Understanding Asthma: Causes, Symptoms, and Treatment Options

School

Trinity University of Asia (formerly Trinity College of Quezon City)**We aren't endorsed by this school

Course

NCM 112

Subject

Nursing

Date

Dec 11, 2024

Pages

Uploaded by UltraPrairieDogPerson1199

ASTHMAASTHMAJOLIEANNA S.JOLIEANNA S.2NU09 GROUP 42NU09 GROUP 4Case PresentationCase Presentation

WHAT IS ASTHMA?Asthma is a common lung condition that causes occasional breathing difficulties. It is definedas hyperactivity of the bronchial tree with paroxysmal narrowing of the small airways andincreased mucus production due to inflammation making it difficult to breathe.

WHAT CAUSES ASTHMA?The exact cause of asthma is unknown, although it is thought to be a combination of geneticand environmental factors.

SIGNS AND SYMPTOMSCOUGHCHEST TIGHTNESSWHEEZINGDYSPNEA

COMMON ALLERGENS SEASONAL (E.G., GRASS, TREE,AND WEED POLLENS) ORPERENNIAL (E.G., MOLD, DUST,ROACHES, ANIMAL DANDER)PREDISPOSING FACTORSAIRWAY IRRITANTS (E.G., AIR POLLUTANTS, COLD, HEAT,WEATHER CHANGES, STRONG ODORSOR PERFUMES, SMOKE,OCCUPATIONAL EXPOSURE)OTHER FACTORSFOODS (E.G., SHELLFISH, NUTS), EXERCISE,STRESS, HORMONAL FACTORS,MEDICATIONS (E.G., ASPIRIN ANDBETABLOCKERS), VIRAL RESPIRATORYTRACT INFECTIONS, ANDGASTROESOPHAGEAL REFLUX

ANATOMY OFTHE LUNGS

PHYSIOLOGY OFBREATHING

PATHOPHYSIOLOGY

DIAGNOSTICS&LABORATORYPhysical ExamSpirometryTest to measure Lung FunctionPeak FlowAdditional TestsMethacholine challengeImaging tests.Allergy testingNitric oxide testSputum eosinophilsProvocative testing for exerciseand cold-induced asthma

THERAPEUTIC MANAGEMENT ANDMEDICAL MANAGEMENT There's currently no cure for asthma, but treatment can help control the symptoms inorder to live a normal, active life. That includes Inhalers, which are devices that let youbreathe in medicine, are the main treatment. Tablets and other treatments may also beneeded if your asthma is severe.

The two main reliever medicines are calledsalbutamol and terbutaline ( bronchodilators)THERAPEUTHIC MANAGEMENT:RELIEVER INHALERSSIDE EFFECTSCommon: Nervousness, shaking (tremor),headache, or dizziness, andhypertension.Serious:Allergic reaction, including: rash,itching/swelling (especially of theface/tongue/throat),severe dizziness,and trouble breathing.CONTRAINDICATIONShigh blood pressure during pregnancy,uterine infection, miscarriage, heartdisease, and hypersensitivity.

Preventer inhalers delivers a low dose ofcorticosteroid to the lungs. Such as Clenil, whichis the most common preventer.THERAPEUTHIC MANAGEMENT:PREVENTER INHALERSSIDE EFFECTSThey do not usually have side effects, butcan sometimes cause:a fungal infection of the mouth or throat(oral thrush)a hoarse voicea sore throatYou can help prevent these side effects by usinga spacer, which is a hollow plastic tube you attachto your inhaler, as well as by rinsing your mouthafter using your inhaler.CONTRAINDICATIONSActive respiratory tract infection (e.g.,pneumonia, tuberculosis)Severe allergy to milk proteins or lactoseCataractsGlaucoma

If using reliever and preventer inhalers does notcontrol the asthma, you may need an inhalerthat combines both.Combination inhalers are used every day tohelp stop symptoms occurring and providelong-lasting relief if they do occur.It is important to use it regularly even ifsymptoms does not persist.e.g. albuterol and ipratropium (CombiventRespimat; Duoneb)budesonide and formoterol (Symbicort)fluticasone and salmeterol (Advair)THERAPEUTHIC MANAGEMENT:COMBINATION INHALERSSIDE EFFECTSSide effects of combination inhalers aresimilar to those of reliever and preventerinhalers.CONTRAINDICATIONContraindication of combination inhalersare similar to those of reliever andpreventer inhalers.

LTRAs are the main tablets used for asthma.Their unique mechanism of action results ina combination of both bronchodilator andanti-inflammatory effects.They also come in syrup and powder form.You take them every day to help stop yoursymptoms occurring.e.g. montelukast, zafirlukast and zileutonTHERAPEUTHIC MANAGEMENT:LEUKOTRIENE RECEPTOR ANTAGONISTS(LTRAS)SIDE EFFECTSmodifiers are generally safe, but they cancause side effects, including:Cold symptoms, such as cough, sore throat orrunny nose.Diarrhea., Ear infection. Fatigue (tiredness).Flu-like symptoms, such as fever.Headache.Heartburn.Itchy skin or rash.CONTRAINDICATIONhypersensitivity to the drug or any componentof their formulationZafirlukast: acute asthma or hepaticimpairment. Montelukast include severe asthma.

Theophylline may also be recommended ifother treatments are not helping to controlyour symptoms. It is a long-acting bronchodilatorIt is used to prevent and treat wheezing,shortness of breath, and chest tightnesscaused by asthma, chronic bronchitis,emphysema, and other lung diseases. Itrelaxes and opens air passages in the lungs,making it easier to breathe.THERAPEUTHIC MANAGEMENT:THEOPHYLLINESIDE EFFECTSCommon: upset stomach, stomach pain, diarrhea,headache, restlessness, difficulty fallingasleep or staying asleep, irritabilitySerious:vomiting, increased or rapid heart rate,irregular heartbeat, seizures, rashCONTRAINDICATIONhypersensitivity to the drug or any componentof their formulation, overactive thyroid gland,a condition with low thyroid hormone levels,diabetes, cystic fibrosis, alcohol use disorder,high blood pressure, angina, a type of chestpain, cor pulmonale, chronic heart failure, fluidin the lungs

as an immediate treatment when you havean asthma attackevery day as a long-term treatment toprevent symptoms – this is usually onlynecessary if you have very severe asthmaand inhalers do not control your symptomse.g. prednisolone, betamethasone,dexamethasone, hydrocortisoneTHERAPEUTHIC MANAGEMENT:STEROID TABLETSSIDE EFFECTSLong-term or frequent use of steroidtablets can occasionally cause side effectssuch as:increased appetite, leading to weightgain, easy bruising, mood changes,fragile bones (osteoporosis), high bloodpressureCONTRAINDICATIONhypersensitivity, concurrentadministration of live or live-attenuatedvaccines, systemic fungal infection,osteoporosis, uncontrolledhyperglycemia, diabetes mellitus,glaucoma, joint infection, uncontrolledhypertension, herpes simplex keratitis,and varicella infection.

For some people with severe asthma,injections of medicines called biologictherapies are given every few weeks. Thesecan help to control the symptoms.They are not suitable for everyone withasthma and can only be prescribed by anasthma specialist.The main side effect is discomfort where theinjection is given.e.g. (omalizumab, mepolizumab, reslizumab,benralizumab, and dupilumab)MEDICAL MANAGEMENT:INJECTIONSSURGERYA procedure called bronchialthermoplasty may be offered as atreatment for severe asthma. It workswell and there are no serious concernsabout its safety.You will be sedated or put to sleep usinga general anaesthetic during a bronchialthermoplasty.It involves passing a thin, flexible tubedown your throat and into your lungs.Heat is then used on the muscles aroundthe airways to help stop them narrowingand causing asthma symptoms.

Assessment of a patient with asthma includesthe following:Assess the patient’s respiratory statusby monitoring the severity of thesymptoms.Assess for breath sounds.Assess the patient’s peak flow.Assess the level of oxygen saturationthrough the pulse oximeter.Monitor the patient’s vital signsNURSING MANAGEMENT:ASSESSMENTDIAGNOSISBased on the data gathered, the nursingdiagnoses appropriate for the patient withasthma include:Ineffective airway clearance related toincreased production of mucus andbronchospasm.Impaired gas exchange related toaltered delivery of inspired O2.Anxiety related to perceived threat ofdeath.

To achieve success in the treatment of a patientwith asthma, the following goals should beapplied:Maintenance of airway patency.Expectoration of secretions.Demonstration of absence/reduction ofcongestion with breath sounds clear,respirations noiseless, improved oxygenexchange.Verbalization of understanding ofcauses and therapeutic managementregimen.Demonstration of behaviors to improveor maintain clear airway.Identification of potential complicationsand how to initiate appropriatepreventive or corrective actions.NURSING MANAGEMENT:CARE PLAN & GOALSINTERVENTIONSThe nurse generally performs the followinginterventions:Assess history. Obtain a history of allergic reactionsto medications before administering medications.Assess respiratory status. Assess the patient’srespiratory status by monitoring the severity ofsymptoms, breath sounds, peak ﬂow, pulse oximetry,and vital signs.Assess medications. Identify medications that thepatient is currently taking. Administer medications asprescribed and monitor the patient’s responses tothose medications; medications may include anantibiotic if the patient has an underlying respiratoryinfection.Pharmacologic therapy. Administer medications asprescribed and monitor patient’s responses tomedications.Fluid therapy. Administer fluids if the patient isdehydrated.

To determine the effectiveness of the plan ofcare, evaluation must be performed. Thefollowing must be evaluated:Maintenance of airway patency.Expectoration or clearance ofsecretions.Absence /reduction of congestion withbreath sound clear, noiselessrespirations, and improved oxygenexchange.Verbalized understanding of causes andtherapeutic management regimen.Demonstrated behaviors to improve ormaintain clear airway.Identified potential complications andhow to initiate appropriate preventive orcorrective actions.NURSING MANAGEMENT:EVALUATIONDISCHARGE PLANA major challenge is to implement basic asthmamanagement principles at the home andcommunity level.Collaborate with patient and health care provider toformulate a plan to achieve desired health outcome.Teach patient and family about asthma purpose andaction of medications, triggers to avoid and how todo so, and proper inhalation technique, peak-flowmonitoring. Emphasize adherence to prescribed therapy,preventive measures, and the need to keep follow-upappointments with health care providers. Teach patient how to implement an action plan andhow and when to seek assistance.Home visits by the nurse to assess the homeenvironment for allergens may be indicated forpatients with recurrent exacerbations.

COMMON MYTHS/ BELIEFS IN ASTHMA

FIRSTAID

HOME REMEDIESThere are no home remedies forasthma attack. Asthma is managed with medications, by avoiding triggers,and by creating an asthma action plan with your doctor. Keep a rescue inhaler on hand for immediate reliefduring an attack. Check the date on the pump regularly to make sure it hasn't expired. Although there are someaction that can be done to alleviate its progressing symptoms and prevent triggering asthma attacks.studies suggests that regular breathingexercises can help reduce asthma symptomse.g. Buteyko method and the Papworth methodbreathing exercisesStress reductionstress and other intense emotions, such asanger, can sometimes bring on asthma attacks.alongside with breathing exercises thistechniques may also be beneficial: deep breathingmindfulnessmeditationmassage therapyhypnotherapy

HOME REMEDIESThese varies from person to person butsome common triggers include:identifying and eliminatingtriggersSmoke, especially from tobacco, but alsofrom burning wood or grasshousehold pets, including cats and dogsdust mitesmoldair pollutioncockroachesSome find that these helps in alleviating theirasthma symptoms. These should only serves asa support to clinical treatment and not as areplacement. Consult with your physician beforeusing any herbal remedies and supplements as itmay have a negative interaction with yourmedicineherbal remedies andsupplementse.g.:Vitamin D supplementTraditional Chinese herbal medicine

HOME REMEDIESaccording to the National Heart, Lung andBlood Institute, the following can helppeoplemanage their asthmalifestyle practicesquitting smokingreaching or maintaing a moderate bodyweightbeing physically activegetting enough sleeppracticing stress managementtechniques, such as mindfulness anddeep breathingData shows that participants with asthma whopracticed asana, or physical yoga poses, andmeditation had:yogareduced frequency of asthma attacksfewer asthma symptomsan enhanced lung capacityan improved blood flowa better response to medication

REFERENCES:3. Anatomy and Physiology of Breathing | ATrain Education. (n.d.). https://www.atrainceu.com/content/3-anatomy-and-physiology-breathingDresden, D. (2021, September 27). What helps asthma? Home and natural remedies to combat the symptoms.https://www.medicalnewstoday.com/articles/home-remedies-for-asthma#yoga5 Myths About Asthma | Allergy & Asthma Network. (n.d.). Allergy & Asthma Network.https://allergyasthmanetwork.org/news/myths-about-asthma/#:~:text=be%20well%20controlled.-,Myth%3A%20If%20you%20aren't%20wheezing%2C%20it%20isn',inflammation%20and%20constriction%20of%20airways.Asthma - Diagnosis and treatment - Mayo Clinic. (2022, March 5). https://www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660Belleza, M., RN. (2021). Asthma. Nurseslabs. https://nurseslabs.com/asthma/Theophylline: MedlinePlus Drug Information. (n.d.). https://medlineplus.gov/druginfo/meds/a681006.html Website, N. (2023b, February 17). Treatment. nhs.uk.https://www.nhs.uk/conditions/asthma/treatment/#:~:text=There's%20currently%20no%20cure%20for,if%20your%20asthma%20is%20severe.

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