Hi, I'm Cathy with Level Up RN. In this video,
we are going to talk about asthma. And at the end of the video, I'm going to give you guys a quick
little quiz to test your knowledge of some of the facts I'll be covering in this video. And if you
haven't already done so, I invite you to subscribe to our channel because we have hundreds of free
videos to help nursing students and nurses. Okay. Let's talk about asthma. Asthma is a
chronic inflammatory disorder of the airway. It is intermittent and reversible. So this is
differentiated from COPD, which I'll talk about in my next video, which is not reversible.
So the pathophysiology behind asthma is that we have a trigger, so it could be an allergen or
it could be cold air, and it causes inflammation and airway hyperresponsiveness which in
turn causes bronchoconstriction and airway obstruction. So signs and symptoms of asthma
include dyspnea, so difficulty breathing, wheezing, chest tightness, coughing, tachypnea,
use of accessory muscles, prolonged expiration. And then with severe and prolonged asthma,
some patients may present with a barrel chest. In terms of how we diagnose asthma. We would
perform pulmonary function tests, so PFTs. We can also run ABGs, so arterial blood gases.
The patients SpO2 may be decreased with an ABG. Also, the patient may have a decreased oxygen
saturation. So their SpO2 may be below 92%.
Now let's talk about the treatment of asthma.
Your patient with asthma will be prescribed bronchodilators. So this will include
control therapy as well as reliever drugs, and we'll talk more about that in a minute. In
addition, they may be prescribed anticholinergics, anti-inflammatories, and leukotriene antagonists.
So there's a number of teaching points that you're going to want to provide your patient with asthma.
They should keep tabs on their asthma using a peak flow meter. So the peak flow meter will
alert them to airway narrowing before they even have symptoms. So if they get that alert like
your airways are possibly in trouble, they can take their reliever drug to kind of head off any
issues. So when they use their peak flow meter, they need to use it three times and record the
highest number out of those three attempts. Not the average number. You also want to counsel
your patient to identify and avoid environmental triggers as well as irritants.
And then for exercise-induced asthma, they should take their bronchodilator 30
minutes before they're going to exercise. And then you want to educate your patient on the difference
between their short-acting asthma medication and their long-acting asthma medication. So albuterol
is a short-acting bronchodilator and that's what we would use as a reliever drug. So albuterol
is for acute asthma attacks, so we have all A's there. And then salmeterol is a long-acting
bronchodilator and it is used as a control therapy, so the patient would take it daily and
this helps with long-term control of asthma. So you definitely need your patient to know
the difference between those two medications, and it's going to be important for you to know
that as well as the nurse. And then lastly, you want to advise your patient to always carry
an emergency inhaler with them wherever they go.
A life threatening complication of asthma is
status asthmaticus which is airway obstruction that is unresponsive to usual therapy, and it
can lead to a pneumothorax as well as cardiac and respiratory arrest. Signs and symptoms of
status asthmaticus can include extremely labored breathing, gasping or inability to speak,
decreased level of consciousness, cyanosis, neck vein distention, and something called
pulsus paradoxus which is a decrease in systolic blood pressure during inspiration. So
treatment of status asthmaticus will include bronchodilators, epinephrine, and corticosteroids.
As the nurse, you're going to administer oxygen and prepare the patient for emergency
intubation and mechanical ventilation.
Okay. Time for a quiz. I have three questions
for you. First question. Prolonged expiration is a symptom of asthma. True or false? The answer
is true. Second question. When using a peak flow meter, your patient should record the average
number after three attempts. True or false? The answer is false. They should record
the highest number after three attempts. Question number three. What type of bronchodilator should your patient use as a reliever
drug during an acute asthma attack? The answer is a short-acting bronchodilator such
as albuterol. So hopefully you did well on that quiz. If not, definitely go back and review our
flashcards or watch the video again. I hope this helped a bunch. Take care and good luck studying.
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