Asthma Lecture by Kathy from Level Up RN

Introduction

• Chronic inflammatory disorder of the airway
• Intermittent and reversible (unlike COPD)

Pathophysiology

• Trigger (allergen, cold air) -> Inflammation and airway hyper-responsiveness
• Results in bronchoconstriction and airway obstruction

Signs and Symptoms

• Dyspnea (difficulty breathing)
• Wheezing
• Chest tightness
• Coughing
• Tachypnea
• Use of accessory muscles
• Prolonged expiration
• Severe/prolonged cases: barrel chest

Diagnosis

• Pulmonary function tests (PFTs)
• Arterial blood gases (ABGs)
• Decreased oxygen saturation (SpO2 below 92%)

Treatment

• Bronchodilators (both control therapy and reliever drugs)
• Anticholinergics
• Anti-inflammatories
• Leukotriene antagonists

Patient Education

• Peak Flow Meter: Use to monitor asthma; use three times and record the highest number
• Identify/Avoid Triggers and Irritants
• Exercise-Induced Asthma: Use a bronchodilator 30 mins before exercise
• Medications: Difference between short-acting and long-acting bronchodilators
  • Albuterol: Short-acting, for acute attacks
  • Salmeterol: Long-acting, for daily control
• Emergency Inhaler: Always carry one

Life-Threatening Complication: Status Asthmaticus

• Definition: Airway obstruction unresponsive to therapy
• Can lead to: Pneumothorax, cardiac/respiratory arrest
• Signs and Symptoms:
  • Extremely labored breathing
  • Gasping, inability to speak
  • Decreased level of consciousness
  • Cyanosis
  • Neck vein distension
  • Pulsus paradoxus (decrease in systolic blood pressure during inspiration)
• Treatment:
  • Bronchodilators
  • Epinephrine
  • Corticosteroids
  • Oxygen administration
  • Prepare for emergency intubation/mechanical ventilation

Quiz

1. Prolonged expiration is a symptom of asthma. True
2. When using a peak flow meter, your patient should record the average number after three attempts. False
3. What type of bronchodilator should your patient use as a reliever drug during an acute asthma attack? Short-acting bronchodilator (e.g., albuterol)

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