ASTHMA

VANESSA T. UCAT, RN
MSN 302
DECEMBER 2015
 Asthma is a chronic disease characterized
by recurrent attacks of breathlessness and
wheezing, which vary in severity and
frequency from person to person.
Etiology
Asthma commonly results from
hyperresponsiveness of the trachea and bronchi
to irritants.
Allergy influences both the persistence and the
severity of asthma, and atopy or the genetic
predisposition for the development of an IgE-
mediated response to common airborne
allergens is the most predisposing factor for the
development of asthma.
It has been divided into two basic types:
1. Extrinsic asthma.
2. Intrinsic asthma.
Sometimes extrinsic and intrinsic can co-exist in
the same patient
Extrinsic (atopic, allergic) Asthma Intrinsic (non-
70% atopic)Asthma 30%
- Initiated by type 1
hypersensivity reaction induced - Initiated by diverse,
by exposure to extrinsic non-immune
antigen/allergens e.g. food, pollen, mechanisms e.g.
dust, etc. infections, drugs like
aspirin, inhaled chemical
- Subtypes include: irritants, cold, stress and
a) atopic (allergic)asthma. exercise.
b) occupational asthma. - No personal or family
c) allergic bronchopulmonary
history of allergic
aspergillosis. reaction.
- Develop early in life - Develop later in life
Symptoms
tightness in the chest
difficulty in breathing or shortness of
breath
wheezing
coughing
Asthma Triggers may include
Tobacco smoke
Infections such as colds, flu, or pneumonia
Allergens such as food, pollen, mold, dust mites, and
pet dander
Exercise
Air pollution and toxins
Weather, especially extreme changes in temperature
Drugs (such as aspirin, NSAID, and beta-blockers)
Emotional stress and anxiety
Singing, laughing, or crying
Smoking, perfumes, or sprays
Acid reflux
10 facts of Asthma according to
World Health Organization
WHO estimates show that 235
million people currently suffer from
asthma.
Asthma deaths will increase in the next 10
years if urgent action is not taken.

Asthma cannot be cured, but proper

diagnosis, treatment and patient education
can result in good asthma control and
management.
Asthma occurs in all countries regardless of level of
development. Over 80% of asthma deaths occur in low and
lower-middle income countries. For effective control, it is
essential to make medications affordable and available,
especially for low-income families.
Asthma is a chronic disease characterized by recurrent
attacks of breathlessness and wheezing, which vary in severity
and frequency from person to person.
Symptoms may occur several times in a day or week in
affected individuals.

For some people the symptoms become worse during

physical activity or at night.

Failure to recognize and avoid triggers that lead to a

tightened airway can be life threatening and may result in an
asthma attack, respiratory distress and even death.
Through appropriate treatment such as using inhaled
corticosteroids to ease bronchial inflammation, the number
of asthma-related deaths can be reduced.
Asthma is the most common chronic disease
among children. But it can be controlled through
different prevention and treatment plans according
to individual symptoms.
The strongest risk factors for developing asthma are
exposure to indoor allergens.
Asthma triggers can include cold air,
extreme emotional arousal such as
anger or fear, and physical exercise.
Asthma is often under-diagnosed and under-
treated, creating a substantial burden to
individuals and families and possibly restricting
individuals activities for a lifetime.
ANATOMY AND PHYSIOLOGY
NORMAL LUNG
 The right and left main bronchi divide into
lobar bronchi.
The lobar bronchi divide into
tertiary/segmental bronchi, each of which
supplies a bronchopulmonary segment.
The segmental bronchi divide into primary
bronchioles which divide into terminal
bronchioles and then divide into respiratory
bronchioles, which go on to divide into
alveolar ducts.
Each alveolar duct divides into five or six
alveolar sacs.
The alveolar sacs are made up of alveoli. The
alveolus is the basic anatomical unit of gas
exchange in the lung.
Beyond terminal bronchiole gas exchange
occurs
The distal airspaces are kept open by elastic
tension in alveolar walls
Function of lungs.
Gas exchange (O2,
CO2)
Depends on
compliance
(stretchability) of lungs
Can only occur in
alveoli that are both
ventilated and
perfused
 Inhaled Allergens

Pollen
House Dust Mites

Mold
Animal Hair and Dander
PATHOPHYSIOLOGY
PATHOPHYSIOLOGY
Exposure to environmental factors such as cold, smoking, and pollutants

IgE antibodies are produced as an immune response

IgE attaches to the mast cells of the lungs

Re-exposure to antigens in the environment results in the antigen binding to the antibody

Mast cell products (chemical mediators) are released histamine, bradykinin, prostaglandin

Mediators affects smooth muscles causing bronchospasm and mucous membrane swelling

Airways are obstructed

Dyspnea

ASTHMA
LABORATORY FINDINGS
LUNG FUNCTION TEST

Lung function tests are asthma tests that

assess lung function.

The two most common lung function tests

used to diagnose asthma are spirometry
and methacholine challenge tests.
 Spirometer
is an equipment used for
measuring the volume of air
inspired and expired by
the lungs ( Pulmonary
Function Tests)
Spirometry will detect:
a. Decreased for expiratory volume (FEV)
b. Decreased peak expiratory flow rate
(PEFR)
c. Diminished forced vital capacity (FVC)
d. Diminished inspiratory capacity (IC)
 Methacholine challenge test - may be
performed if your symptoms and
screening spirometry do not clearly or
convincingly establish a diagnosis of
asthma.
XRAY
NCP
Ineffective breathing pattern related to
smooth muscle constriction of the
bronchioles as evidenced by dyspnea
Impaired gas exchange related to
decrease amount of air to the lungs
Moderate anxiety related to fear of being
rendered by medical interventions
Fatigue related to fluid accumulation to
the lungs
 Identify and eliminate the presence of environmental
factors
Assess respiratory status by closely evaluating breathing
patterns and monitoring vital signs
Elevate head of bead and position appropriately
Encourage deep breathing exercises
Encourage rest and limit activities and promote restful
environment
Administer prescribed medications, such as
bronchodilators, anti-inflammatories
Monitor therapeutic and adverse effects of drug therapy
 Encourage patient to decrease smoking
Demonstrate appropriate nebulization techniques
Keep environmental pollution to minimum like dust,
smoke, and feather pillows, according to individual
situation.
Encourage or assist with abdominal or pursed lip
breathing exercises.
Assist with measured to improve effectiveness of
cough effort.
Increased fluid intake to 2 liters per day as
prescribed. Provide warm or tepid liquids.
 Promote adequate oxygenation and a normal
breathing pattern
Help the child cope with poor self-esteem
by encouraging him to ventilate feelings and
concerns. Listen actively as the child speaks,
focus on the childs strengths, and help him
to identify the positive and negative aspects
of his situation.
Provide child and family teaching. Assist the
child and family to name signs and symptoms
of an acute attack and appropriate treatment
measures
MEDICAL MANAGEMENT
MEDICAL MANAGEMENT
Long-acting control Medication

Quick relief medication

LONG-ACTING CONTROL
MEDICATION
Long-acting beta-agonists. A beta-agonist is a
type of drug called bronchodilator, which opens
your airways.
Leukotriene modifiers block chemicals that
cause inflammation.
Mast cell stabilizers curb the release of
chemicals that cause inflammation.
Theophylline is a bronchodilator used to
prevent nighttime symptoms.
An immunomodulator is an injection given if
you have moderate to severe asthma related
to allergies that doesnt respond to inhaled
certain drugs.
QUICK RELIEF MEDICATION
Short-acting beta-
agonists (bronchodilators)
Anticholinergics. These are
bronchodilators that can be paired with,
or used instead of, short-acting beta-
agonists.
Systemic corticosteroids are anti-
inflammatory drugs that get symptoms
under control quickly.
Inhalers, Nebulizers, and Pills as
Asthma Medicine
 Thank you for listening! (: