Lecture Notes: Asthma

Introduction

• Presenter: Cereth, Registered Nurse
• Focus: Asthma (part of respiratory system review series)
• Reminder: Access free quiz after the video to test knowledge

What is Asthma?

• Chronic lung disease causing narrowing and inflammation of airways
• Affects bronchi and bronchioles which are chronically inflamed
• No cure, but manageable with medications

Asthma Triggers and Symptoms

• Common Triggers:
  • Pet dander, smoke, pollen, pollution, perfumes, dust mites, pests, cold/dry air, mold
  • Respiratory infections, GERD, hormonal shifts, exercise, certain drugs (e.g., beta blockers, NSAIDs)
• Symptoms During Attack:
  • Chest tightness, difficulty breathing, coughing, wheezing
  • Air trapping leading to potential respiratory acidosis

Pathophysiology of Asthma

• Normal breathing: Oxygen in, CO2 out
• Asthma attack: Smooth muscles around bronchi/bronchioles constrict
• Mucosal lining inflammation increases, excessive mucus production
• Airflow decrease leads to poor gas exchange, respiratory acidosis

Asthma Attack Severity

• Varies among patients
• Importance of identifying triggers
• Early vs Active Signs:
  • Early: Shortness of breath, fatigue, nighttime cough, wheezing
  • Active: Severe chest tightness, wheezing, persistent cough, increased respiratory rate

Management and Treatment

• Peak Flow Meter:
  • Measures airflow, helps monitor asthma control
  • Personal best readings guide action plans
• Action Plans:
  • Zones (Green, Yellow, Red) guide patient response

Medications

• Bronchodilators:

  • Beta Agonists:
    • Short-acting (e.g., Albuterol) for fast relief
    • Long-acting for maintenance (e.g., Salmeterol)
  • Anticholinergics:
    • Short-acting (e.g., Ipratropium)
    • Long-acting (e.g., Tiotropium)
  • Theophylline:
    • Oral, risk of toxicity, requires blood level monitoring

• Anti-inflammatories:

  • Corticosteroids:
    • Reduce inflammation, prevent thrush with spacers
  • Leukotriene Modifiers:
    • Oral, reduce muscle constriction and mucus production
  • Immunomodulators (Omalizumab):
    • Sub-Q, blocks IgE, for poorly controlled asthma
  • Cromolyn:
    • Inhaled, non-steroidal, decreases histamine release

Nursing Interventions During Attack

• Monitor vital signs, maintain calm
• Position in high Fowler's, administer bronchodilators
• Oxygen therapy, assess lung sounds, cyanosis, and peak flow readings
• Education on triggers, peak flow meter usage, and action plans

Special Considerations

• Exercise-induced asthma shouldn't prevent exercise
  • Warm-up, pre-exercise inhalers, cold weather precautions
• Emphasis on avoiding known triggers and using action plans effectively

Conclusion

• Asthma management is about identifying triggers, monitoring symptoms, and using medications effectively
• Importance of education and adherence to individualized action plans

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