Asthma makes the airways hyper-reactive to many types of stimuli that do not affect healthy lungs. In an asthma attack, the muscle tissues in the bronchi spasm while the cells lining the airway swell and secrete mucus. This causes bronchoconstriction, making it difficult to breathe in air and expel it (Cramer & Davidson).

References
Cramer, D. & Davidson, T. (2011). Asthma. In L. J. Fundukian (Ed.), Gale Encyclopedia of Medicine, Vol. 1. (4th ed.). Detroit: Gale. Retrieved April 14, 2013, from NRCX via Gale: http://0.find.galegroup.com.libcat. ferris.edu/nrcx/start.do?prodId=NRC Basile, M. (2010). Asthma. In L. J. Fundukian (Ed.), Gale Encyclopedia of Genetic Disorders, Vol. 1. (3rd ed.). Detroit: Gale. Retrieved April 14, 2013, from NRCX via Gale: http://0-find. Gale group.com.libcat.ferris.edu/nrcx/ start. do?prodId=NRC

Asthma:
What you need to know

Evidence-Based Teaching Brochure By: Rachel Hodges

Clinical Manifestations: Wheezing Short of breath Cough Tightness in the chest

often marked by asthmatic episodes followed by asthma-free periods (Cramer & Davidson). Nursing Diagnoses: Ineffective airway clearance related to airway spasm, secretion retention, and amount of mucus. The patient will show the ability to maintain the cleanliness of the airway with the expected outcomes: there are no secretions, and there is clear lung sounds. Ineffective breathing pattern related to spasm of the airway and respiratory muscle fatigue. The patient will display adequate respiratory status with the criteria: respiratory rate is within normal limits, no use of additional respiratory muscles, and no complaints of pain with breathing. Impaired gas exchange related to bronchospasm and damage to the alveoli. The patient will display effective gas exchange with the outcomes: free from symptoms of respiratory failure, cyanosis, nostril breathing and blood gas analysis results within normal limits. Significance to Nursing: It is the nurses legal and ethical responsibility to provide patient teaching about how to prevent asthma attacks, triggers that can precipitate an attack, medications that are used to treat asthma, and signs and symptoms of the condition.

The incidence rate of asthma has been increasing, and if this continues it will lead to more emergency room visits and office visits for specialists and family physicians. All of these facilities would require more nurses in order to care for the increasing number of patients diagnosed with asthma. Health care providers that are involved in the care of asthmatics include: asthma specialists like an allergist, internist, otolaryngologist, pediatrician, pulmonologist, or pulmonary rehabilitation therapist; nurses, and respiratory therapists. NCLEX Style Questions: Which of the following is an appropriate expected outcome for an adult client with wellcontrolled asthma? 1. Chest X-ray demonstrates minimal hyperinflation. 2. Temperature remains lower than 100 F. 3. Arterial blood gas analysis demonstrates a decrease in PaO2. 4. Breath sounds are clear. The nurse should teach the client with asthma that which of the following is one of the most common precipitating factors of an acute asthma attack? 1. Occupational exposure to toxins. 2. Viral respiratory infections. 3. Exposure to cigarette smoke. 4. Exercising in cold temperatures.

Some people with asthma are free of symptoms most of the time but occasionally have episodes of shortness of breath. Others spend much of their time wheezing or have frequent bouts of shortness of breath until properly treated. Asthma attacks may last only a few minutes or can continue for hours and even days (Cramer & Davidson). Potential Complications: During pregnancy, lowered oxygen levels can cause serious damage to the fetus and its developing organs. If proper emergency treatment is delayed in a severe asthma attack complete respiratory failure can occur where the patient stops breathing and cannot be revived (Basile). Lifespan and Cultural Considerations: The elderly often have other types of lung diseases such has emphysema and chronic bronchitis. These have to be taken into account when treating symptoms of asthma. Side effects from beta-agonist receptor drugs including a speeding heart and tremor are more common in older adults (Cramer & Davidson). The onset of asthma can occur in childhood or adulthood. Approximately 20% of cases begin in the first year of life. Adult-onset asthma tends to be more continuous while child-onset asthma is